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 expertsfrom the KFF health policy nonprofit and Georgetown University saidthey 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.
Protesters march in Milwaukee calling for more community control of the police. (Photo by Isiah Holmes/Wisconsin Examiner)
What has become of the city of Milwaukee’s Fire and Police Commission (FPC) since the passage of Act 12, which traded its policy-making powers over the police department for a fiscal deal with the state? That’s the question the Milwaukee Turners’ – described as Milwaukee’s oldest civic group – sought to answer with hard data.
From June to December 2024, the Turners’ “Confronting Mass Incarceration team” monitored the FPC – itself one of the nation’s oldest civilian-led oversight bodies for police and fire departments. The team monitored the FPC’s meetings, who attended, what attendees did, and how commissioners engaged in the meetings. A white paper published earlier this month, detailing the team’s findings, noted among other things that:
The FPC spent 81% of its time discussing personnel matters, and often discussed these during closed sessions which the public cannot view. The Turners noted 359 minutes were spent discussing personnel matters, whereas just 49 minutes were spent on public comment.
The Turners noticed what they described in the white paper as “an overall lack of active engagement and participation from commissioners.”
Law enforcement personnel attended FPC meetings more frequently than members of the general public. During the monitoring period, 30 police personnel attended meetings whereas 20 members of the public attended. Of those members of the public who attended the meetings, half engaged in public comment and of those, only three received a direct response from commissioners.
The report states the FPC “appears to serve as a rubber stamp” and that the commission “has failed to secure public trust.” Dr. Emily Sterk, a research and advocacy associate with Milwaukee Turners who worked on the project, explained why the numbers looked the way they do. While citizens can discuss whatever they want during public comment, commissioners can’t discuss anything that isn’t on the agenda due to open meetings laws. “So therefore they just have this practice to, you know, have public comment but then not even address the public that is there,” Sterk told Wisconsin Examiner.
While she understands the legal reason for this practice, Sterk said, “that is, for us, subjectively very troubling when a member of the public makes the time and effort to get themselves down there, go to this meeting which – as we alluded to in the white paper – the regular sessions are very frequently heavily delayed because of the closed sessions that are taking place.” As a result, the commission ends up engaging in back-and-forth discussions with city officials and law enforcement more frequently than the public, whose comments may be left unheard.
The Wisconsin Examiner’s Criminal Justice Reporting Project shines a light on incarceration, law enforcement and criminal justice issues with support from the Public Welfare Foundation.
Leon Todd, executive director of the FPC, told Wisconsin Examiner that personnel matters such as promotions, hiring or setting recruitment standards “are extremely important.” Todd added, “I don’t think it is necessarily problematic that the FPC spends a goodly amount of time on that. It is part of their core functions. It’s been part of their core responsibilities for more than 150 years…Since 1885 no person has been appointed or promoted to any position in the police or fire departments without the express approval of the FPC board.”
Yet even this function of the FPC has come under fire. In January, the commission was criticized by conservative elected officials, right-wing media outlets and the Milwaukee Police Association after an officer was denied promotion. WISN12 reported that the FPC considered promotions for seven officers, and only denied officer Jason Daering. A couple of weeks later in early February, the FPC reversed its position and voted to promote Daering to sergeant. Prior to the final vote, FPC co-chair Bree Spencer said that the police department didn’t provide a full file, that Daering did not appear for an interview and was unprepared. “So we really encourage, going forward, that people take this process seriously,” said Spencer.
The commission’s voting record was another issue for the Milwaukee Turners. In their report, the group noted that over its monitoring period last year, the FPC took up 122 agenda items, of which 120 received unanimous approval. Only two agenda items – one involving the promotion of a detective and another concerning reappointing a former police officer – received No votes, with both items receiving two No votes. “Given the current practices of the FPC, including closed sessions and lack of Commissioner participation during regular sessions, the public is left unaware of why these aye or no votes were made,” the report states. “We observed an overall lack of transparency when it comes to Commissioners’ voting records. Even if Commissioners are actively participating in deliberation and debate during closed sessions, the public has no way of knowing this.”
Todd also pushed back against the Milwaukee Turners’ claim that the FPC has become a rubber stamp. Harkening back to the pre-Act 12 era Todd, who was appointed by former mayor Tom Barrett in November 2020, recalled the FPC’s record of pushing for police reform measures “that the [police] department did not agree with.” From a ban on chokeholds and no-knock warrants, to approving a policy of publicly releasing video of incidents like police shootings within 15 days of the incident. Those decisions – made when the FPC was led by Chairman Ed Fallone and Vice Chairwoman Amanda Avalos – were “probably, if not the reason, a big reason why the Legislature took away [FPC’s] policy-making authority, because they were acting independently and listening to community members from Milwaukee,” Todd told Wisconsin Examiner.
A Milwaukee police squad in front of the Municipal Court downtown. (Photo | Isiah Holmes)
After the passage of Act 12 in 2023, Fallone and Avalos resigned their positions in protest. Stripping the FPC of its decades-old policy-making powers emerged as a bargaining chip in negotiations between Milwaukee elected officials and the Republican-controlled Legislature. In exchange for targeting the FPC, reversing the Milwaukee Public School district decision to remove school resource officers from its facilities at the request of students and community members, and agreeing to never reduce the police force, Milwaukee was allowed to raise its sales tax which allowed the county to avoid a fiscal catastrophe. Act 12’s law enforcement aspects had previously been proposed as bills favored by Republican lawmakers and the Milwaukee Police Association, which failed to pass.
For the FPC, it seems that many roads lead back to the shared revenue and sales tax deal codified by Act 12. In its report, Milwaukee Turners recommended that Act 12 be amended to return the policy-making powers of the FPC. This state-level solution, however, relies on cooperation from the Republican-controlled Legislature which helped craft, negotiate, and implement Act 12.
Protesters gather at the Milwaukee County Courthouse to call for transparency in the death of Breon Green. (Photo | Isiah Holmes)
In the meantime, the Turners recommend that the FPC bring ideas for policy changes to the common council. “We recommend that the FPC dedicate less of their regular sessions to closed door personnel matters, and instead publicly engage in discussions about new and amended [Standard Operating Procedures] that are brought forth by the [Milwaukee Police Department],” the report reads, adding that “the Common Council might actively invite policy recommendations from the FPC, especially as it relates to the concerns of their constituents.”
Todd told Wisconsin Examiner that the commission adopted a new rule requiring that the police department provide copies of any new or amended policies to the FPC within 48 hours, and no less than 30 days before the policies take effect. When that happens, a communication file is created by the FPC which goes into the regular agenda, and thus becomes public. Todd said that so far, the commission has not sent policy recommendations to the common council.
Todd is considering other ways to beef up the FPC’s oversight capacity. Specifically, he wants to encourage a focus on the FPC’s audit unit as a way of being “more proactive” and “not just reactive.” Todd pointed to an audit on police pursuits, and the police department, Todd said, is also looking to create a vehicle pursuit committee. The commission also continues tracking citizen complaints about officer behavior, as well as progress the department makes in eliminating discriminatory stop and frisk practices as part of the Collins settlement agreement. This year, the audit unit is expecting to do six or seven audits which are unrelated to the Collins settlement, said Todd.
Additionally, an ordinance passed in the common council to ensure the elected body is quickly notified of policy changes.
How the commission attracts more members of the public to attend meetings is another issue. Todd acknowledged that there have been fewer citizens attending public comment after the passage of Act 12. “I think that’s unfortunate,” he told Wisconsin Examiner. “I think that we welcome people to come and express their views, their input.”
Milwaukee police officers on the scene of an officer-involved shooting at King Park in 2024. (Photo by Isiah Holmes/Wisconsin Examiner)
The last major policy he could recall passed before Act 12 was the video release policy concerning police shootings and related deaths. Local activists fought for the reform, as did the families of people killed in incidents involving Milwaukee-area police.
Todd said that the FPC still has “soft power” such as through audits, which it can use to influence the police department. “So I’m hoping that we will get more public input going forward,” he said, noting that FPC recently welcomed in a new commissioner, Krissie Fung, from the Milwaukee Turners.
“Our findings highlight the importance of fostering a culture of police and fire accountability within the FPC,” the Turners’ white paper concludes. “By advocating for legislative changes to restore policy making authority, increasing public engagement, and ensuring rigorous Commissioner participation, the FPC can rebuild public confidence and strengthen its capacity to address systemic inequalities in policing.”
“We really hope to continue to provide civilian oversight of the FPC and see what happens over the course of the next few months,” said Sterk, “especially as we continue our lobbying for the amendment of Act 12, as we hope members of the FPC and members of the public do as well.”
Gov. Tony Evers ordered the two audits into Milwaukee Public Schools in 2024. Evers meets children at a Dane County child care center in 2023. (Erik Gunn | Wisconsin Examiner)
An audit released Thursday found that Milwaukee Public Schools faces challenges due to declining enrollment, competitive school-choice dynamics, a teacher shortage and staff turnover as well as a “culture of fear” and resistance to change. The district needs to make systemic changes, the audit found, in order to adequately support its students, especially those who are the most vulnerable.
The operational audit was ordered by Gov. Tony Evers after news broke that the district has been excessively late in submitting required financial documents to the Department of Public Instruction. The crisis led to the resignation of Keith Posley as MPS superintendent and the state Department of Public Instruction withholding $16.6 million from the district.
The independent audit, conducted by MGT of America Consulting LLC, is the first of two ordered by Evers, who formerly served as state superintendent and as a public school teacher. The second, ongoing audit is meant to examine the effectiveness of teaching and instruction in classrooms.
“This audit is a critical next step for getting MPS back on track and, ultimately, improving outcomes for our kids,” Evers said in a statement. “I urge and expect the district to take these recommendations seriously and move forward quickly with implementing this audit’s findings.”
Evers allocated $5.5 million from federal American Rescue Plan funds for the audits and said there is a remaining $3 million that will go towards ensuring the district can start implementing the recommendations.
Evers said that he will also propose allocating an additional $5 million in his 2025-27 budget to provide ongoing support to address audit results and implement audit recommendations, though he would need the Republican-led Legislature to allocate the money. The money would only be awarded to the district if the state thinks MPS has made substantial and sufficient progress implementing the audit recommendations.
“MPS must make systemic changes to ensure that students — particularly the most vulnerable — are at the center of every decision,” auditors wrote. “Ultimately, this work is in service of students, whose future success hinges on a district capable of delivering equitable, high-quality education.”
The audit acknowledged that “proficiency rates sit at just 9% in math and 12% in reading, far below state and national averages, signaling a systemic failure to prioritize student outcomes.”
The audit identified internal and external factors that have contributed to the challenges the district has faced.
Internal factors included leadership instability, including a series of superintendents with short tenures and revolving leaders, a “culture of fear and reluctance to change,” high turnover and recruitment challenges, ineffective reporting protocols that have hindered accountability and financial mismanagement, lack of honesty, transparency and ineffective public communications that have contributed to a lack of public trust.
External factors included stalled population growth and enrollment declines, “competitive school-choice dynamics,” national teacher and staff shortages, MPS students who face significant economic challenges and outdated facilities that have made it difficult to maintain healthy, safe and adequately equipped learning environments.
“These challenges, coupled with outdated facilities and a history of financial mismanagement, have eroded public trust and disproportionately affected the District’s most vulnerable students,” auditors wrote.
The audit laid out goals that the district should prioritize that include creating a “coherent central system,” “fostering meaningful communication and collaboration across departments within the District” and operating and funding strategically by investing in strategies and systems that prepare the District for financial sustainability, operational efficiency and long-term success.
Some of the specific recommendations include hiring a chief communications officer and chief operations officer, restructuring the central office to clarify roles, investing in the Office of Human Resources, redesigning employee reporting processes, investing in training for the Department of Research, Assessment and Data, continuing to use support offered by DPI and improving collaboration between the MPS Board of Directors and district leadership.
MPS said in a press release that the audit “validates the progress we are making while also serving as a guide for continued improvements.”
“It highlights the strength of our existing systems and the dedication behind key initiatives, reinforcing the steps we have taken to move our students forward. At the same time, it identifies areas for growth, reaffirming our commitment to continuous improvement,” MPS stated. “While acknowledging the need for focused support, the report makes clear that we have an opportunity to build on this momentum, strengthening our schools and communities while creating a more unified path forward.”
DPI Superintendent Jill Underly said in a statement that the audit “offers a clear and practical blueprint for getting the district back on course, ensuring it better serves students and families.”
Underly said she was optimistic that the district would turn the recommendations into “meaningful change” with the leadership of Brenda Cassellius, who was selected this week by the Board to be the new MPS superintendent and previously served as superintendent of Boston Public Schools and commissioner of education in Minnesota.
“This report also underscores the importance of the DPI’s ongoing efforts to support MPS in financial reporting, including the development of a Corrective Action Plan. These efforts are both realistic and essential for helping the district regain compliance and thrive,” Underly said.
Underly accepted the 2024 Diversity Award from the State Council on Affirmative Action on behalf of her agency. (Screenshot via Wisconsin DOA YouTube)
Department of Public Instruction Superintendent Jill Underly became tearful Friday while speaking about a friend she knew in high school, who was kicked out of her home after coming out as gay to her parents.
“Her parents were furious. They said it went against everything they believed, everything they hoped for her, and when she started to cry her dad said, ‘I want you to give us the key’ and she said, ‘My key? My key to my car?’ and her mom chimed in and said, ‘No, the key to our house.’” Underly said, adding that the friend had to stay on another friend’s couch.
“When I saw her at school, she was so tired and worried. She said she missed her dog. She missed her bed. She missed her brother,” Underly said. “What this story teaches us is the critical lesson — inclusion begins at home. Our families play a critical role in fostering an environment of love and acceptance for everyone and other identities. But what about our schools? What about our teachers?”
Underly was accepting the 2024 Diversity Award from the State Council on Affirmative Action on behalf of her agency. She noted that many Wisconsin children are continuing to deal with mental health challenges with students of color and LGBTQ+ students facing disproportionate challenges.
“There’s so many kids who cannot be themselves at home, so they see school as that safe place of belonging,” Underly said.
The council established the Diversity Award in 2000 to “recognize state agencies, Wisconsin Technical Colleges and UW campuses for their strong commitment to the recruitment, retention and promotion of a diverse workforce as measured by the creation of programs, initiatives and practices.”
This year DPI received the award because of its work on its 2024-26 Equity and Inclusion Strategic Plan. The agency developed the plan in accordance with Executive Order 59, which Gov. Tony Evers signed in 2019. The order requires state agencies to create equity and inclusion plans and other strategic plans, analyze how much is spent by agencies for DEI activities, including for staffing, and review reported outcomes resulting from DEI activities.
DPI’s plan laid out the current status of diversity of the agency and laid out specific goals and actions that it could take to improve equity and inclusion, including addressing disparities throughout its hiring process, improving retention of staff from underrepresented and historically marginalized groups and fostering an inclusive community and creating a culture that is “respectful, free of bias and where accountability is present at all levels of the agency.”
“While a significant portion of public school students identify as being of color or of mixed races, a much smaller percentage of DPI staff and teachers reflect this diversity. Addressing this imbalance is vital,” the plan states. “To effectively serve all students, especially those from historically marginalized groups, it is crucial to enhance staff diversity throughout the educational system, from the DPI down to individual classrooms.”
The plan notes that among 576 permanent DPI employees in 2021-2023, an average of 11% were staff of color, 18% had disabilities and 3% were veterans.
One way the agency could improve its workforce diversity is by increasing outreach to and visibility of the state application and hiring process for DPI positions, the plan suggests.
Underly thanked Gov. Tony Evers for his dedication to diversity, equity and inclusion in her speech and said the award is a “testament to the dedicated efforts that the team at DPI, who built and continue to implement our equity and inclusion plan with passion and purpose.”
“We aren’t afraid of the politics, and we will support diversity. We will support equity. We will support inclusion and we will support belonging for employees, for our teachers across the state and for every single child,” Underly said.
The celebration of the agency’s DEI efforts comes in a year when efforts to foster diversity have been increasingly targeted by Republicans in the state. In May, Republicans launched an audit to look at DEI initiatives throughout state government, including to determine specific activities that are being performed in compliance with Executive Order 59.
At the time, Sen. Eric Wimberger (R-Green Bay) called DEI a “neo-Marxian philosophy meant to pit one socially-constructed class against another,” and said that Evers’ executive order “divided Wisconsinites into identity groups against each other’s benefit.”
DPI’s interim communications director Chris Bucher told the Examiner in an email Friday that it “would probably be safe to assume” that similar efforts will come forward next legislative session as “some continue to seek to divide instead of bring us together.”
“All kids belong in Wisconsin’s schools, no matter their background, and our schools are some of the most diverse places. As you have seen with bills and rhetoric the last few legislative sessions, promoting inclusion and belonging in our schools has been coined by some as a negative thing,” Bucher wrote.
Bucher said the work of the department would not be affected by efforts to “minimize the unique backgrounds and perspectives of kids in our schools and meet their individual needs,” and that that the department would continue to advocate for inclusion.
“Our diversity is a strength, and as the needs of kids continue to grow, finding ways to improve belonging in our schools is critical,” he said. “We will continue advocating for our diverse schools to be places where all perspectives are welcome, and the provisions outlined in Dr. Underly’s budget proposal are a good starting point in achieving our goals.”
Underly has proposed spending an additional $4 billion for education, including increasing the state’s share of funding for special education, creating additional mental health supports, and implementing free school meals for all students and early literacy initiatives.
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