SB 1164 Wisconsin Senate · 2025-2026 Regular Session

Relating to: preventing surprise bills for emergency medical services and other items and services under health insurance policies and plans. (FE)

This bill aims to protect patients from unexpected medical bills by establishing rules for how health insurance plans must handle emergency care and services provided by out-of-network providers. It requires insurance plans to cover emergency medical services without prior authorization and ensures that cost-sharing amounts for out-of-network emergency care are no higher than what would apply for in-network care. Additionally, the bill mandates that plans pay out-of-network providers directly for services rendered at participating facilities and counts patient cost-sharing payments toward in-network deductibles and out-of-pocket maximums. These provisions apply to defined network plans, preferred provider plans, and self-insured governmental plans that have networks of participating providers.
Bill status failed 1 of 4 stages cleared
Introduction
Mar 2026
Committee Review
Floor Vote
Governor
Introduced Mar 19, 2026 Last action Mar 30, 2026
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Full legislative history

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Total actions
4
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0
Committee
0
Mar 19, 2026
Introduced
Introduced by Senators Roys, Larson, Ratcliff and Smith; cosponsored by Representatives Prado, Brown, Clancy, Emerson, Goodwin, Madison, McCarville, Sinicki, Tenorio and Subeck
upper
4 primary · 0 co-sponsors

Sponsors