Healthcare (Insurance)

in committee · New York · Senate Jan 7, 2026

S 4163: Enacts the "health insurance preauthorization disclosure act"

Enacts the "health insurance preauthorization disclosure act"; requires health insurance companies to provide participating health care providers with a list of health care treatments and services that require preauthorization from the health insurance company.

Topics ✓ HealthcareSupports HealthcareRequires insurers to disclose preauthorization requirements, improving provider transparency and patient access to timely care.85% confidence

Sub-Topics Insurance

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in committee · New York · Senate Jan 7, 2026

S 5114: Requires insurance coverage for child and family treatment and support services and children's home and community based services

Requires all policies that provide coverage for inpatient hospital care to include benefits for child and family treatment and support services and children's home and community based services.

Topics ✓ HealthcareSupports HealthcareRequires insurance coverage for child/family treatment services, expanding health coverage for children's care per bill's explicit mandate.95% confidence

Sub-Topics Children's Health Hospitals Insurance

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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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