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Wisconsin Statutes Insurance (Ch. 600 to 655) § 648.65. Enrollee immunity

Current as of January 01, 2025 | Updated by Findlaw Staff

(1) Immunity. An enrollee of a care management organization is not liable for health care, service, equipment, or supply charges that are covered under the care management organization's contract with the department.

(2) Prohibited recovery attempts. No person may bill, charge, collect a deposit from, seek compensation from, file or threaten to file with a credit reporting agency with respect to, or have any recourse against an enrollee or any person acting on the enrollee's behalf, for any health care, service, equipment, or supply charges for which the enrollee or person acting on his or her behalf is not liable under sub. (1).

(3) Immunity not affected. The immunity of an enrollee under subs. (1) and (2) is not affected by any of the following:

(a) A breach or default on an agreement by the care management organization or the failure of any person to compensate the provider.

(b) The insolvency of the care management organization or any person contracting with the care management organization or the commencement or the existence of conditions permitting the commencement of insolvency, delinquency, or bankruptcy proceedings involving the care management organization or other person, regardless of whether the care management organization or other person has agreed to compensate, directly or indirectly, the provider for health care, services, equipment, or supplies for which the enrollee is not liable under sub. (1)

(c) The inability of the provider or other person who is owed compensation for health care, services, equipment, or supplies to obtain compensation from the care management organization.

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Cite this article: FindLaw.com - Wisconsin Statutes Insurance (Ch. 600 to 655) § 648.65. Enrollee immunity - last updated January 01, 2025 | https://codes.findlaw.com/wi/insurance-ch-600-to-655/wi-st-648-65/

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