Chapter 176G - HEALTH MAINTENANCE ORGANIZATIONS
- Section 176G:1 - Definitions
- Section 176G:2 - Application of laws
- Section 176G:3 - Health maintenance organizations; organization; accounting; contracts
- Section 176G:4 - Required coverage for certain conditions and groups
- Section 176G:4A - Employees terminated due to plant closings; coverage
- Section 176G:4B - Confidentiality of information; mental or nervous condition; exceptions
- Section 176G:4C - Home care benefits
- Section 176G:4D - Nonprescription enteral formulas for home use; modified low protein food products
- Section 176G:4E - Off-label use of prescription drugs for cancer treatment; liability
- Section 176G:4F - Bone marrow transplants; group health maintenance contract coverage for certain patients
- Section 176G:4G - Off-label use of prescription drugs for HIV/AIDS treatment
- Section 176G:4H - Items medically necessary for diagnosis and treatment of diabetes
- Section 176G:4I - Required coverage for prenatal care, childbirth and postpartum care
- Section 176G:4J - Scalp hair prostheses necessary due to cancer or leukemia treatment
- Section 176G:4K - Newborn hearing screening tests
- Section 176G:4L - Coverage for hospice services
- Section 176G:4M - Mental health benefits; biologically-based mental disorders; rape-related mental disorders; non-biologically-based mental disorders of children and adolescents under age 19
- Section 176G:4N - Coverage for speech, hearing and language disorders
- Section 176G:4O - Outpatient services; hormone replacement therapy for peri and post menopausal women; contraceptive services; approved prescription contraceptive drugs or devices; exception
- Section 176G:4P - Patient care services provided pursuant to qualified clinical trials
- Section 176G:4Q - Coverage for human leukocyte or histocompatibility locus antigen testing
- Section 176G:4R - [Repealed]
- Section 176G:4S - Coverage for prosthetic devices and repairs
- Section 176G:4T - Coverage for eligible dependents under age of 26 years
- Section 176G:4U - Restriction or discontinuance of coverage for medically necessary hypodermic syringes prohibited
- Section 176G:4V - Coverage for diagnosis and treatment of autism spectrum disorder
- Section 176G:4W - Coverage for treating cleft lip and cleft palate for children under age 18
- Section 176G:4X - Coverage for prescribed, orally administered anticancer medications
- Section 176G:4Y - Coverage for abuse deterrent opioid drug products
- Section 176G:4Z - When preauthorization for substance use disorder treatment not required
- Section 176G:4AA - Coverage for medically necessary acute treatment and clinical stabilization services
- Section 176G:4BB - [See also Version 2 as added by a different 2016 act] Coverage for long-term antibiotic therapy for patients with Lyme disease
- Section 176G:4BB - [See also Version 1 as added by a different 2016 act] Coverage for prescription eye drops; coverage for refills in accordance with Medicare Part D guidelines
- Section 176G:4CC - Coverage for treatment for HIV associated lipodystrophy syndrome
- Section 176G:4DD - Prescriptions filled in lesser quantity pursuant to sec. 18 of chapter 94C
- Section 176G:4EE - Plan to provide adequate coverage and access to broad spectrum of pain management services
- Section 176G:4FF - Coverage for tobacco use cessation counseling and approved products
- Section 176G:4GG - Coverage for treatment of pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections and pediatric acute-onset neuropsychiatric syndrome
- Section 176G:4HH - [Repealed]
- Section 176G:4II - Coverage for refills of prescription eye drops
- Section 176G:4JJ - Coverage for mental health or substance use disorder services delivered through psychiatric collaborative care model
- Section 176G:4KK - Coverage for medically necessary mental health acute treatment, community-based acute treatment, etc.
- Section 176G:4LL - Provision of benefits on nondiscriminatory basis for medically necessary emergency services programs
- Section 176G:4MM - Coverage for an annual mental health wellness examination
- Section 176G:4NN - Coverage for federally-defined preventive services
- Section 176G:4OO - Coverage for standard fertility preservation services
- Section 176G:4PP - [Effective 11/21/2024] Health maintenance contract coverage for postpartum depression screenings
- Section 176G:4QQ - [Effective 11/21/2024] Health maintenance contract coverage for donor human milk
- Section 176G:4RR - [Effective 11/21/2024] Health maintenance contract coverage for universal postpartum home visiting services
- Section 176G:4SS - [Effective 2/11/2025] Coverage for diagnostic examinations for breast cancer, digital breast tomosynthesis screening and medically necessary and appropriate screening with breast magnetic resonance imaging or screening breast ultrasound
- Section 176G:5 - Emergency services provided to members for emergency medical conditions
- Section 176G:5A - Divorced or separated spouses; coverage
- Section 176G:6 - Contracts
- Section 176G:6A - Group health maintenance contract
- Section 176G:6B - Retroactive claims denial for behavioral health services
- Section 176G:7 - [Repealed]
- Section 176G:8 - Public dissemination of deceptive or misleading materials
- Section 176G:9 - Trade regulation practices; application of law
- Section 176G:10 - Reports; audits, examinations or inspections; confidentiality; summons and oaths of officers and agents
- Section 176G:10A - Applicability of chapter 176V
- Section 176G:10B - Applicability of chapter 176W
- Section 176G:11 - Contracts with group insurance commission or local governments
- Section 176G:11A - Alternative dental coverage option
- Section 176G:12 - Health regulations not limited
- Section 176G:13 - Name restriction
- Section 176G:14 - Licensure applicants; documents required; approval by commissioner
- Section 176G:15 - Bond; waiver
- Section 176G:16 - Contracts, rates, evidence of coverage; disapproval of commissioner
- Section 176G:16A - Disapproval of certain health maintenance contracts based on high deductibles
- Section 176G:16B - Compliance with minimum standards
- Section 176G:17 - Rules and regulations; standardized claim form
- Section 176G:17A - Open enrollment for nongroup medicare beneficiaries; period, notice of termination
- Section 176G:19 - Discrimination against abuse victims in terms of health maintenance contract
- Section 176G:20 - Insolvent health maintenance organization; administrative supervision, rehabilitation or liquidation; priority of claims
- Section 176G:20A - Revocation or suspension
- Section 176G:21 - Participating provider; contracts with health maintenance organizations; hold harmless clause; limitation on collection actions
- Section 176G:22 - Health care providers; liability of member of health maintenance organization; limitation on collection of amounts owed
- Section 176G:23 - Insolvency of health maintenance organization; replacement coverage
- Section 176G:24 - Health maintenance contracts; genetic tests; discrimination based on genetic information
- Section 176G:25 - Initial adjusted net worth
- Section 176G:26 - Deposit
- Section 176G:27 - Merger or acquisition
- Section 176G:28 - Registration
- Section 176G:29 - Order enjoining health maintenance organization or director, officer, employee or agent from violating or continuing to violate secs. 27 to 29
- Section 176G:30 - Statements
- Section 176G:31 - Attribution of members to primary care provider
- Section 176G:32 - Disclosure of patient-level data and contracted prices of individual health care services by carriers to providers
- Section 176G:33 - Coverage for health care services delivered via telehealth