Healthcare (Insurance)

failed · Wisconsin · Senate Mar 23, 2026

SB 203: Relating to: regulation of pharmacy benefit managers, fiduciary and disclosure requirements on pharmacy benefit managers, and application of prescription drug payments to health insurance cost-sharing requirements. (FE)

SB 203 regulates pharmacy benefit managers (PBMs) by requiring them to pay pharmacies within 30 days for electronic claims and 60 days for paper claims. It mandates that claims for 340B drugs (federally discounted medications) include specific identifiers for processing. The bill also prohibits PBMs from forcing pharmacies to join multiple networks or penalizing them for declining to join such networks. These provisions directly affect PBMs, pharmacies, and prescribers within the state’s health insurance system.

Topics ✓ HealthcareSupports HealthcareRegulates PBMs to ensure timely pharmacy payments, prevent anti-competitive practices, and improve access to medications - directly strengthening healthcare delivery and patient access.95% confidence

Sub-Topics Insurance Prescription Drugs

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failed · Wisconsin · Senate Mar 23, 2026

SB 492: Relating to: coverage of nonopioid drug alternatives for the treatment and management of pain.

SB 492 requires health insurance plans and self-insured employers to cover nonopioid pain treatment options equally with opioids. It mandates coverage for at least two nonopioid prescription drugs (approved by the FDA and not controlled substances) and three non-drug pain management options, such as physical therapy. The bill prohibits health plans from imposing stricter prior authorization or step therapy rules on nonopioid drugs compared to opioids. It also requires annual public reporting of pain management coverage details on plan websites. This affects all health plans covering prescription drugs in Wisconsin, directly impacting patients seeking nonopioid pain treatment options.

Topics ✓ HealthcareSupports HealthcareMandates equal insurance coverage for nonopioid pain treatments, expanding patient access to alternatives and reducing opioid dependency.95% confidence

Sub-Topics Insurance

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failed · Wisconsin · Assembly Mar 23, 2026

AB 583: Relating to: resolution of claims against the state for wrongful imprisonment of innocent persons, exempting from taxation certain amounts an individual receives from the claims board or legislature, health benefits and other assistance for wrongfully imprisoned persons, and making an appropriation. (FE)

AB 583 helps people wrongfully imprisoned in Wisconsin by providing them with tax-exempt compensation, health coverage, and transition support. It exempts state compensation payments for wrongful imprisonment from state income tax, covers health insurance premiums (with shared costs), and requires a 5-day transition plan for released individuals to access housing, job help, and healthcare. The bill creates new funding mechanisms (like appropriations under 20.515) to pay for these benefits and mandates state agencies to coordinate with counties on post-release support. It directly affects individuals who receive state compensation under wrongful imprisonment claims (s. 775.05) and the state budget.

Topics ✓ Budget & TaxesSupports Budget & TaxesExempts wrongful imprisonment compensation from state income tax, providing tax relief for affected individuals and creating new appropriations for related benefits.95% confidence ✓ Criminal JusticeSupports Criminal JusticeProvides tax-exempt compensation, health coverage, and transition support for wrongfully imprisoned individuals, directly advancing criminal justice reform by rectifying systemic errors and aiding reintegration.95% confidence ✓ HealthcareSupports HealthcareBill explicitly provides tax-exempt health coverage, covers premiums, and mandates healthcare access via 5-day transition plans for wrongfully imprisoned individuals, expanding benefits.90% confidence ✓ HousingSupports HousingBill mandates housing access in 5-day transition plan for wrongfully imprisoned persons, directly supporting housing access for vulnerable individuals.90% confidence

Sub-Topics Appropriations Income Tax State Budget Insurance

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failed · Wisconsin · Assembly Mar 23, 2026

AB 432: Relating to: transparency and regulation of prior authorization requirements under health insurance plans. (FE)

AB 432 regulates prior authorization processes for health insurance plans in Wisconsin. It requires insurance companies to follow specific transparency rules when denying coverage for medical services (called "adverse determinations"), mandating that these decisions be made by qualified health providers like physicians or nurse practitioners under medical directors' oversight. The bill defines key terms like "prior authorization" (pre-approval for services) and "urgent health care service" (requiring faster decisions), and sets deadlines for non-urgent cases. It directly affects health insurance plans, self-insured employer plans, and enrollees who seek covered services. The law aims to make the approval process clearer and more timely for patients.

Topics ✓ HealthcareSupports HealthcareMandates transparent prior authorization processes with qualified providers, reducing arbitrary denials and improving patient access to covered services.85% confidence

Sub-Topics Healthcare Workforce Insurance

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signed · Wisconsin · Senate Mar 19, 2026

SB 264: Relating to: coverage of breast cancer screenings by the Medical Assistance program and health insurance policies and plans. (FE)

SB 264 requires health insurance plans and the Medical Assistance program to cover specific breast cancer screenings without out-of-pocket costs for enrollees. It defines two key types of screenings: "diagnostic breast examinations" (used to evaluate symptoms or abnormalities, like mammograms) and "supplemental breast screening examinations" (for high-risk individuals without symptoms, using MRI or ultrasound). The bill prohibits cost-sharing (such as copays) for all diagnostic screenings and for the first supplemental screening per year, while allowing limited cost-sharing for additional supplemental screenings in the same year. This directly affects individuals with health insurance or Medical Assistance who require these screenings, particularly those at higher risk for breast cancer.

Topics ✓ HealthcareSupports HealthcareMandates no-cost breast cancer screenings coverage, expanding access and removing financial barriers for patients under Medical Assistance and insurance plans.95% confidence

Sub-Topics Insurance

failed · Wisconsin · Assembly Mar 23, 2026

AB 351: Relating to: virtual credit card payments in health insurance policies.

AB 351 requires health insurance companies to accept virtual credit card payments for premium payments. It directly affects policyholders who pay premiums and insurers who process those payments. The key provision adds virtual credit cards as a valid payment method, alongside traditional cards or electronic transfers. This change aims to provide consumers with more flexible payment options for their health insurance coverage.

Topics ✓ HealthcareSupports HealthcareAdds virtual credit card payments for premiums, improving consumer access to health insurance payment options without restricting coverage or funding.85% confidence

Sub-Topics Insurance

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failed · Wisconsin · Senate Mar 23, 2026

SB 251: Relating to: cost-sharing caps on prescription drugs and medical supplies to treat asthma under health insurance policies and plans. (FE)

SB 251 requires specific health insurance plans - including those offered by state/local governments - to cover asthma prescription drugs and related medical supplies (like inhalers) without deductibles. It caps patient out-of-pocket costs at $25 per month for asthma medications and $50 per month for related supplies, preventing higher costs as treatment needs increase. This applies to limited service health organizations, preferred provider plans, and defined network plans covering asthma treatment. The bill takes effect for new policy years starting after its enactment, ensuring consistent affordability for covered asthma care.

Topics ✓ HealthcareSupports HealthcareMandates no deductibles for asthma meds/supplies with $25/$50 monthly cost caps, expanding coverage and reducing patient financial burden for essential treatments.95% confidence

Sub-Topics Insurance

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failed · Wisconsin · Assembly Mar 23, 2026

AB 588: Relating to: statutory right to contraception.

AB 588 establishes a statutory right to contraception in Wisconsin, protecting patients' access to FDA-approved contraceptive methods and providers' ability to offer them. The bill prohibits state or local governments from implementing laws that restrict access to FDA-approved contraceptives (like pills, IUDs, or condoms), single out contraceptive services, or make it harder to obtain them. It allows individuals, providers, or the Attorney General to sue if this right is violated, with courts able to block restrictive policies and award legal fees. The law specifically does not affect insurance coverage requirements for contraception. It directly affects all patients seeking contraception and healthcare providers offering these services.

Topics ✓ HealthcareSupports HealthcareEstablishes statutory right to contraception, prohibits restrictions on FDA-approved methods, protecting patient access and provider rights within healthcare services.95% confidence

Sub-Topics Insurance Women's Health

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failed · Wisconsin · Assembly Mar 23, 2026

AB 368: Relating to: prior authorization for coverage of physical therapy, occupational therapy, speech therapy, chiropractic services, and other services under health plans.

AB 368 prevents health insurance plans from requiring prior authorization for the first 12 visits of physical therapy, occupational therapy, speech therapy, or chiropractic care per treatment episode. It also eliminates prior authorization for non-drug pain management (like therapy) for chronic pain patients during the first 90 days of treatment (up to twice weekly). Health plans must explain coverage denials in plain language, apply similar copays for these therapies as for primary care, and decide on reauthorization requests within 3 business days. This bill directly affects patients seeking these services, healthcare providers, and all health benefit plans or self-insured employer health plans in the state.

Topics ✓ HealthcareSupports HealthcareRemoves prior authorization barriers for therapy access, ensuring timely care and clearer coverage explanations per treatment episode.95% confidence

Sub-Topics Insurance Primary Care

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failed · Wisconsin · Senate Mar 23, 2026

SB 566: Relating to: coverage of infertility services under health policies and plans and granting rule-making authority. (FE)

SB 566 requires most health insurance plans to cover infertility treatment and fertility preservation services, directly affecting individuals seeking these services and their insurers. It mandates coverage for diagnosis and treatment of infertility (defined as failure to conceive after specified timeframes) and standard fertility preservation (like egg freezing before cancer treatment), including at least four egg retrievals and unlimited embryo transfers per medical guidelines. Insurers cannot impose stricter cost-sharing or exclusions for infertility care compared to other pregnancy-related benefits. The bill applies to group health plans and self-insured plans, excluding certain disability policies and state/local self-insured plans.

Topics ✓ HealthcareSupports HealthcareMandates insurance coverage for infertility treatment and fertility preservation, expanding patient access to essential reproductive health services.95% confidence

Sub-Topics Insurance

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