Healthcare (Medicaid)

failed · Wisconsin · Assembly Mar 23, 2026

AB 163: Relating to: redeterminations of eligibility for the Medical Assistance program and database confirmation for public assistance program eligibility. (FE)

AB 163 requires regular eligibility reviews for the Medical Assistance program (a public health benefits program) every six months, replacing automatic renewals. Recipients must report changes affecting their benefits within 10 days or face a six-month loss of coverage. The bill mandates state agencies to cross-check public benefit databases against death records and other state databases (like employment or prison records) every three months to remove deceased individuals and verify eligibility. It also establishes data-sharing agreements between agencies to confirm applicant information using sources like federal benefit records, with all eligibility reviews required to be completed by January 1, 2026.

Topics ✗ HealthcareOpposes HealthcareBill mandates stricter eligibility reviews and six-month coverage loss for non-compliance in Medical Assistance program, restricting access to public health benefits.85% confidence

Sub-Topics Medicaid Public Health

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failed · Wisconsin · Senate Mar 23, 2026

SB 83: Relating to: utilization management controls for antipsychotic prescription drugs under the Medical Assistance program. (FE)

SB 83 creates exceptions to prior authorization requirements for antipsychotic drugs under the state's Medical Assistance program (Medicaid). It specifies four situations where prior approval isn't needed for recipients aged 18+: if the drug was previously approved at a different dose, the recipient was recently enrolled after 30 days of continuous use, prior authorization expired after 60 days of continuous use, or the recipient was stabilized on the drug after a recent hospital discharge. The bill does not override federal Medicaid rules. It directly affects Medicaid recipients prescribed antipsychotic medications who meet these specific criteria.

Topics ✓ HealthcareSupports HealthcareRemoves prior authorization barriers for antipsychotic drugs under Medicaid, improving patient access to necessary treatments for stabilized recipients.95% confidence

Sub-Topics Hospitals Medicaid

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failed · Wisconsin · Senate Mar 23, 2026

SB 50: Relating to: health care costs omnibus, granting rule-making authority, making an appropriation, and providing a penalty. (FE)

SB 50 establishes a Prescription Drug Affordability Review Board to address prescription drug costs, requiring it to meet quarterly and include balanced representation from pharmaceutical manufacturers, health insurers, healthcare providers, and the public. The bill allocates $500,000 annually for state operations related to this board and funds a pilot project to create value-based diabetes medication arrangements with pharmacy benefit managers. It also modifies Medicaid copayment rules to prevent providers from denying care due to inability to pay copays, while creating a new tool for prescribers to disclose drug costs to patients. Additionally, the bill authorizes partnerships with out-of-state drug repositories and allows pharmacists to count free clinic volunteer hours toward continuing education requirements.

Topics ✓ Budget & TaxesSupports Budget & TaxesAllocates $500,000 annually for Prescription Drug Board operations and funds diabetes pilot project, directly advancing state budget allocation for healthcare initiatives.90% confidence ✓ HealthcareSupports HealthcareCreates Prescription Drug Affordability Review Board to lower costs, allocates $500k for operations/pilot, modifies Medicaid copays to improve affordability.95% confidence

Sub-Topics Appropriations Medicaid Prescription Drugs Primary Care

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signed · Wisconsin · Assembly Apr 9, 2026

AB 604: Relating to: coverage under the Medical Assistance program for incarcerated individuals. (FE)

AB 604 would require Wisconsin's Department of Health Services to request a federal Medicaid waiver to provide pre-release medical coverage for incarcerated individuals eligible for Medicaid. It specifically covers case management, medication-assisted treatment for substance use disorders, and a 30-day supply of prescription medications for up to 90 days before release. This bill directly affects incarcerated people who qualify for Medicaid, aiming to improve continuity of care upon reentry. The waiver request must be submitted by January 1, 2027, to allow state and federal reimbursement for these services. The bill focuses on concrete policy changes to expand healthcare access during a critical transition period.

Topics ✓ Criminal JusticeSupports Criminal JusticeProvides pre-release Medicaid coverage including substance use treatment to improve reentry outcomes, directly reducing recidivism through rehabilitation-focused continuity of care.95% confidence ✓ HealthcareSupports HealthcareExpands Medicaid coverage pre-release for incarcerated individuals, ensuring continuity of care including medication-assisted treatment and prescriptions.95% confidence

Sub-Topics Corrections Probation & Parole Medicaid

failed · Wisconsin · Assembly Mar 23, 2026

AB 199: Relating to: reimbursement of emergency services under the Medical Assistance program when a patient is not transported, reporting on changes to the scope of practice of emergency medical responders and emergency medical services practitioners, and eligibility for the expenditure restraint incentive program. (FE)

AB 199 changes reimbursement rates for ambulance services under Wisconsin's Medical Assistance program (state Medicaid) when patients are not transported to a facility. Starting January 1, 2027, the state will increase payments for "ambulance response and treatment, no transport" (code A0998) to match the rate for transport services (code A0429), directly benefiting ambulance providers. The bill also requires the Department of Health Services to annually report by September 15 on how national changes to emergency medical responder scope of practice may affect training in Wisconsin. These provisions specifically impact ambulance service providers, state health officials, and the Medical Assistance program.

Topics ✓ Budget & TaxesSupports Budget & TaxesIncreases state Medicaid reimbursement rates for ambulance services, directly raising government spending on emergency medical services under the Medical Assistance program.95% confidence ✓ HealthcareSupports HealthcareIncreases Medicaid reimbursement rates for ambulance services, directly funding emergency care providers under public health program.95% confidence

Sub-Topics Government Spending Healthcare Workforce Medicaid Medical Licensing Tags Public Safety

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failed · Wisconsin · Senate Mar 23, 2026

SB 407: Relating to: grant program for an integrated mental health facility. (FE)

SB 407 creates a grant program to fund Rogers Behavioral Health's new integrated mental health facility in the Chippewa Valley. The bill requires Rogers to submit detailed certification plans for all service levels (inpatient, residential, partial hospitalization, intensive outpatient, and outpatient care) to meet state licensing requirements before receiving funds. It also mandates that the facility accept Medical Assistance recipients (Wisconsin's Medicaid program), admit involuntary patients within two years, and provide annual reports to the Department of Health Services for five years. This bill directly affects Rogers Behavioral Health and mental health patients in the Chippewa Valley region seeking comprehensive care.

Topics ✓ HealthcareSupports HealthcareCreates grant program funding mental health facility, mandates Medicaid acceptance, and ensures service compliance for improved access to care.95% confidence

Sub-Topics Medicaid Mental Health

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failed · Wisconsin · Assembly Mar 23, 2026

AB 97: Relating to: extension of eligibility under the Medical Assistance program for postpartum women. (FE)

AB 97 extends health coverage under Wisconsin's Medicaid program (Medical Assistance) for postpartum women from 60 days to 365 days after pregnancy, directly affecting pregnant and postpartum women who qualify for the program. The bill changes eligibility rules to ensure coverage continues without regard to income changes during this extended period. It also adds a provision allowing women with family incomes above 300% of the poverty line to qualify if their income is spent on medical care or health insurance premiums. This policy update aims to provide longer-term health coverage for new mothers during a critical postpartum period.

Topics ✓ HealthcareSupports HealthcareExtends Medicaid postpartum coverage from 60 to 365 days, removes income barriers during extended period, and expands access to health services for vulnerable women.95% confidence

Sub-Topics Insurance Medicaid

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failed · Wisconsin · Assembly Mar 23, 2026

AB 54: Relating to: utilization management controls for antipsychotic prescription drugs under the Medical Assistance program. (FE)

AB 54 prohibits the state department from requiring prior authorization or other utilization management controls for FDA-approved antipsychotic prescription drugs under the Medical Assistance program. This directly affects Medicaid beneficiaries who rely on these medications, removing barriers to accessing prescribed antipsychotic treatments. The bill creates a new statute section explicitly stating that utilization management controls (such as step therapy or prior approval) cannot be imposed on these specific drugs. The policy change aims to streamline access to necessary antipsychotic medications without altering drug approval standards.

Topics ✓ HealthcareSupports HealthcareRemoves prior authorization barriers for Medicaid antipsychotic drugs, improving patient access to prescribed treatments.95% confidence

Sub-Topics Medicaid Prescription Drugs

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failed · Wisconsin · Senate Mar 23, 2026

SB 598: Relating to: coverage under the Medical Assistance program for incarcerated individuals. (FE)

SB 598 would require the state health department to seek a federal Medicaid waiver enabling coverage for incarcerated individuals in the Medical Assistance program (state Medicaid) up to 90 days before release. It specifically covers case management, medication-assisted treatment for substance use disorders, and a 30-day supply of prescription medications for those already eligible for Medical Assistance. If approved, the federal government would fund the program’s share of these services, with the state covering its portion. This bill directly affects incarcerated individuals transitioning to community care, aiming to improve continuity of health services upon release.

Topics ✓ Criminal JusticeSupports Criminal JusticeProvides pre-release healthcare and medication-assisted treatment for incarcerated individuals, directly supporting rehabilitation and reducing recidivism through substance use disorder care.90% confidence ✓ HealthcareSupports HealthcareBill expands Medicaid coverage for incarcerated individuals to include case management, medication-assisted treatment, and prescriptions pre-release, improving access to healthcare services and mental health support.90% confidence

Sub-Topics Corrections Medicaid

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