Wisconsin Statutes

No policy, plan, or contract may exclude coverage for mental health or behavioral treatment or services provided by the charter school established under a contract under s. 118.40 (2x) (cm), if the policy, plan, or contract covers the mental health or behavioral health treatment or services when provided by another health care provider.
Wis. Stat. Ann. § 632.87 further discusses other services that must be covered by policies, plans, and contracts.

Amended by Wis. AB 6.

Limited service health organizations, preferred provider plans, and defined network plans are subject to s. 632.87 (4m).

Amended by Wis. AB 6.

This bill changed state law so that Medicaid plans would cover the following:

• Telehealth mental health services, even if they are provided by an out-of-state provider
• In-home services without requiring fail-first protocol

Wis. Stat. Ann. § 632.89 states that if a group health benefit plan or self-insured plan provides coverage for any inpatient, outpatient, or transitional hospital treatment, then it must also cover services inpatient, outpatient, and transitional services for the treatment of nervous or mental disorders, alcoholism, or other drug abuse problems.
Wis. Stat. Ann. § 632.89 also requires that the exclusions and limitations, deductibles, copayments, coinsurance, annual and lifetime payment limitations, out of pocket limits, out of network charges, day, visit or appointment limits, limitations regarding referrals to nonphysician providers and treatment programs, and duration or frequency of coverage limits under these plans cannot be more restrictive than the treatment limitations applied to substantially all other coverage under the plan.

Amended by Wis. SB 362.

Disability insurance policies self-insured health plans of the state or a county, city, town, village, or school district shall provide coverage for an insured of treatment for autism spectrum disorder if the treatment is prescribed by a physician and provided by any who are qualified to provide intensive-level services or nonintensive-level services. Certain minimum coverage amounts are required, and the coverage may only be subject to the deductibles, coinsurance, or copayments that generally apply to other conditions covered under the policy or plan.
Wis. Stat. Ann. § 632.895 also discusses generally other conditions that must be covered under certain insurance plans.