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Bill > SB764


WI SB764

WI SB764
Cost-sharing cap on epinephrine delivery systems under health insurance policies and plans. (FE)


summary

Introduced
12/12/2025
In Committee
12/12/2025
Crossed Over
Passed
Dead

Introduced Session

2025-2026 Regular Session

Bill Summary

This bill prevents every health insurance policy and every self-insured governmental health plan that covers medically necessary epinephrine delivery systems from imposing cost sharing in an amount that exceeds $60 for two doses of the epinephrine delivery system, regardless of the type of epinephrine delivery system. The bill defines “epinephrine delivery system” to mean a device that is approved by the federal Food and Drug Administration, that contains a premeasured dose of epinephrine, and that is used to administer epinephrine into the human body to prevent or treat a life-threatening allergic reaction. Health insurance policies are referred to in the bill as disability insurance policies. For further information see the state fiscal estimate, which will be printed as an appendix to this bill. This proposal may contain a health insurance mandate requiring a social and financial impact report under s. 601.423, stats. LRB-5531/1 EKL:amn&skw 2025 - 2026 Legislature SENATE BILL 764

AI Summary

This bill requires health insurance policies and self-insured governmental health plans to limit cost-sharing for epinephrine delivery systems (EDS) to a maximum of $60 for two doses, regardless of the specific type of device. An epinephrine delivery system is defined as a federally FDA-approved device containing a premeasured dose of epinephrine used to prevent or treat life-threatening allergic reactions. The bill specifies that while insurers must not charge more than $60 for two doses, they are not required to charge this amount and can choose to charge less or even provide the devices at no cost. The legislation will apply to new policy or plan years beginning on or after the effective date, with special provisions for policies governed by existing collective bargaining agreements that may need to be renegotiated. The bill will take effect on the first day of the fourth month following its publication, giving insurers time to adjust their policies to comply with the new cost-sharing limits.

Committee Categories

Agriculture and Natural Resources

Sponsors (23)

Last Action

Fiscal estimate received (on 12/16/2025)

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