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Wisconsin Legislature: SB1136: Bill Text
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SB1136: Bill Text
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2025 - 2026 LEGISLATURE
LRB-6541/1
EKL:cdc
2025 SENATE BILL 1136
March 19, 2026 - Introduced by Senators
Hesselbein
,
Larson
and
Ratcliff
, cosponsored by Representatives
Joers
,
Bare
,
Brown
,
Clancy
,
DeSmidt
,
Hysell
,
Sinicki
and
Stubbs
. Referred to Committee on Insurance, Housing, Rural Issues and Forestry.
SB1136,1,4
1
An Act
to amend
40.51 (8), 40.51 (8m), 66.0137 (4), 120.13 (2) (g) and 185.983
2
(1) (intro.);
to create
609.823 and 632.851 of the statutes;
relating to:
prior
3
authorization for treatment of severe misalignment or malocclusion of teeth
4
under health insurance policies and plans.
Analysis by the Legislative Reference Bureau
This bill prohibits health insurance policies and self-insured governmental health plans that provide coverage for dental and related expenses from solely relying upon the Salzmann Evaluation Index in making prior authorization decisions for the coverage of any treatment of severe misalignment or malocclusion of teeth. Health insurance policies are referred to as disability insurance policies in the bill.
The people of the state of Wisconsin, represented in senate and assembly, do enact as follows:
SB1136,1
5
Section
1
.
40.51 (8) of the statutes is amended to read:
SB1136,2,4
6
40.51
(8)
Every health care coverage plan offered by the state under sub. (6)
1
shall comply with ss. 631.89, 631.90, 631.93 (2), 631.95, 632.72 (2), 632.722,
2
632.729, 632.746 (1) to (8) and (10), 632.747, 632.748, 632.798, 632.83, 632.835,
3
632.85,
632.851,
632.853, 632.855, 632.861, 632.867, 632.87 (3) to (6), 632.885,
4
632.89, 632.895 (5m) and (8) to (17), and 632.896.
SB1136,2
5
Section
2
.
40.51 (8m) of the statutes is amended to read:
SB1136,2,9
6
40.51
(8m)
Every health care coverage plan offered by the group insurance
7
board under sub. (7) shall comply with ss. 631.95, 632.722, 632.729, 632.746 (1) to
8
(8) and (10), 632.747, 632.748, 632.798, 632.83, 632.835, 632.85,
632.851,
632.853,
9
632.855, 632.861, 632.867, 632.885, 632.89, and 632.895 (11) to (17).
SB1136,3
10
Section
3
.
66.0137 (4) of the statutes is amended to read:
SB1136,2,17
11
66.0137
(4)
Self-insured health plans.
If a city, including a 1st class city,
12
or a village provides health care benefits under its home rule power, or if a town
13
provides health care benefits, to its officers and employees on a self-insured basis,
14
the self-insured plan shall comply with ss. 49.493 (3) (d), 631.89, 631.90, 631.93 (2),
15
632.722, 632.729, 632.746 (10) (a) 2. and (b) 2., 632.747 (3), 632.798, 632.85,
16
632.851,
632.853, 632.855, 632.861, 632.867, 632.87 (4) to (6), 632.885, 632.89,
17
632.895 (9) to (17), 632.896, and 767.513 (4).
SB1136,4
18
Section
4
.
120.13 (2) (g) of the statutes is amended to read:
SB1136,2,22
19
120.13
(2)
(g) Every self-insured plan under par. (b) shall comply with ss.
20
49.493 (3) (d), 631.89, 631.90, 631.93 (2), 632.722, 632.729, 632.746 (10) (a) 2. and
21
(b) 2., 632.747 (3), 632.798, 632.85,
632.851,
632.853, 632.855, 632.861, 632.867,
22
632.87 (4) to (6), 632.885, 632.89, 632.895 (9) to (17), 632.896, and 767.513 (4).
SB1136,5
23
Section
5
.
185.983 (1) (intro.) of the statutes is amended to read:
SB1136,3,7
24
185.983
(1)
(intro.) Every voluntary nonprofit health care plan operated by a
1
cooperative association organized under s. 185.981 shall be exempt from chs. 600 to
2
646, with the exception of ss. 601.04, 601.13, 601.31, 601.41, 601.42, 601.43, 601.44,
3
601.45, 611.26, 611.67, 619.04, 623.11, 623.12, 628.34 (10), 631.17, 631.89, 631.93,
4
631.95, 632.72 (2), 632.722, 632.729, 632.745 to 632.749, 632.775, 632.79, 632.795,
5
632.798, 632.85,
632.851,
632.853, 632.855, 632.861, 632.867, 632.87 (2) to (6),
6
632.885, 632.89, 632.895 (5) and (8) to (17), 632.896, and 632.897 (10) and chs. 609,
7
620, 630, 635, 645, and 646, but the sponsoring association shall:
SB1136,6
8
Section
6
.
609.823 of the statutes is created to read:
SB1136,3,11
9
609.823 Prior authorization for treatment of severe misalignment or
10
malocclusion of teeth.
Limited service health organizations, preferred provider
11
plans, and defined network plans are subject to s. 632.851.
SB1136,7
12
Section
7
.
632.851 of the statutes is created to read:
SB1136,3,14
13
632.851 Prior authorization for treatment of severe misalignment or
14
malocclusion of teeth. (1)
In this section:
SB1136,3,15
15
(a) “Disability insurance policy” has the meaning given in s. 632.895 (1) (a).
SB1136,3,16
16
(b) “Self-insured health plan” has the meaning given in s. 632.85 (1) (c).
SB1136,3,20
17
(2)
No disability insurance policy or self-insured health plan that provides
18
coverage for dental and related services may solely rely upon the Salzmann
19
Evaluation Index in making prior authorization decisions for the coverage of any
20
treatment of severe misalignment or malocclusion of teeth.
SB1136,8
21
Section
8
. Initial applicability.
SB1136,3,24
22
(
1
) For policies and plans containing provisions inconsistent with this act, this
23
act first applies to policy or plan years beginning on the effective date of this
24
subsection, except as provided in sub. (2).
SB1136,4,5
1
(
2
) For policies and plans that are affected by a collective bargaining
2
agreement containing provisions inconsistent with this act, this act first applies to
3
policy or plan years beginning on the effective date of this subsection or on the day
4
on which the collective bargaining agreement is newly established, extended,
5
modified, or renewed, whichever is later.
SB1136,9
6
Section
9
. Effective date.
SB1136,4,8
7
(
1
) This act takes effect on the first day of the 4th month beginning after
8
publication.
SB1136,4,9
9
(end)
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true
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true
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