Wisconsin Statutes Insurance (Ch. 600 to 655) § 632.853. Coverage of drugs and devices

A health care plan, as defined in s. 628.36(2)(a)1., or a self-insured health plan, as defined in s. 632.85(1)(c), that provides coverage of only certain specified prescription drugs or devices shall develop a process through which a physician may present medical evidence to obtain an individual patient exception for coverage of a prescription drug or device not routinely covered by the plan. The process shall include timelines for both urgent and nonurgent review.