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Bill

AB 774

Relating to: prohibiting step therapy protocols for certain cancer drugs.

2025-2026 Regular Session Introduced by Margaret Arney and 13 co-sponsors

Prohibits step therapy for certain cancer drugs, ensuring patients can access appropriate treatments without being forced to try less effective options first.

Failed to pass pursuant to Senate Joint Resolution 1
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Bill Summary · AB 774

Summary of Assembly Bill 774 (Wisconsin, 2025)

Title

Relating to prohibiting step therapy protocols for certain cancer drugs.

Purpose and intent

This bill seeks to prohibit the use of step therapy protocols for certain cancer drugs. Step therapy (also known as “fail-first” or “prior authorization” protocols) typically requires patients to try less expensive or non-preferred therapies before higher-cost or targeted cancer treatments. The bill aims to ensure that appropriate cancer medications can be prescribed without mandatory adherence to a tiered sequencing or stepwise approach.

Key provisions (as available from the bill text and summaries)

  • Prohibition on step therapy for specified cancer drugs: Health plans and potentially other covered entities would be barred from enforcing step therapy protocols for certain cancer medications.
  • Standards for coverage decisions: Creates expectations that patients and providers should not be impeded by step therapy when selecting applicable oncologic therapies.
  • Scope of applicability: Likely targets health plans, insurers, or coverage administrators operating within Wisconsin, affecting how cancer drugs are approved and reimbursed.
  • Exceptions or safeguards: The bill’s text (as typical in such proposals) may include limited exceptions (e.g., safety concerns, clinical exceptions, or emergency use) but would need to be reviewed to confirm. The available information does not specify exact carve-outs.
  • Enforcement and penalties: The bill would establish enforcement mechanisms and potential remedies for violations (e.g., state regulatory action, reporting requirements), though specifics are not provided in the summary materials available.

Who would be affected

  • Cancer patients and their treatment providers: Individuals seeking access to cancer drugs would be protected from being forced to undergo less optimal therapy first.
  • Health plans and insurers operating in Wisconsin: Entities that authorize, deny, or require step therapy protocols for covered cancer medications.
  • Pharmacy benefit managers (PBMs) and covered entities: Organizations involved in formulary management and prior authorization processes for oncology drugs.
  • Healthcare providers: Physicians and oncology specialists who would have greater flexibility to prescribe the most appropriate cancer drugs without step therapy barriers.

Procedural and timeline aspects

  • Introduction and referrals: AB 774 was introduced on December 17, 2025, with initial referral to the Assembly Committee on Health, Aging and Long-Term Care.
  • Sponsorship: The bill has multiple sponsors from both the primary and co-sponsor lists, including Representatives Subeck, Joers, Arney, Bare, Clancy, DeSmidt, Johnson, Phelps, Roe, Spaude, Stroud, Stubbs, Tenorio, Palmeri, and others; Senators were listed as cosponsors.
  • Status as of the provided information: The bill was referred to committee following its introduction, with no final passage data available in the provided materials. The action history notes a legislative step “Failed to pass pursuant to Senate Joint Resolution 1” dated March 23, 2026, which may indicate a procedural outcome not fully explained in the summary context. Please verify the current status in the latest legislative record.

Practical impact and considerations

  • Access to cancer therapy: If enacted, the bill would likely improve timely access to effective cancer drugs by removing barriers associated with step therapy.
  • Cost vs. care balance: Insurers might face higher upfront costs for oncology drugs; the bill shifts emphasis toward clinical appropriateness and patient welfare.
  • Implementation: Health plans would need to adjust prior authorization policies, formulary rules, and documentation practices to align with the prohibition on step therapy for specified cancer drugs.

If you’d like, I can pull the exact legislative text or committee amendments to provide more precise language on exceptions, scope, and enforcement mechanisms.

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

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