State Law

Wisconsin Statutes-Insurance-Chapter 609. Defined Network Plans

08/29/2023 Wisconsin Section 609.30

Provider disclosures

Anti-gag clause, Anti-retaliation

Anti-gag Clause

(1) Plan may not contract. A defined network plan may not contract with a participating provider to limit the provider’s disclosure of information, to or on behalf of an enrollee, about the enrollee’s medical condition or treatment options.

Anti-retaliation

(2) Plan may not penalize or terminate. A participating provider may discuss, with or on behalf of an enrollee, all treatment options and any other information that the provider determines to be in the best interest of the enrollee. A defined network plan may not penalize or terminate the contract of a participating provider because the provider makes referrals to other participating providers or discusses medically necessary or appropriate care with or on behalf of an enrollee.

See https://docs.legis.wisconsin.gov/statutes/statutes/609/30