Bill would tighten prior-authorization rules, set time limits and continuity protections
Senate Bill 434, introduced Sept. 29, 2025, would require faster prior-authorization decisions, minimum one-year authorizations, and 90-day continuity of prior approvals when enrollees switch plans. The bill also limits retroactive payment denials except for provider misrepresentation or enrollee ineligibility.
The full story
Senate Bill 434, introduced Sept. 29, 2025, would impose new timing, documentation and transparency requirements for prior authorization under Wisconsin health plans, including insurer-administered and certain limited network products. The bill was introduced by Senators Cabral-Guevara, Jacque and Nass and cosponsored by Representatives Dittrich, Behnke, Goeben, Kreibich, Maxey, Mursau and Palmeri; it was referred to the Committee on Insurance, Housing, Rural Issues and Forestry.
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