Healthcare (Insurance)

in committee · New York · Senate Jan 7, 2026

S 4119: Provides for insurance coverage for electrolysis procedures when deemed medically necessary

This bill requires most health insurance plans in New York to cover medically necessary electrolysis procedures to stop hair growth, including for gender-affirming care. It applies to all individual and group health insurance policies, including major medical and comprehensive plans, mandating coverage without specific exclusions for gender-affirming treatment. Insurers may still apply standard deductibles and co-insurance, but must provide this coverage as part of their medical benefits. The law takes effect 90 days after enactment for new or renewed policies.

Topics ✓ HealthcareSupports HealthcareMandates insurance coverage for medically necessary electrolysis, including gender-affirming care, expanding access to healthcare services without exclusions.95% confidence

Sub-Topics Insurance

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in committee · New York · Senate Jan 7, 2026

S 8039: Prohibits hospitals, health systems, and health care providers from charging facility fees that are not covered by the patient's health insurance carrier

Prohibits hospitals, health systems, and health care providers from charging facility fees that are not covered by the patient's health insurance carrier.

Topics ✓ HealthcareSupports HealthcareProhibits surprise facility fees not covered by insurance, protecting patients from unexpected costs and improving access to care.95% confidence

Sub-Topics Hospitals Insurance

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in committee · New York · Senate Jan 7, 2026

S 4174: Requires health insurers to provide full coverage for the prevention, early detection, diagnosis and treatment of autism spectrum disorder

Requires health insurers to provide full coverage for the prevention, early detection, diagnosis and treatment of autism spectrum disorder; establishes an advisory panel on health insurance coverage for autism spectrum disorder to annually compile a list of treatments and therapy options for which health insurers will be required to provide coverage; establishes a toll-free, 24 hour a day, autism and health insurance coverage hotline to receive and act upon complaints and questions from families with autistic children, relating to insurance coverage for autism spectrum disorder.

Topics ✓ HealthcareSupports HealthcareMandates full insurance coverage for autism care, expanding patient access to prevention, diagnosis, and treatment services.95% confidence

Sub-Topics Insurance

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in committee · New York · Assembly Jan 7, 2026

A 8864: Provides that coverage for outpatient diagnosis and treatment of substance use disorder shall not be subject to preauthorization

This bill removes preauthorization requirements for outpatient diagnosis and treatment of substance use disorder under most health insurance policies. It directly affects health insurers and patients seeking treatment for substance use disorders, ensuring such coverage cannot be blocked by prior approval. The law mandates that insurers provide this coverage without stricter financial limits or treatment restrictions than those applied to general medical and surgical care. The policy change applies immediately to all new, renewed, or modified insurance policies issued after the effective date.

Topics ✓ HealthcareSupports HealthcareRemoves preauthorization barriers for substance use disorder treatment, improving patient access to care without insurer delays or restrictions.95% confidence

Sub-Topics Insurance Substance Abuse

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in committee · New York · Assembly May 4, 2026

A 1206: Requires certain health insurance policies to provide coverage for diabetes and prediabetes screening

Bill A 1206 mandates that certain health insurance policies must provide coverage for diabetes and prediabetes screening. This requirement applies to policies that include coverage for physician services or offer major medical and comprehensive benefits. Insurers are prohibited from imposing any deductibles, co-payments, co-insurance, or other cost-sharing requirements for these screenings. The screenings covered must be conducted pursuant to a national evidence-based practice guideline, aiming to make preventative care more accessible to policyholders.

Topics ✓ HealthcareSupports HealthcareMandates insurance coverage for diabetes screening without cost-sharing, expanding patient access to preventative care per evidence-based guidelines.95% confidence

Sub-Topics Insurance

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in committee · New York · Assembly Jan 7, 2026

A 2686: Provides coverage for iatrogenic fertility preservation services under certain conditions

This bill requires health insurance plans to cover standard fertility preservation services when a medical treatment - such as surgery, radiation, or chemotherapy - directly causes or risks iatrogenic infertility (fertility impairment affecting reproductive organs or processes). It directly affects patients undergoing medical treatments that may harm fertility, ensuring they can access services like egg or sperm freezing before starting treatment. The law mandates coverage for these specific services under defined conditions, without requiring prior authorization. It takes effect immediately upon enactment and was recently referred to the Health committee for further review.

Topics ✓ HealthcareSupports HealthcareMandates insurance coverage for fertility preservation services during medical treatments causing infertility, expanding patient access to critical healthcare services.92% confidence

Sub-Topics Insurance

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in committee · New York · Senate Jan 7, 2026

S 4076: Requires insurance coverage for medical genetic testing for adoptees and persons placed in foster care

This bill (S 4076) requires most health insurance plans in New York to cover comprehensive medical genetic testing for two specific groups: adoptees (as defined by New York law) and individuals who were placed in foster care. It mandates coverage for tests analyzing DNA, RNA, chromosomes, or proteins to identify inherited genetic conditions, including predispositions to diseases. Insurers may limit coverage to New York residents and apply standard deductibles or co-insurance, but must provide this testing coverage as part of hospital, surgical, or medical care plans. The law applies to individual, group, and health service corporation insurance policies issued or renewed after its effective date.

Topics ✓ HealthcareSupports HealthcareMandates insurance coverage for genetic testing for adoptees/foster care, expanding access to preventative healthcare services without restricting benefits.95% confidence

Sub-Topics Hospitals Insurance

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in committee · New York · Senate Jan 7, 2026

S 6813: Enacts the optometry freedom act

This bill prohibits health insurance carriers and vision care plans from restricting optometrists' choice of suppliers for covered materials like eyeglasses, contact lenses, and frames. It directly affects optometrists (licensed eye care professionals) and vision plans by banning contract terms that force them to use specific labs or vendors for patient supplies. The key provision requires that optometrists can select their own sources for materials and labs without insurance plan interference, covering items such as lenses, frames, and medical eye devices. This creates a clear policy change in how vision care reimbursement arrangements operate.

Topics ✓ HealthcareSupports HealthcareBill removes insurance restrictions on optometrists' supplier choices, improving patient access to vision care materials and protecting provider autonomy within healthcare services.90% confidence

Sub-Topics Insurance

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in committee · New York · Assembly Jan 7, 2026

A 5140: Requires health insurance policies to include coverage for doula services as required coverage for maternity care

This bill requires New York health insurance policies covering maternity care to include doula services as a standard benefit. It applies to all individual and group health insurance plans providing maternity coverage, directly affecting insurers and people receiving maternity care. The law mandates that coverage must include doula services alongside hospital stays (48 hours after vaginal birth, 96 hours after C-section), while prohibiting duplicate payments for services already provided by midwives or physicians. Insurers must cover doulas without additional cost to policyholders as part of existing maternity care requirements.

Topics ✓ HealthcareSupports HealthcareMandates insurance coverage for doula services in maternity care, expanding patient access to comprehensive support and standardizing benefits.95% confidence

Sub-Topics Hospitals Insurance Women's Health

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in committee · New York · Assembly Jan 7, 2026

A 4262: Enacts the Health Care Nondiscrimination Act of 2025

Enacts the Health Care Nondiscrimination Act; requires insurance coverage and health plans to implement equality and non-discrimination between licensed health care providers; requires fee parity between different classes of licensed providers providing the similar or like-kind services; requires practitioners to discuss and refer or prescribe non-pharmacological treatment alternatives before prescribing an opioid treatment; allows any licensed health care provider to perform certain services, including certifying disability and employment by school districts; provides for enforcement and penalties.

Topics ✓ HealthcareSupports HealthcareRequires nondiscrimination in coverage, fee parity for similar services, and non-opioid referrals before opioids, advancing patient rights and access to equitable care.95% confidence

Sub-Topics Insurance Substance Abuse

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