Wisconsin 2025-2026 Regular Session

Wisconsin Senate Bill SB1164

Introduced
3/19/26  
Refer
3/19/26  

Caption

An Act to create 609.04 and 609.24 (5) of the statutes; Relating to: preventing surprise bills for emergency medical services and other items and services under health insurance policies and plans. (FE)

Impact

The enactment of SB 1164 would significantly alter the landscape of health insurance practices in the state. It will likely create a more standardized approach to how emergency medical services are billed, ensuring that patients are only responsible for in-network costs unless they are adequately informed otherwise. This adjustment could lead to improved accessibility to necessary medical services without the fear of exorbitant bills, fostering a more patient-centered healthcare framework. Additionally, insurance companies may need to adjust their policies and billing procedures to comply with the new regulations, impacting their financial operations.

Summary

Senate Bill 1164 addresses the issue of surprise medical billing, particularly in the context of emergency medical services and various other items and services covered under health insurance policies and plans. The legislation aims to ensure that patients receiving emergency care are not burdened with unexpected medical expenses due to out-of-network providers. By establishing guidelines for health insurers and medical service providers, the bill seeks to enhance transparency and protect patients from potential financial distress associated with unforeseen medical costs during emergencies.

Contention

Notably, there could be points of contention surrounding SB 1164 relating to the balance of responsibilities between healthcare providers and insurers. Some stakeholders may argue that the regulations could impose financial burdens on providers, especially those operating in rural or underserved areas where networks are limited. There are also concerns from insurance companies about the potential for increased premiums as they adjust to the new standards and are required to manage out-of-network charges more effectively. Balancing patient protections with the financial viability of healthcare providers and insurers remains a focus of ongoing discussions.

Companion Bills

WI AB1218

Crossfiled An Act to create 609.04 and 609.24 (5) of the statutes; Relating to: preventing surprise bills for emergency medical services and other items and services under health insurance policies and plans. (FE)

Previously Filed As

WI AB1218

Preventing surprise bills for emergency medical services and other items and services under health insurance policies and plans. (FE)

WI SB711

Coverage and reimbursement of emergency ambulance services under health insurance policies and plans. (FE)

WI AB720

Coverage and reimbursement of emergency ambulance services under health insurance policies and plans. (FE)

WI H456

No Surprises for Ambulance Services Act

WI AB1127

Coverage of speech therapies as a treatment for stuttering under health insurance policies and plans and the Medical Assistance program and providing speech therapy to a child in need of protection or services. (FE)

WI SB373

Prior authorization for coverage of physical therapy, occupational therapy, speech therapy, chiropractic services, and other services under health plans.

WI AB368

Prior authorization for coverage of physical therapy, occupational therapy, speech therapy, chiropractic services, and other services under health plans.

WI SB262

Insurance; health benefit policies to cover preventive services; provide

WI SB566

Coverage of infertility services under health policies and plans and granting rule-making authority. (FE)

WI AB568

Coverage of infertility services under health policies and plans and granting rule-making authority. (FE)

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