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Wisconsin · Through 2023-24 Wisconsin Statutes updated through 2025 Wis. Act 247 (published 9-4-26)

Wis. Stat. § 609.34: Clinical decision-making; medical director.

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Where this section sits in the code
  1. Chs. 600-655, Insurance
  2. Chapter 609 Defined Network Plans

(1) A defined network plan that is not a preferred provider plan shall appoint a physician as medical director. The medical director shall be responsible for clinical protocols, quality assurance activities, and utilization management policies of the plan.

(2) A preferred provider plan may contract for services related to clinical protocols and utilization management. A preferred provider plan or its designee is required to appoint a medical director only to the extent that the preferred provider plan or its designee assumes direct responsibility for clinical protocols and utilization management policies of the plan. The medical director, who shall be a physician, shall be responsible for such protocols and policies of the plan.

Collected 2026-09-05T12:01:30Z. Source file · JSON

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