Wisconsin Statutes & Annotations
Chapter 609 - Defined network plans.

609.001 - Joint ventures; legislative findings. - 609.001 Joint ventures; legislative findings. (1) The legislature finds that...

609.01 - Definitions. - 609.01 Definitions. In this chapter: (1b) “Defined network plan" means...

609.03 - Indication of operations. - 609.03 Indication of operations. (1) Certificate of authority. An insurer...

609.05 - Primary provider and referrals. - 609.05 Primary provider and referrals. (1) Except as provided in...

609.10 - Standard plan and point-of-service option plan required. - 609.10 Standard plan and point-of-service option plan required. (1) (ac)...

609.17 - Reports of disciplinary action. - 609.17 Reports of disciplinary action. Every limited service health organization,...

609.20 - Rules for preferred provider and defined network plans. - 609.20 Rules for preferred provider and defined network plans. (1m)...

609.205 - Public health emergency for COVID-19. - 609.205 Public health emergency for COVID-19. (1) In this section,...

609.22 - Access standards. - 609.22 Access standards. (1) Providers. A defined network plan shall...

609.24 - Continuity of care. - 609.24 Continuity of care. (1) Requirement to provide access. (a)...

609.30 - Provider disclosures. - 609.30 Provider disclosures. (1) Plan may not contract. A defined...

609.32 - Quality assurance. - 609.32 Quality assurance. (1) Standards; other than preferred provider plans....

609.34 - Clinical decision-making; medical director. - 609.34 Clinical decision-making; medical director. (1) A defined network plan...

609.35 - Applicability of requirements to preferred provider plans. - 609.35 Applicability of requirements to preferred provider plans. Notwithstanding ss....

609.36 - Data systems and confidentiality. - 609.36 Data systems and confidentiality. (1) Information and data reporting....

609.38 - Oversight. - 609.38 Oversight. The office shall perform examinations of insurers that...

609.60 - Optometric coverage. - 609.60 Optometric coverage. Health maintenance organizations and preferred provider plans...

609.65 - Coverage for court-ordered services for the mentally ill. - 609.65 Coverage for court-ordered services for the mentally ill. (1)...

609.655 - Coverage of certain services provided to dependent students. - 609.655 Coverage of certain services provided to dependent students. (1)...

609.70 - Chiropractic coverage. - 609.70 Chiropractic coverage. Limited service health organizations, preferred provider plans,...

609.71 - Disclosure of payments. - 609.71 Disclosure of payments. Limited service health organizations, preferred provider...

609.715 - Coverage of alcoholism and other diseases. - 609.715 Coverage of alcoholism and other diseases. Defined network plans...

609.717 - Mental health services provided by a recovery charter school. - 609.717 Mental health services provided by a recovery charter school....

609.75 - Adopted children coverage. - 609.75 Adopted children coverage. Limited service health organizations, preferred provider...

609.755 - Coverage of dependents. - 609.755 Coverage of dependents. Limited service health organizations, preferred provider...

609.76 - Coverage of student on medical leave. - 609.76 Coverage of student on medical leave. Limited service health...

609.77 - Coverage of breast reconstruction. - 609.77 Coverage of breast reconstruction. Limited service health organizations, preferred...

609.78 - Coverage of treatment for the correction of temporomandibular disorders. - 609.78 Coverage of treatment for the correction of temporomandibular disorders....

609.79 - Coverage of hospital and ambulatory surgery center charges and anesthetics for dental care. - 609.79 Coverage of hospital and ambulatory surgery center charges and...

609.80 - Coverage of mammograms. - 609.80 Coverage of mammograms. Defined network plans are subject to...

609.805 - Coverage of contraceptives. - 609.805 Coverage of contraceptives. Defined network plans are subject to...

609.81 - Coverage related to HIV infection. - 609.81 Coverage related to HIV infection. Limited service health organizations,...

609.82 - Coverage without prior authorization for emergency medical condition treatment. - 609.82 Coverage without prior authorization for emergency medical condition treatment....

609.83 - Coverage of drugs and devices. - 609.83 Coverage of drugs and devices. Limited service health organizations,...

609.837 - Copayment equality for oral and injected chemotherapy. - 609.837 Copayment equality for oral and injected chemotherapy. Limited service...

609.84 - Experimental treatment. - 609.84 Experimental treatment. Limited service health organizations, preferred provider plans,...

609.846 - Discrimination based on COVID-19 prohibited. - 609.846 Discrimination based on COVID-19 prohibited. Limited service health organizations,...

609.85 - Coverage of lead screening. - 609.85 Coverage of lead screening. Health maintenance organizations and preferred...

609.86 - Coverage of hearing aids, cochlear implants, and related treatment for infants and children. - 609.86 Coverage of hearing aids, cochlear implants, and related treatment...

609.87 - Coverage of treatment for autism spectrum disorders. - 609.87 Coverage of treatment for autism spectrum disorders. Defined network...

609.875 - Coverage of colorectal cancer screening. - 609.875 Coverage of colorectal cancer screening. Defined network plans are...

609.88 - Coverage of immunizations. - 609.88 Coverage of immunizations. Defined network plans are subject to...

609.885 - Coverage of COVID-19 testing. - 609.885 Coverage of COVID-19 testing. Defined network plans, preferred provider...

609.89 - Written reason for coverage denial. - 609.89 Written reason for coverage denial. Limited service health organizations,...

609.90 - Restrictions related to domestic abuse. - 609.90 Restrictions related to domestic abuse. Limited service health organizations,...

609.91 - Restrictions on recovering health care costs. - 609.91 Restrictions on recovering health care costs. (1) Immunity of...

609.92 - Hospitals, individual practice associations and providers of physician services. - 609.92 Hospitals, individual practice associations and providers of physician services....

609.925 - Election to be subject to restrictions. - 609.925 Election to be subject to restrictions. (1) Notice of...

609.93 - Scope of election by an individual practice association or clinic. - 609.93 Scope of election by an individual practice association or...

609.935 - Notices of election and termination. - 609.935 Notices of election and termination. (1) In accordance with...

609.94 - Summary of restrictions. - 609.94 Summary of restrictions. (1) A health maintenance organization insurer...

609.95 - Minimum covered liabilities. - 609.95 Minimum covered liabilities. A health maintenance organization insurer, whether...

609.96 - Initial capital and surplus requirements. - 609.96 Initial capital and surplus requirements. (1) Minimum capital and...

609.97 - Compulsory and security surplus. - 609.97 Compulsory and security surplus. (1) Amount of compulsory surplus....

609.98 - Special deposit. - 609.98 Special deposit. (1) Definition. In this section, “premiums" has...