609.93 Scope of election by an individual practice association or clinic.
(1) Individual practice association. The election by an individual practice association under s. 609.92 to be exempt from s. 609.91 (1) (b) or the failure of the individual practice association to so elect applies to health care costs arising from health care provided by any provider, other than a hospital, under a contract with, or through membership in, the individual practice association. A provider, other than a hospital, may not exercise an election under s. 609.92 or 609.925 separately from an individual practice association with respect to health care costs arising from health care provided under a contract with, or through membership in, the individual practice association.
(2) Clinics.
(a) The election by a clinic under s. 609.92 to be exempt from s. 609.91 (1) (b) with respect to services described in s. 609.91 (1) (b) 2. and 3. or the failure of the clinic to so elect, or the election by a clinic under s. 609.925 to be subject to s. 609.91 (1) (c) or the failure of the clinic to so elect, applies to health care costs arising from health care provided by any provider through the clinic. A provider may not exercise an election under s. 609.92 or 609.925 separately from the clinic with respect to health care costs provided through the clinic.
(b) The commissioner may, by rule, specify the types of health care facilities or organizations that qualify as clinics for purposes of this subsection.
History: 1989 a. 23.
Structure Wisconsin Statutes & Annotations
Wisconsin Statutes & Annotations
Chapter 609 - Defined network plans.
609.001 - Joint ventures; legislative findings.
609.03 - Indication of operations.
609.05 - Primary provider and referrals.
609.10 - Standard plan and point-of-service option plan required.
609.17 - Reports of disciplinary action.
609.20 - Rules for preferred provider and defined network plans.
609.205 - Public health emergency for COVID-19.
609.30 - Provider disclosures.
609.34 - Clinical decision-making; medical director.
609.35 - Applicability of requirements to preferred provider plans.
609.36 - Data systems and confidentiality.
609.65 - Coverage for court-ordered services for the mentally ill.
609.655 - Coverage of certain services provided to dependent students.
609.70 - Chiropractic coverage.
609.71 - Disclosure of payments.
609.715 - Coverage of alcoholism and other diseases.
609.717 - Mental health services provided by a recovery charter school.
609.75 - Adopted children coverage.
609.755 - Coverage of dependents.
609.76 - Coverage of student on medical leave.
609.77 - Coverage of breast reconstruction.
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.
609.80 - Coverage of mammograms.
609.805 - Coverage of contraceptives.
609.81 - Coverage related to HIV infection.
609.82 - Coverage without prior authorization for emergency medical condition treatment.
609.83 - Coverage of drugs and devices.
609.837 - Copayment equality for oral and injected chemotherapy.
609.84 - Experimental treatment.
609.846 - Discrimination based on COVID-19 prohibited.
609.85 - Coverage of lead screening.
609.87 - Coverage of treatment for autism spectrum disorders.
609.875 - Coverage of colorectal cancer screening.
609.88 - Coverage of immunizations.
609.885 - Coverage of COVID-19 testing.
609.89 - Written reason for coverage denial.
609.90 - Restrictions related to domestic abuse.
609.91 - Restrictions on recovering health care costs.
609.92 - Hospitals, individual practice associations and providers of physician services.
609.925 - Election to be subject to restrictions.
609.93 - Scope of election by an individual practice association or clinic.
609.935 - Notices of election and termination.
609.94 - Summary of restrictions.
609.95 - Minimum covered liabilities.
609.96 - Initial capital and surplus requirements.