On May 6, the Wisconsin Legislature’s Joint Committee on Finance sent a memo to their members detailing all of the budget items included in Wisconsin Governor Tony Evers’ Fiscal Year 2025-2027 budget request that they intend to remove from further consideration by the committee.  The committee took this up as one vote at their first executive session addressing the FY2025-2027 budget, which occurred on Thursday, May 8 in Madison. 

As Republicans hold a 12-4 majority on this committee, the committee voted to remove these budget items.  However, it is important to note that even if certain budget items from the Governor’s budget request remained in the budget bill after this vote, a majority of committee members would still need to vote to approve including those budget items in the committee’s version of the budget bill.  Those votes will occur at committee meetings on various dates in the future, as the committee considers different state agency budget items.  In addition, the Joint Committee on Finance can offer their own budget amendments to different state agencies.   

The committee removed over 600 budget items from Governor Evers’ budget request, including the following budget items likely of interest to WiAHC members:

Office of the Commissioner of Insurance

• Exemptions from Prior Authorization Requirements
• Authorize the Insurance Commissioner to provide, by administrative rule, that any health benefit plan or self-insured health plan that uses a prior authorization process shall exempt health care providers from obtaining prior authorizations for a health care item or service for a period of time established by the Commissioner if, in the most recent evaluation period, the health benefit plan or self-insured health plan has approved or would have approved a proportion of prior authorization requests submitted by the health care provider for the health care item or service that is not less than a benchmark threshold specified by the Commissioner.

• Prior Authorization Restrictions and Disclosure Requirements
• Specify that the clinical review criteria used by any health care plan for any prior authorization requirement or restriction must: (a) be based on nationally recognized, generally accepted standards except where provided by law; (b) be developed in accordance with the current standards of a national medical accreditation entity; (c) ensure quality of care and access to needed health care services; (d) be evidence-based; (e) be sufficiently flexible to allow deviations from current standards when justified; and (f) be evaluated and updated when necessary and no less frequently than once every year.