Healthcare

in committee · New York · Senate Jan 7, 2026

S 6164: Relates to prescription drugs in Medicaid managed care programs; repealer

Requires Medicaid managed care, and Child Health Plus plans to adopt the procedural protections of the Preferred Drug Program, including "prescriber prevails", for all drugs.

Topics ✓ HealthcareSupports HealthcareRequires Medicaid managed care to adopt 'prescriber prevails' protections, ensuring doctors' drug choices aren't overridden, improving patient access and rights.95% confidence

Sub-Topics Children's Health Medicaid Prescription Drugs

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in committee · New York · Senate Jan 7, 2026

S 8550: Requires certain health insurance plans cover electrocardiograms for adults and children who have received a coronavirus vaccine

Requires certain health insurance plans cover electrocardiograms for adults and children who have received a coronavirus vaccine regardless of family history of heart disease or conditions.

Topics ✓ HealthcareSupports HealthcareMandates insurance coverage for ECGs post-vaccine, expanding preventive care access without prior health history restrictions.95% confidence

Sub-Topics Insurance

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in committee · New York · Senate Jan 7, 2026

S 4009: Relates to covering mental illness under the healthy New York program

This bill (S 4009) requires insurers and certain health corporations to cover the diagnosis and treatment of mental health conditions under the Healthy New York program. It amends insurance law to mandate this coverage in group/school blanket policies, individual policies, and health service contracts for inpatient care or physician services. The key provision directly affects insurers, medical expense indemnity corporations, and health service corporations offering these specific plans. It ensures policyholders receiving these insurance types have access to mental health care as part of their coverage, without adding new exemptions or cost-sharing requirements. The bill takes immediate effect upon enactment.

Topics ✓ HealthcareSupports HealthcareMandates insurers to cover mental health diagnosis/treatment under Healthy New York, expanding coverage and strengthening mental health services per bill's explicit requirements.95% confidence

Sub-Topics Hospitals Insurance Mental Health

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in committee · New York · Assembly Jan 7, 2026

A 5199: Ensures that temporary protected status beneficiaries continue to receive Medicaid benefits

This bill (A 5199) ensures that New York residents with Temporary Protected Status (TPS) or Deferred Action for Childhood Arrivals (DACA) status maintain Medicaid benefits even if the federal government ends those programs. It directly affects TPS beneficiaries and DACA recipients in New York by preventing the state from canceling their Medicaid coverage due to changes in federal immigration designations. Key provisions require the state health department to: (1) keep Medicaid benefits active for TPS/DACA recipients if federal programs end, and (2) extend eligibility to former TPS/DACA recipients who meet all other Medicaid requirements except immigration status. The law takes effect immediately upon enactment.

Topics ✓ HealthcareSupports HealthcareBill maintains Medicaid coverage for TPS/DACA recipients, protecting healthcare access for vulnerable populations without restricting benefits.95% confidence ✓ ImmigrationSupports ImmigrationBill explicitly protects Medicaid access for TPS/DACA recipients, maintaining critical health services amid federal program uncertainty95% confidence

Sub-Topics Medicaid DACA & Dreamers

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in committee · New York · Assembly Jan 7, 2026

A 8136: Relates to prescription drug cost-sharing assistance

Authorizes insurance policies which provide coverage for prescription drugs where cost-sharing obligations are determined by category of prescription drugs to offer a program to insureds that utilizes rebates or discounts to lower an insured's cost-sharing for prescription drugs if the insured's cost-sharing under such program would be more favorable than the cost-sharing that would otherwise be applicable to the prescription drug.

Topics ✓ HealthcareSupports HealthcareAuthorizes rebates/discounts to lower patient prescription costs under insurance, improving affordability and access to medications per bill summary.95% confidence

Sub-Topics Insurance Prescription Drugs

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in committee · New York · Senate Jan 7, 2026

S 586: Establishes a mandated window of five business days for both Medicaid and private insurers to respond to pre-authorization claims for testing and/or treatments made by physicians on behalf of oncology patients

Establishes a mandated window of five business days for both Medicaid and private insurers to respond to pre-authorization claims for testing and/or treatments made by physicians on behalf of oncology patients.

Topics ✓ HealthcareSupports HealthcareMandates 5-day insurer response window for oncology pre-authorizations, improving timely access to cancer treatments and reducing delays in care.95% confidence

Sub-Topics Medicaid

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died · New York · Senate Jun 1, 2026

S 6551: Includes image-guided biopsies under certain insurance coverage for breast cancer screening

This bill (S 6551) requires health insurance plans in New York to cover image-guided breast biopsies when recommended by a physician based on nationally recognized clinical guidelines. It directly affects patients seeking breast cancer screening and diagnosis, as well as insurance companies that must now include this specific procedure in mandatory coverage. The bill amends insurance law to explicitly add "image-guided breast biopsies" to the list of covered services alongside mammograms, ultrasounds, and MRI scans. Coverage applies only when the procedure aligns with evidence-based guidelines developed by independent medical organizations. The change takes effect January 1, 2026, for all new or renewed insurance policies.

Topics ✓ HealthcareSupports HealthcareMandates insurance coverage for image-guided breast biopsies per clinical guidelines, expanding diagnostic access for breast cancer screening and aligning with covered services like mammograms.95% confidence

Sub-Topics Insurance

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in committee · New York · Assembly Jan 7, 2026

A 6475: Requires health insurance policies to cover comprehensive genetic screening for ovarian and prostate cancers

This bill (A 6475, the "Ana Lucia Act") requires health insurance plans to cover comprehensive genetic screening and FDA-approved biomarker testing for ovarian and prostate cancers. It mandates full coverage - without deductibles or coinsurance - when recommended by a doctor, geneticist, or genetic counselor, for both diagnosed patients and their family members. The law prohibits insurers from using genetic test results to deny coverage to family members who carry inherited mutations. This directly affects patients with ovarian or prostate cancer, their relatives, and health insurers operating under New York's insurance laws. The coverage applies to all policies issued or renewed after the bill takes effect.

Topics ✓ HealthcareSupports HealthcareMandates full insurance coverage for genetic screening without cost-sharing and prohibits denial of coverage based on genetic results, expanding access and protecting patient rights.95% confidence

Sub-Topics Insurance

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in committee · New York · Assembly Jan 7, 2026

A 609: Requires coverage for delivery through store and forward technology

Requires insurers to provide coverage for delivery through store and forward technology; requires prescription drug policies to cover the cost of contraceptive care delivered via telemedicine.

Topics ✓ HealthcareSupports HealthcareMandates insurer coverage for telemedicine delivery and contraceptive care, expanding access to healthcare services and aligning with coverage expansion indicators.95% confidence ✓ TechnologySupports TechnologyMandates insurer coverage for store-and-forward telemedicine, advancing tech-enabled healthcare delivery and access to digital health services.95% confidence

Sub-Topics Insurance Prescription Drugs Telehealth

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in committee · New York · Assembly Jan 7, 2026

A 1912: Directs the department of financial services to study health insurance coverage through the Marketplace

Directs the department of financial services to study health insurance coverage through the Marketplace, including collecting data on how many people are insured, and studying the feasibility of creating programs, subsidies, and/or tax credits to help expand health care coverage.

Topics ✓ HealthcareSupports HealthcareDirects study to expand coverage via subsidies/tax credits, aligning with support indicators like expanding access and funding mechanisms.95% confidence

Sub-Topics Insurance

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