Senate Bill 901 aims to establish a cost-sharing cap on insulin for health insurance policies and governmental self-insured health plans in Wisconsin. Specifically, the bill prohibits these plans from imposing cost-sharing amounts on insulin that exceed $35 for a one-month supply. This new provision is introduced as section 632.895 (6) (b), which defines cost-sharing and clarifies that while plans may impose lower costs, they are not required to impose any cost-sharing on insulin. The bill also amends existing statutes to ensure that the coverage for insulin is distinct from other diabetes treatments, which may still be subject to standard exclusions, limitations, deductibles, and coinsurance.

Additionally, the bill renumbers and amends existing provisions related to diabetes treatment coverage, including the title of section 632.895 (6) to explicitly mention insulin. It also clarifies that the coverage for insulin infusion pumps and other diabetes-related supplies remains subject to certain limitations. The proposed changes are intended to enhance access to insulin for individuals with diabetes by reducing their out-of-pocket costs, thereby addressing a critical healthcare need in the state.

Statutes affected:
Bill Text: 609.83, 632.895(6)(title), 632.895