TUE AM News: Legislation would create new state office for reviewing claim denials; Exact Sciences reports $878M in Q4 revenues

February 17, 2026

— Circulating legislation would set new requirements for health insurers while creating a state office tasked with reviewing claim denials, among other responsibilities.

Sen. Dora Drake, D-Milwaukee, and Rep. Clinton Anderson, D-Beloit, recently sent a co-sponsorship memo on LRB-6396, which would establish the Office of the Public Intervenor under the state Office of the Commissioner of Insurance.

Authors describe it as a “public health aide” that would help Wisconsinites with claims, policies, appeals and other legal actions related to health insurance coverage. Anyone with coverage would have the right to request a review of any health insurance claim denial from the new office, in addition to existing independent review rights provided by state law.

Plus, the office would be authorized under the bill to levy an assessment on insurance providers based on their health insurance premium volume, according to an overview from the Legislative Reference Bureau.

In the memo, bill authors argue no one in the state should have to delay their health care due to “misleading” health insurance practices. They say claim denials often come with vague reasoning and in some cases lack “tangible justification” altogether.

“Worst of all, artificial intelligence is increasingly used to decide whether or not a claim should be denied,” they wrote. “The people of Wisconsin deserve honesty, from legislators and insurers alike.”

One provision of the bill would require insurers to publish an annual report on claim denials for health insurance policies, including their use of AI or other “algorithmic decision-making” in processing these claims. They would generally have to disclose the use of these technologies under another provision.

“This bill dramatically increases insurer transparency via mandatory AI or algorithmic decision-making reporting, if used at any point during the insurance claim process,” authors wrote.

OCI would also have to keep a public database of insurers’ claim denial rates and the findings of related independent reviews.

The legislation would create new requirements for health insurers, such as having them process claims “within a reasonable time frame” to prevent care delays and provide detailed explanation of denials.

Plus, it would bar them from using “vague or misleading terms” in denying claims, stalling claim reviews to avoid timely payments, allowing non-physicians to determine if care is medically necessary, mandating prior approval in a way that causes “harmful delays” and more.

The co-sponsorship deadline is Friday.

See the bill text.

— Exact Sciences had $878 million in revenue in the fourth quarter of 2025, marking a 23% increase over the same period of 2024.

The Madison-based diagnostics company recently released its latest financial performance figures, which shows revenue from screening alone was $695 million for the quarter, an increase of 26% over the year. It also had $183 million in precision oncology revenue, up 14% on a reported basis.

Looking at the year overall, the business reports $3.25 billion in 2025 revenues, touting an 18% increase. That total included $2.53 billion in screening revenue and $717 million in precision oncology revenue.

Meanwhile, fourth-quarter net loss was $86 million, compared to $49.8 million in the fourth quarter of 2024. For the full year, net loss was $208 million, which Exact Sciences says is an improvement of $821 million.

Exact Sciences Chairman and CEO Kevin Conroy noted the company launched three new tests in 2025 while screening more people for cancer and guiding more personalized treatment decisions. In a statement on the financial report, he said momentum is building for the business.

“Our core products are driving strong growth, our portfolio is expanding, and we are uniquely positioned to drive lasting change in the way cancer is found and treated globally,” he said.

See the release.

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— The Sustainable Business Council is launching a free six-month accelerator program for Green Bay-area businesses.

The program has space for up to 10 small to mid-sized businesses, according to yesterday’s announcement. It’s meant to help participants boost their sustainability practices and reduce their footprint, with “nature-based solutions” such as green stormwater infrastructure.

Cohort businesses will get coaching on greenhouse gas and energy management, waste reduction practices, water stewardship and biodiversity, as well as access to tools for measuring and managing environmental impacts.

They’ll also get planning support for at least one project that aligns with the city’s Clean Energy Green Bay and Green Stormwater Infrastructure plans.

The group is accepting applications through March 27, and the program runs from early April to late June, with implementation support from July to September.

See more and apply here.

— Milwaukee-area groups are launching a new program to prepare high school students for the workforce, with a focus on AI readiness.

Employ Milwaukee, the Milky Way Tech Hub and United Neighborhood Centers of Milwaukee yesterday rolled out the four-week afterschool program, which will teach students about AI tools and other technology used in the workforce.

The curriculum covers resume building, interviewing, organization and productivity, as well as cybersecurity and more, according to yesterday’s release. The inaugural cohort will run March 2-26.

Julie Cayo, president and CEO of Employ Milwaukee, calls the effort a “proactive, community-driven response” that will help local young people compete in the workforce.

“As AI and automation continue to reshape industries, our region must invest in the skills that tomorrow’s jobs will demand,” Cayo said in a statement.

See the release and get more program details.

— This year’s Wisconsin Economic Forecast Luncheon is being held April 29 in Madison, featuring Robert Dietz of the National Association of Home Builders as a keynote speaker.

WisPolitics-State Affairs, WisBusiness and the Wisconsin Bankers Association are partnering on the annual event, which explores national and state economic trends.

In addition to Dietz, the chief economist and senior vice president for economics and housing policy for NAHB, the event will include remarks by Tim Schneider, president and CEO of Bank Five Nine in Oconomowoc. An economist from the state Department of Workforce Development will also deliver remarks.

See event details and register here.

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TOPICS

AGRIBUSINESS

– Wisconsin Corn-Soy Expo drew strong Midwest attendance

ENVIRONMENT

– ‘Only in Wisconsin’: Lake Winnebago’s first legal bar opens for sturgeon spearing season

– Lake Winnebago sturgeon spearing opens with 1,029 caught

– Pollution from Chicago area bumps Milwaukee’s air quality down to moderate

HEALTH CARE

– New measles case identified in out-of-state traveler who visited Madison