601.56 Study and rules on standards for health insurers.
(1) Study.
(a) The commissioner shall study whether, in their transactions with health care providers, compliance by health insurers with certain standards, such as standard codes, forms and formats, is likely to reduce the cost of health care administration. The study shall investigate compliance with standards in at least all of the following types of transactions between insurers and health care providers:
1. Confirmation of eligibility.
2. Pretreatment authorization.
3. Referral to specialty providers.
4. Coordination of benefits.
(b) On or before February 1, 1994, the commissioner shall submit the results of the study to the legislature under s. 13.172 (2) and to the governor.
(2) Rules. If, as a result of the study under sub. (1), the commissioner determines that in transactions with health care providers compliance by health insurers with certain standards will likely reduce the cost of health care administration, the commissioner shall promulgate rules to establish and implement appropriate standards.
History: 1993 a. 16.
Structure Wisconsin Statutes & Annotations
Wisconsin Statutes & Annotations
Chapter 601 - Insurance — administration.
601.04 - Certificate of authority; fee.
601.13 - Financial services; deposits.
601.16 - Official seal and signature.
601.19 - Organization of the office.
601.20 - Advisory councils and committees.
601.32 - Supervision of industry, supplementary fee.
601.33 - Exemption from taxation.
601.41 - General duties and powers.
601.415 - Miscellaneous duties.
601.423 - Social and financial impact reports.
601.43 - Examinations and alternatives.
601.44 - Conducting examinations.
601.46 - Commissioner's records and reports.
601.465 - Nondisclosure of information.
601.48 - Participation in organizations.
601.51 - Provision of certified copies and notices.
601.55 - Nondomestic insurers; additional requirements.
601.56 - Study and rules on standards for health insurers.
601.57 - Study and rules on health insurance identification cards.
601.58 - Interstate insurance product regulation compact.
601.61 - Auxiliary procedural powers.
601.63 - Notice and effective date of orders.
601.64 - Enforcement procedure.
601.65 - Marketing firm forfeitures.
601.71 - Enforcement of policyholder rights.
601.715 - Registered agent for service of process.
601.72 - Service of process through state officer.
601.73 - Procedure for service of process through state officer.
601.80 - Definitions; healthcare stability plan.
601.83 - Healthcare stability plan; administration.
601.85 - Accounting, reports, and audits.
601.952 - Information security program.
601.953 - Investigation of cybersecurity event.