Wisconsin § 628.36 - Limitations on corporations supplying health care services.

§ 628.36. Limitations on corporations supplying health care services.

628.36(1) (1) Payment methods. Any corporation operating a voluntary health care plan may pay health care professionals on a salary, per patient or fee-for-service basis to provide health care to policyholders or beneficiaries of the corporation. 628.36(2) (2) Discrimination against professionals. 628.36(2)(a) (a) In this section: 628.36(2)(a)1. 1. “Health care plan” means an insurance contract providing coverage of health care expenses. 628.36(2)(a)2. 2. “Provider” means a health care professional, a health care facility or a health care service or organization. 628.36(2)(b) (b) 628.36(2)(b)1. 1. Except for health maintenance organizations, preferred provider plans and limited service health organizations, no health care plan may prevent any person covered under the plan from choosing freely among providers who have agreed to participate in the plan and abide by its terms, except by requiring the person covered to select primary providers to be used when reasonably possible. 628.36(2)(b)2. 2. No provider may be required to participate exclusively in a health care plan as a condition of participation in it. 628.36(2)(b)3. 3. Except as provided in subd. 4. , no provider may be denied the opportunity to participate in a health care plan, other than a health maintenance organization, a limited service health organization or a preferred provider plan, under the terms of the plan. 628.36(2)(b)4. 4. Any health care plan may exclude a provider from participation in the health care plan for cause related to the practice of his or her profession. 628.36(2)(b)5. 5. All health care plans, including health maintenance organizations, limited service health organizations and preferred provider plans are subject to s. 632.87 (3) . 628.36(2m) (2m) Pharmaceutical services. 628.36(2m)(a) (a) In this subsection: 628.36(2m)(a)1. 1. “Health maintenance organization” has the meaning given in s. 609.01 (2) . 628.36(2m)(a)2. 2. “Limited service health organization” has the meaning given in s. 609.01 (3) . 628.36(2m)(a)2m. 2m. “Pharmaceutical services” do not include the administration of a drug product or device or vaccine under s.