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Wisconsin Watch partners with Gigafact to produce fact briefs — bite-sized fact checks of trending claims. Read our methodology to learn how we check claims.

No.

Experts said they know of no states that routinely audit insurance companies over denying health care claims.

Wisconsin Gov. Tony Evers said Feb. 18 he wants to make his state the first to audit based on high rates of claim denials and do “corrective action” enforced through fines. 

The Wisconsin insurance commissioner’s office and experts from the KFF health policy nonprofit and Georgetown University said they know of no states using claim denial rates to trigger audits.

The National Association of Insurance Commissioners and the national state auditors association said they do not track whether states do such auditing.

ProPublica reported in 2023 it surveyed every state’s insurance agency and found only 45 enforcement actions since 2018 involving denials that violated coverage mandates.

Forty-five percent of U.S. adults surveyed in 2023 said they were billed in the past year for a medical service they thought should have been free or covered by their insurance.

This fact brief is responsive to conversations such as this one.

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Tom Kertscher joined Wisconsin Watch as a full-time Milwaukee-based reporter in October 2024 after starting as a freelance Fact Briefs reporter in January 2023. In addition to contributing to Wisconsin Watch’s collaboration with The Gigafact Project to combat online misinformation, he reports on Wisconsin policy, labor, energy and the rapid expansion of data centers across the state. Kertscher is a former longtime reporter at the Milwaukee Journal Sentinel, a contributing writer for Milwaukee Magazine and the author of two sports books, on Al McGuire and Brett Favre.