An Act to create 49.45 (30y), 49.46 (2) (b) 12e., 609.803 and 632.895 (15r) of the statutes; Relating to: reimbursement of maternal mental health screenings under the Medical Assistance program and coverage of maternal mental health screenings by health insurance policies and plans. (FE)
Summary
AB1086 would require Wisconsin’s Department of Health Services to seek any needed federal Medicaid waiver or state plan amendment so that maternal mental health screenings can be reimbursed under Medical Assistance. The bill directs DHS to develop standards and best practices for those screenings in consultation with organizations focused on improving maternal mental health, including groups led by Black, Indigenous, and other people of color. It also specifies that screenings may be provided by licensed midwives, nurse-midwives, certified nurse-midwife advanced practice registered nurses, or other licensed providers acting within their scope of practice.
The bill further creates a new insurance coverage mandate requiring disability insurance policies, limited service health organizations, preferred provider plans, defined network plans, and self-insured governmental health plans that include maternity coverage to cover a maternal mental health screening for each pregnancy. It includes applicability rules for collective bargaining agreements and delayed effective dates for one provider-licensure amendment. In practical terms, the bill would expand access to postpartum and perinatal mental health screening services and shift some costs to Medicaid and private insurers.
Impact
AB1086 would amend Wisconsin statutes governing Medical Assistance and health insurance coverage by creating new provisions in ss. 49.45, 49.46, 609.803, and 632.895. It would make maternal mental health screenings reimbursable under Medicaid if they meet DHS standards, and it would require certain health plans and self-insured public plans to cover one screening per pregnancy. The bill also creates an insurance mandate that could trigger a required social and financial impact report under state law, and it would affect coverage terms for public employers and plans subject to collective bargaining agreements.
Sentiment
The bill’s framing suggests generally supportive sentiment around expanding maternal mental health care and improving access to screening during pregnancy. Its emphasis on consultation with organizations led by Black, Indigenous, and other people of color indicates an equity-focused approach and likely reflects concern about disparities in maternal health outcomes. However, the bill did not advance and ultimately failed to pass pursuant to Senate Joint Resolution 1, so there is no recorded committee or floor vote history in the provided materials to show broader legislative support or opposition.
Contention
The main points of potential contention are the insurance mandate and the Medicaid implementation requirements. Insurers, self-insured public plans, and employers could object to the added coverage obligation and associated costs, while the bill itself acknowledges that it may require a social and financial impact report. Another possible issue is federal Medicaid compliance, since DHS must seek a waiver or state plan amendment if needed and would not have to implement the provision if federal approval is denied. There may also be discussion over who may provide the screenings, though the bill broadly includes midwives, nurse-midwives, certified nurse-midwife APRNs, and other licensed providers within scope of practice.
Crossfiled
An Act to create 49.45 (30y), 49.46 (2) (b) 12e., 609.803 and 632.895 (15r) of the statutes; Relating to: reimbursement of maternal mental health screenings under the Medical Assistance program and coverage of maternal mental health screenings by health insurance policies and plans. (FE)