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WI SB703
Bill
Status
12/2/2025
Primary Sponsor
Rob Hutton
Click for details
AI Summary
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Requires contracts between plan sponsors (employers) and benefit plan administrators, large group health insurers, or pharmacy benefit managers to specify that the plan sponsor owns all claims data, which cannot be sold without permission from both the plan sponsor and the individual
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Mandates administrators and insurers provide claims data, payment information, fees, discounts, broker compensation, and medical records within 7 business days of written request, with plan sponsors allowed up to 3 requests per year covering up to 24 months of data
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Requires pharmacy benefit managers to disclose within 7 business days amounts paid to pharmacies, prescription drug rebates by drug and therapeutic category, and all revenue and fees derived from the contract including manufacturer remuneration
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Defines "high-cost claims" as those exceeding $25,000 for medical claims or $10,000 for pharmacy claims, with itemized billing and medical records required before payment upon request
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Prohibits administrators, insurers, and pharmacy benefit managers from charging fees beyond reasonable expenses or imposing conditions restricting data access, and bars modification or withholding of information when requesters attest to federal law compliance
Legislative Description
Plan sponsors’ right to access claims data.
Last Action
Available for scheduling
1/9/2026