Healthcare

in committee · New York · Assembly Jan 7, 2026

A 5106: Prohibits certain requirements in insurance contracts

This bill prohibits insurers and health maintenance organizations from including specific restrictive clauses in contracts with healthcare providers. It bans requirements that force insurers to include all provider group members in networks, place them in the same network tier, include them in all products, block value-based benefit designs, impose "most-favored-nation" terms (except for rate negotiations), or restrict fee disclosure. The law directly affects insurers and healthcare providers negotiating contracts, preventing certain contractual terms from being enforced. The ban takes effect January 1, 2026, making any violating contract clause void while keeping other contract terms valid.

Topics ✓ HealthcareSupports HealthcareBans insurer restrictions on provider networks, fee disclosure, and value-based designs, improving provider flexibility and patient access to care.85% confidence

Sub-Topics Insurance

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in committee · New York · Assembly Jan 7, 2026

A 5282: Relates to access to appropriate drugs at reasonable prices, formulary exceptions, standing prior authorizations and external appeals

Relates to access to appropriate drugs at reasonable prices, formulary exceptions, standing prior authorizations and external appeals; to access to retail pharmacies, prescription synchronization, limits on patient drug costs, explanations of benefits and rebates; to prescription drug synchronization; to pharmacy benefit management; and to limits on copayments and drug substitutions.

Topics ✓ HealthcareSupports HealthcareBill mandates reasonable drug prices, limits patient costs, expands access via formulary exceptions, and restricts excessive copays - directly improving patient access and affordability per healthcare support indicators.92% confidence

Sub-Topics Insurance Prescription Drugs

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in committee · New York · Assembly Jan 7, 2026

A 5309: Relates to directing the commissioner of health to issue a statewide standing order for the provision of doula services

This bill requires New York's health commissioner to create a statewide standing order allowing healthcare providers to offer doula services without individual patient authorization. It directly affects pregnant, birthing, and postpartum individuals (up to 12 months after birth) by enabling access to doula support through existing healthcare systems. The key mechanism is a non-patient-specific order that streamlines provider access to doula services, removing barriers to coverage. The bill aims to integrate doula care into standard maternal health support without requiring separate patient consent for each service.

Topics ✓ HealthcareSupports HealthcareBill removes authorization barriers for doula services, improving access to healthcare for pregnant/postpartum individuals through existing systems, directly advancing patient access.90% confidence

Sub-Topics Women's Health

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in committee · New York · Senate Jan 7, 2026

S 7569: 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 HealthcareBill directs study to expand coverage via subsidies/credits, aligning with support indicators for expanding health care access.95% confidence

Sub-Topics Insurance

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passed · New York · Senate Mar 18, 2026

S 3820: Requires health insurance policies include coverage for anesthesia for the duration of a medical procedure

Requires health insurance policies include coverage for anesthesia for the entire duration of a procedure for which a licensed medical practitioner has issued an order for such anesthesia.

Topics ✓ HealthcareSupports HealthcareMandates insurance coverage for anesthesia duration, expanding patient access to essential medical services without restrictions95% confidence

Sub-Topics Insurance

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passed · New York · Senate Jan 27, 2026

S 3155: Relates to insurance coverage for in vitro fertilization

This bill (S 3155) requires health insurers to provide in vitro fertilization (IVF) coverage without discrimination. It prohibits insurers from denying or limiting IVF coverage based on factors like age, disability, sexual orientation, gender identity, or perceived quality of life. The bill specifically bans insurers from requiring all embryos from a previous IVF cycle to be transferred before covering a subsequent cycle for women aged 35 or older. These changes directly affect individuals seeking IVF treatment by expanding access and preventing discriminatory practices in insurance coverage.

Topics ✓ HealthcareSupports HealthcareMandates IVF insurance coverage without discrimination, expanding access to reproductive healthcare services and protecting patient rights per bill requirements.95% confidence

Sub-Topics Insurance

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in committee · New York · Senate Jun 12, 2025

S 6895: Relates to high deductible health plans and health savings accounts

This bill clarifies cost-sharing rules for health plans paired with Health Savings Accounts (HSAs). It ensures that for HSA-qualified high-deductible plans, cost-sharing requirements (like copays) don't make enrollees ineligible for HSAs. Specifically, cost-sharing only applies after an enrollee meets the IRS's minimum deductible, except for preventive care services, which always have no cost-sharing regardless of the deductible. This directly affects individuals enrolled in such health plans who use HSAs to save for medical expenses.

Topics ✓ HealthcareSupports HealthcareBill clarifies cost-sharing rules to maintain HSA eligibility, protecting a healthcare financing tool that helps patients manage costs without restricting coverage.85% confidence

Sub-Topics Primary Care

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in committee · New York · Senate Jan 7, 2026

S 5314: Establishes patient safety and quality assurance measures regarding the distribution of patient-specific medication from an insurer-designated pharmacy

Establishes patient safety and quality assurance measures regarding the distribution of patient-specific medication from an insurer-designated pharmacy; prohibits certain "brown bagging" and "white bagging" policies regarding pharmacy provided medications.

Topics ✓ HealthcareSupports HealthcareProhibits insurer policies restricting medication access (brown/white bagging), enhancing patient safety and access to prescribed medications.95% confidence

Sub-Topics Insurance Prescription Drugs

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in committee · New York · Assembly Jan 7, 2026

A 1628: Requires the coverage of alternative treatment options by the medical assistance program and private insurers

Requires that non-pharmaceutical alternative treatment options including but not limited to treatment provided by a licensed acupuncturist, licensed massage therapist, licensed chiropractor, and yoga instructor be covered by the medical assistance program and by private health insurers.

Topics ✓ HealthcareSupports HealthcareMandates coverage of alternative treatments (acupuncture, chiropractic) by insurers and medical assistance, expanding health coverage and access to non-pharmaceutical care.95% confidence

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in committee · New York · Assembly Jan 7, 2026

A 2695: Requires certain health insurance plans cover annual electrocardiograms for covered children under the age of nineteen

This bill requires health insurance plans to cover annual electrocardiogram (EKG) tests and their interpretation for children under 19 years old. It directly affects insured children and their families by mandating this specific preventive heart screening as part of standard pediatric care. The key provision adds EKG coverage as a required service at each well-child visit, with more frequent testing allowed if a physician orders it based on clinical judgment. This policy change ensures insurance coverage for this heart screening without requiring additional patient costs, applying to all policies issued after the bill's effective date.

Topics ✓ HealthcareSupports HealthcareMandates insurance coverage for preventive pediatric EKGs, expanding access to heart screenings for children under 19 as part of standard care.95% confidence

Sub-Topics Children's Health Insurance

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