2025 - 2026 LEGISLATURE
LRB-0082/1
EKL:amn&skw
December 17, 2025 - Introduced by Representatives Subeck, Anderson, Arney, Bare, Clancy, DeSmidt, Joers, Madison, Phelps, Roe, Sinicki, Spaude, Stroud, Stubbs, Tenorio, Udell and Palmeri, cosponsored by Senators Hesselbein, Spreitzer, L. Johnson, Ratcliff, Roys and Wall. Referred to Committee on Insurance.
AB775,1,3
1An Act to amend 609.83; to create 632.895 (12r) of the statutes; relating to:
2cost-sharing cap on epinephrine delivery systems under health insurance
3policies and plans. Analysis by the Legislative Reference Bureau
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.
The people of the state of Wisconsin, represented in senate and assembly, do enact as follows:
AB775,1
1Section 1. 609.83 of the statutes is amended to read: AB775,2,42609.83 Coverage of drugs and devices. Limited service health 3organizations, preferred provider plans, and defined network plans are subject to 4ss. 632.853, 632.861, and 632.895 (12r), (16t), and (16v). AB775,25Section 2. 632.895 (12r) of the statutes is created to read: AB775,2,106632.895 (12r) Epinephrine delivery systems. (a) In this subsection, 7“epinephrine delivery system” means a device that is approved by the federal food 8and drug administration, that contains a premeasured dose of epinephrine, and 9that is used to administer epinephrine into the human body to prevent or treat a 10life-threatening allergic reaction. AB775,2,1511(b) Every disability insurance policy, and every self-insured health plan of the 12state or a county, city, village, town, or school district, that provides coverage of 13medically necessary epinephrine delivery systems may not impose cost sharing on 14epinephrine delivery systems in an amount that exceeds $60 for two doses of the 15epinephrine delivery system, regardless of the type of epinephrine delivery system. AB775,2,2016(c) Nothing in this subsection prohibits a disability insurance policy or self-17insured health plan from imposing cost sharing on epinephrine delivery systems in 18an amount less than the amount specified under par. (b). Nothing in this 19paragraph requires a disability insurance policy or self-insured health plan to 20impose any cost sharing on epinephrine delivery systems. AB775,321Section 3. Initial applicability. AB775,2,2222(1) Epinephrine delivery systems. AB775,3,3
1(a) For policies and plans containing provisions inconsistent with s. 632.895 2(12r), the treatment of s. 632.895 (12r) first applies to policy or plan years beginning 3on the effective date of this paragraph, except as provided in par. (b). AB775,3,84(b) For policies and plans that are affected by a collective bargaining 5agreement containing provisions inconsistent with s. 632.895 (12r), the treatment 6of s. 632.895 (12r) first applies to policy or plan years beginning on the effective date 7of this paragraph or on the day on which the collective bargaining agreement is 8newly established, extended, modified, or renewed, whichever is later. AB775,3,1110(1) This act takes effect on the first day of the 4th month beginning after 11publication.
