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Wisconsin Legislature: AB774: Bill Text
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AB774: Bill Text
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2025 - 2026 LEGISLATURE
LRB-0080/1
EKL:cdc
2025 ASSEMBLY BILL 774
December 17, 2025 - Introduced by Representatives
Subeck
,
Joers
,
Arney
,
Bare
,
Clancy
,
DeSmidt
,
Johnson
,
Phelps
,
Roe
,
Spaude
,
Stroud
,
Stubbs
,
Tenorio
and
Palmeri
, cosponsored by Senators
Hesselbein
,
L. Johnson
,
Jacque
,
Ratcliff
and
Spreitzer
. Referred to Committee on Health, Aging and Long-Term Care.
AB774,1,3
1
An Act
to renumber
632.866 (1) (a);
to create
632.866 (1) (ag), 632.866 (1)
2
(cm) and 632.866 (2m) of the statutes;
relating to:
prohibiting step therapy
3
protocols for certain cancer drugs.
Analysis by the Legislative Reference Bureau
This bill prohibits an insurer, pharmacy benefit manager, or utilization review organization from requiring a step therapy protocol for a drug that is prescribed for metastatic cancer or a cancer-associated condition and the use of the drug is approved by the federal Food and Drug Administration, consistent with best practices for the treatment of metastatic cancer or the cancer-associated condition, and supported by peer-reviewed publications that are based on evidence-based research. A step therapy protocol, as defined in current law, establishes a specific sequence in which medically appropriate prescription drugs are covered by a policy or plan. Current law requires insurers, pharmacy benefit managers, and utilization review organizations to use clinical review criteria for establishing a step therapy protocol that are based on clinical practice guidelines that meet certain specific criteria and to provide access to a process to request an exception to the step therapy protocol.
The people of the state of Wisconsin, represented in senate and assembly, do enact as follows:
AB774,1
1
Section
1
.
632.866 (1) (a) of the statutes is renumbered 632.866 (1) (ar).
AB774,2
2
Section
2
.
632.866 (1) (ag) of the statutes is created to read:
AB774,2,6
3
632.866
(1)
(ag) “Cancer-associated condition” means any symptom or side
4
effect that is associated with metastatic cancer or the treatment of metastatic
5
cancer and that, in the judgment of a health care provider, further jeopardizes the
6
health of a patient if left untreated.
AB774,3
7
Section
3
.
632.866 (1) (cm) of the statutes is created to read:
AB774,2,10
8
632.866
(1)
(cm) “Metastatic cancer” means cancer that has spread from the
9
primary or original site of the cancer to nearby tissues, lymph nodes, or other areas
10
or parts of the body.
AB774,4
11
Section
4
.
632.866 (2m) of the statutes is created to read:
AB774,2,15
12
632.866
(2m)
Step therapy protocol prohibited.
An insurer, pharmacy
13
benefit manager, or utilization review organization may not require a step therapy
14
protocol for a drug that is prescribed for metastatic cancer or a cancer-associated
15
condition and the use of the drug is all of the following:
AB774,2,16
16
(a) Approved by the federal food and drug administration.
AB774,2,18
17
(b) Consistent with best practices for the treatment of metastatic cancer or the
18
cancer-associated condition.
AB774,2,20
19
(c) Supported by peer-reviewed publications that are based on evidence-based
20
research.
AB774,2,21
21
(end)
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