Healthcare (Medicaid)

in committee · New York · Senate Jun 12, 2025

S 5534: Prohibits Medicaid from requiring prior authorization for certain HIV medications

Prohibits Medicaid service providers from requiring prior authorization for antiretroviral prescription drugs for the treatment or prevention of the human immunodeficiency virus (HIV) or acquired immunodeficiency syndrome (AIDS).

Topics ✓ HealthcareSupports HealthcareRemoves prior authorization barriers for HIV medications, improving patient access to essential treatments under Medicaid, aligning with healthcare access and patient rights indicators.95% confidence

Sub-Topics Medicaid

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in committee · New York · Senate Jan 7, 2026

S 4178: Establishes a workgroup to conduct analysis on the ambulatory patient group rates and commercial insurance rates for behavioral health services

S 4178 creates a workgroup to analyze reimbursement rates for behavioral health services under Medicaid and commercial insurance. The workgroup, including providers, insurers, consumers, and experts, will study current rates versus actual care costs and develop recommendations for fairer payment models. It specifically focuses on clinics licensed under mental health laws (Articles 31/32) and child health programs, requiring a final report to lawmakers by October 1, 2027. This bill does not change current rates but sets up a review process to inform future policy.

Topics ✓ HealthcareSupports HealthcareBill establishes workgroup to analyze and improve reimbursement rates for behavioral health services, aiming for fairer payment models to strengthen mental health provider access and coverage.85% confidence

Sub-Topics Children's Health Medicaid Mental Health

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in committee · New York · Senate Jan 7, 2026

S 1266: Establishes the incontinence supplies insurance program for Medicaid beneficiaries

Establishes the incontinence supplies insurance program for Medicaid beneficiaries who are also residents of the state of New York and obtain a note from a physician indicating a need for an item.

Topics ✓ HealthcareSupports HealthcareExpands Medicaid coverage to include incontinence supplies, improving access to necessary medical items for beneficiaries.95% confidence

Sub-Topics Medicaid

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in committee · New York · Assembly Jan 7, 2026

A 5397: Relates to Medicaid reimbursement rates for inpatient psychiatric care

Requires Medicaid reimbursement rates for inpatient psychiatric care to remain consistent and uniform throughout the duration of the patient's hospitalization, regardless of length of stay.

Topics ✓ HealthcareSupports HealthcareEnsures consistent Medicaid reimbursement for psychiatric care, preventing payment fluctuations that could hinder access to mental health services.95% confidence

Sub-Topics Medicaid Mental Health

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in committee · New York · Senate Apr 4, 2025

S 7110: Relates to establishing a remote maternal health services pilot program for Medicaid recipients

Relates to establishing a remote maternal health services pilot program for Medicaid recipients; provides that such program shall be established during fiscal years 2025-2026, 2026-2027 and 2027-2028 to provide: remote maternal health services to eligible Medicaid recipients, medically necessary remote maternal health services to such eligible recipients for up to 12 months postpartum and payment to healthcare providers who provide remote maternal health services.

Topics ✓ Budget & TaxesSupports Budget & TaxesBill allocates state funds for Medicaid provider payments to establish a maternal health pilot program, directly advancing public health spending within state budget framework.90% confidence ✓ HealthcareSupports HealthcareExpands Medicaid coverage for remote maternal health services, including 12-month postpartum care, and funds provider payments to improve access and strengthen maternal healthcare access.95% confidence

Sub-Topics Medicaid Women's Health

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in committee · New York · Senate Jan 7, 2026

S 3602: Ensures that temporary protected status beneficiaries continue to receive Medicaid benefits

S 3602 prevents New York's Medicaid program from ending benefits for Temporary Protected Status (TPS) and DACA recipients if the federal government terminates these programs. It ensures current beneficiaries retain coverage and extends eligibility to former TPS/DACA recipients who meet all requirements except immigration status. The law takes effect immediately upon enactment. This applies solely to New York State's Medicaid program, not federal benefits.

Topics ✓ HealthcareSupports HealthcarePrevents Medicaid coverage loss for TPS/DACA recipients, maintaining healthcare access under NY Medicaid program as required by bill's explicit intent to retain benefits.95% confidence ✓ ImmigrationSupports ImmigrationBill protects and extends Medicaid benefits for TPS and DACA recipients, directly providing immigrant services and protections at the state level.95% confidence

Sub-Topics Medicaid DACA & Dreamers

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in committee · New York · Assembly Jan 7, 2026

A 4748: Relates to plans for safety net hospitals to increase revenue

This bill (A 4748) requires designated "safety net hospitals" to submit annual plans to the state health department outlining specific strategies to increase revenue. Safety net hospitals are defined as public hospitals, critical access hospitals, or facilities serving high percentages of Medicaid, uninsured, or dual-eligible patients (e.g., 35% outpatient volume or 30% inpatient volume). The plan must detail concrete actions like attracting private insurance patients, retaining patients moving from Medicaid to private insurance, offering profitable procedures, enrolling eligible patients in Medicaid, collecting payments from able-to-pay patients, and developing underutilized land. The law mandates annual follow-up reports to track progress toward these revenue goals.

Topics ✓ HealthcareSupports HealthcareRequires safety net hospitals serving Medicaid/uninsured patients to develop revenue plans, ensuring continued access to care and financial stability for critical healthcare providers.95% confidence

Sub-Topics Hospitals Medicaid

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in committee · New York · Senate Jan 7, 2026

S 3599: Establishes regional minimum hourly base reimbursement rates for home care aides

This bill establishes regional minimum hourly payment rates that Medicaid must reimburse home care providers for services delivered to Medicaid patients. It directly affects home care agencies and providers employing aides covered by minimum wage laws, requiring rates to cover all direct care costs - including base wages, overtime, benefits, taxes, and mandated programs like COVID-19 sick pay. The commissioner must set these rates regionally based on cost factors, adjust them annually for labor law changes, and publish them publicly. Oversight includes comptroller reviews of managed care contracts to ensure rates meet the minimum standards.

Topics ✓ Budget & TaxesSupports Budget & TaxesMandates higher Medicaid reimbursement rates covering all direct care costs, increasing state budget allocations for essential home care services.90% confidence ✓ HealthcareSupports HealthcareMandates Medicaid reimbursement rates covering all costs for home care aides, ensuring provider sustainability and patient access to services.95% confidence ✓ Labor & EmploymentSupports Labor & EmploymentMandates Medicaid reimbursement rates covering base wages, benefits, and mandated programs, directly advancing worker compensation standards for home care aides.95% confidence

Sub-Topics Audits & Accountability Long-Term Care Medicaid Labor Standards Minimum Wage

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in committee · New York · Assembly Jan 7, 2026

A 1710: Provides for coverage for certain individuals under the 1332 state innovation program

This bill establishes a new health coverage option under New York's 1332 state innovation program, allowing the state to create a health plan for specific uninsured New Yorkers who don't qualify for Medicaid or ACA marketplace plans. It directly affects residents under 65 with household incomes between 133% and 250% of the federal poverty line, including some noncitizens ineligible for Medicaid due to immigration status. Key provisions include requiring coverage for essential health services (like cancer care access at Medicaid rates, dental, vision, and chronic illness support), automatic enrollment for children born to eligible parents, and continued coverage during pregnancy for one year postpartum. The program requires federal approval under the ACA's Section 1332 waiver process and operates alongside existing Medicaid and marketplace plans.

Topics ✓ HealthcareSupports HealthcareExpands health coverage for uninsured NY residents (133-250% FPL) via new 1332 program, requiring essential health services for previously excluded groups.92% confidence ✓ ImmigrationSupports ImmigrationExplicitly includes noncitizens ineligible for Medicaid due to immigration status in health coverage program, providing services to this group.90% confidence

Sub-Topics Insurance Medicaid

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in committee · New York · Assembly Jan 7, 2026

A 1897: Relates to including the services and care of school psychologists under Medicaid

This bill expands Medicaid coverage to include services provided by school psychologists who are certified or authorized under New York's education law. It directly affects students in public schools, as it allows school psychologists to bill Medicaid for services that were previously not covered under the program. The key provision adds school psychologists to Medicaid's covered providers, specifying that this change does not alter their existing scope of practice defined by education law. The bill requires state agencies to implement necessary rule changes before its effective date, 180 days after enactment.

Topics ✓ Budget & TaxesSupports Budget & TaxesExpands Medicaid coverage to fund school psychology services, increasing government spending on essential mental health programs for students.85% confidence ✓ EducationSupports EducationExpands Medicaid coverage for school psychologists' services, enabling schools to access additional funding for student mental health support without altering existing educational scope.95% confidence ✓ HealthcareSupports HealthcareExpands Medicaid coverage to include school psychologists' mental health services, improving student access to mental healthcare under public health insurance.95% confidence

Sub-Topics Student Health Healthcare Workforce Medicaid Medical Licensing

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