Healthcare (Insurance)

passed both · New York · Assembly Jun 2, 2026

A 6522: Relates to Medicaid accountable care organizations

Bill A 6522 allows specific Medicaid Accountable Care Organizations (ACOs) to purchase group health insurance policies for their members and employees. It permits ACOs comprised solely of private physician practices to offer experience-rated health insurance plans. The bill establishes requirements for these policies, including minimum coverage numbers and methods for premium payment. It also exempts qualifying ACOs from certain small group rating rules, provided they meet criteria such as having a minimum number of employers and a significant Medicaid patient base.

Topics ✓ HealthcareSupports HealthcareBill enables Medicaid ACOs to offer experience-rated insurance plans, expanding coverage options and access for members while exempting them from restrictive rating rules.92% confidence

Sub-Topics Insurance Medicaid

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passed · New York · Senate Apr 29, 2026

S 6494: Requires health insurance policies to include coverage for doula services as required coverage for maternity care

This bill requires all health insurance policies in New York to cover doula services as part of mandated maternity care. It directly affects health insurers and policyholders by adding doulas (non-medical birth support professionals) to the list of covered services alongside hospital stays and midwife care. The key provision amends insurance law to mandate that maternity coverage includes doula services for at least 48 hours post-birth (or 96 hours for C-sections), without duplicating physician or midwife services already provided. This applies to all new, renewed, or modified policies issued 180 days after the law takes effect.

Topics ✓ HealthcareSupports HealthcareMandates insurance coverage for doula services in maternity care, expanding patient access to non-medical birth support without cost-sharing.95% confidence

Sub-Topics Hospitals Insurance Women's Health

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in committee · New York · Senate Jan 27, 2026

S 8096: Prohibits the diminution of retiree health benefits by a public employer

Prevents public employers from diminishing health insurance benefits provided to retirees and their dependents or the contributions such employer makes for such health insurance coverage below the level of such benefits or contributions made on behalf of such retirees and their dependents by such public employer.

Topics ✓ HealthcareSupports HealthcarePrevents public employers from diminishing retiree health insurance benefits, directly protecting existing coverage for Medicare-eligible dependents.95% confidence ✓ Labor & EmploymentSupports Labor & EmploymentPrevents public employers from reducing retiree health benefits, protecting a key employment-related benefit for former workers.95% confidence

Sub-Topics Insurance

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in committee · New York · Senate Apr 7, 2026

S 3185: Provides outpatient insurance coverage for non-pharmacological treatments and non-opioid drugs for chronic pain

Bill S 3185 mandates that health insurance policies covering pain management services must also provide outpatient coverage for non-opioid treatments for chronic pain, defined as pain lasting over three months. This directly affects individuals with chronic pain by expanding their covered treatment options to include complementary and integrative therapies. The bill ensures that insurance companies cannot impose stricter financial requirements or treatment limitations on non-opioid chronic pain treatments than they do for other medical benefits or for opioid-based pain treatments. This aims to provide comparable access and coverage for these non-opioid alternatives.

Topics ✓ HealthcareSupports HealthcareMandates insurance coverage for non-opioid chronic pain treatments, expanding patient access to covered options without restrictive financial barriers.95% confidence

Sub-Topics Insurance Substance Abuse

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in committee · New York · Assembly Jan 7, 2026

A 7310: Requires certain health insurance policies to provide coverage for diagnostic testing for ovarian cancer

Provides that every health insurance policy which provides coverage for hospital, surgical or medical care shall provide coverage for the standard diagnostic testing for ovarian cancer upon the recommendation of a physician; provides that such standard diagnostic testing shall include a pelvic examination, a sonogram and a CA 125 blood test and related laboratory and diagnostic services.

Topics ✓ HealthcareSupports HealthcareMandates insurance coverage for ovarian cancer diagnostics, expanding patient access to preventive care and standard testing services.95% confidence

Sub-Topics Hospitals Insurance

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in committee · New York · Senate Feb 26, 2025

S 5635: Provides coverage for iatrogenic fertility preservation services under certain conditions

S 5635, the "Fertility Protection Act," requires health insurance plans to cover fertility preservation services (like egg or sperm freezing) when a medical treatment - such as cancer therapy, surgery, or radiation - poses a risk of causing infertility. It directly affects patients undergoing such treatments who need to preserve fertility before starting care. The bill amends social services law to mandate this coverage under specific conditions, defining "iatrogenic infertility" as fertility impairment caused by medical interventions. The policy change takes effect immediately upon enactment.

Topics ✓ HealthcareSupports HealthcareMandates insurance coverage for fertility preservation during infertility-risk treatments, expanding patient access to reproductive health services.95% confidence

Sub-Topics Insurance

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in committee · New York · Assembly Jan 7, 2026

A 3839: Relates to insurance reimbursement for cost of vaccinations

This bill requires health insurance plans to reimburse providers for the full cost of administering recommended vaccines. It mandates coverage for both vaccine acquisition costs (using CDC private sector rates plus a 21% minimum for shipping/storage) and all administration expenses (including counseling, supplies, and routine nursing activities based on current Medicare rates). The law directly affects healthcare providers who administer vaccines, ensuring they are compensated for both the vaccine itself and the full process of delivery. It applies to all CDC-recommended vaccines for diseases like measles, polio, and hepatitis B, as determined by health authorities.

Topics ✓ HealthcareSupports HealthcareMandates full insurance reimbursement for vaccine costs, ensuring provider compensation and improving patient access to vaccinations per CDC recommendations.95% confidence

Sub-Topics Insurance Medicare

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in committee · New York · Assembly Jan 7, 2026

A 5074: Requires insurance coverage for the cost of donated breast milk

This bill requires all health insurance plans covering prescription drugs to also cover the cost of donated breast milk. It directly affects insurance companies and policyholders by mandating this coverage under existing prescription drug coverage policies. The key provision amends three sections of the insurance law to explicitly include donated breast milk costs in all relevant insurance policies, effective immediately. This creates a concrete policy change without altering existing coverage requirements for other medical expenses.

Topics ✓ HealthcareSupports HealthcareMandates insurance coverage for donated breast milk, expanding health insurance benefits for infant nutrition access under prescription drug coverage policies.95% confidence

Sub-Topics Insurance Prescription Drugs

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in committee · New York · Assembly May 6, 2026

A 5255: Provides for coverage for the treatment of asthma

This bill requires health insurance plans to cover specific asthma treatments and education. It mandates coverage for rescue inhalers, spacers, nebulizers, and related equipment for all policyholders, with additional school supplies for children under 19. Insurance must also cover asthma self-management education - taught by certified providers - during diagnosis, when symptoms change significantly, or for refresher sessions, including home visits when medically necessary. The coverage applies to all policies issued or renewed after the effective date, subject to standard deductibles and coinsurance. This directly affects people with asthma and their families who rely on insurance for treatment.

Topics ✓ HealthcareSupports HealthcareMandates insurance coverage for asthma treatments, equipment, and education, expanding patient access to essential care and strengthening coverage requirements.95% confidence

Sub-Topics Insurance

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passed both · New York · Assembly Jun 1, 2026

A 6561: Includes image-guided biopsies under certain insurance coverage for breast cancer screening

This bill amends New York's insurance law to require health insurers to cover image-guided breast biopsies as part of mandatory breast cancer screening. It directly affects patients seeking breast cancer detection and insurers who must provide this coverage when recommended by a physician following nationally recognized clinical guidelines. The key change adds "image-guided breast biopsies" to the list of covered screening and diagnostic imaging procedures, alongside mammograms and ultrasounds. Coverage applies only when the procedure is recommended by a physician and aligns with evidence-based clinical guidelines. The requirement takes effect January 1, 2026, for new or renewed insurance policies.

Topics ✓ HealthcareSupports HealthcareRequires insurers to cover image-guided breast biopsies for screening, expanding diagnostic access under mandatory coverage per clinical guidelines.95% confidence

Sub-Topics Insurance

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