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Bill

SB 1164

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

2025-2026 Regular Session Introduced by Chris Larson and 3 co-sponsors

Wisconsin bill prohibits surprise medical billing from out-of-network emergency providers to protect patients from unexpected healthcare debt.

Failed to pass pursuant to Senate Joint Resolution 1
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WeVote Research Nonpartisan
Bill Summary · SB 1164

Legislative bill overview

SB 1164 aims to protect Wisconsin residents from unexpected medical bills by preventing "surprise billing"—charges from out-of-network providers during emergency medical services and other covered health services. The bill would establish protections under health insurance policies and plans to limit patient liability when they receive emergency care or services from providers outside their insurance network.

Why is this important

Surprise billing is a significant consumer protection issue affecting thousands of patients annually. Many people discover after emergency treatment that their healthcare providers weren't in-network, resulting in substantial out-of-pocket costs despite having insurance coverage. This legislation directly addresses medical debt and financial hardship caused by circumstances largely beyond patient control.

Potential points of contention

  • Insurance industry concerns: Health insurers and insurers' advocates may argue the bill increases regulatory burdens, reduces their ability to manage networks, or increases premiums for consumers by limiting their cost-control mechanisms.
  • Provider network impacts: Healthcare providers and hospital systems might contend the bill reduces their negotiating power with insurers or limits their ability to direct patient care through network restrictions.
  • Scope definition: The bill's specific coverage parameters (which services qualify, what constitutes "emergency," and reimbursement rate formulas) could face debate over whether protections are sufficiently broad or potentially overreaching.

Compiled from official sources — confirm details with the bill’s official record.

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