Healthcare (Insurance)

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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in committee · New York · Senate Feb 5, 2025

S 785: Adds medical and health insurance information within the definitions of personal identifying information; repealer

This bill expands the legal definition of "personal identifying information" to explicitly include medical information and health insurance details. It directly affects individuals whose medical history, treatment records, or health insurance policy numbers could be misused, as these now count as sensitive data under identity theft laws. Key provisions add specific definitions: "medical information" covers health history and treatment, while "health insurance information" includes policy numbers and claims history. The bill modifies existing penal, business, and technology laws to incorporate these changes, removing prior related provisions through repeal. This update strengthens protections by making unauthorized use of health data prosecutable under current identity theft statutes.

Topics ✓ HealthcareSupports HealthcareExpands definition of sensitive data to include medical/insurance info, strengthening patient data protection under identity theft laws.95% confidence ✓ TechnologySupports TechnologyExpands PII definition to include medical/health insurance data, strengthening privacy protections under identity theft laws as per bill's explicit intent.95% confidence

Sub-Topics Insurance

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in committee · New York · Assembly Jan 7, 2026

A 7920: Limits the substitution of abuse-deterrent analgesic opioid drug products for analgesic opioids lacking such technology

This bill requires health insurance plans to cover at least one abuse-deterrent opioid pain medication per active ingredient, ensuring patients can access FDA-approved options designed to reduce misuse. It limits cost-sharing (like copays) for these drugs to the same level as non-abuse-deterrent opioids, preventing insurers from increasing patient costs to comply. The law also prohibits prior authorization rules from forcing prescribers to use non-abuse-deterrent opioids to access safer alternatives. It directly affects patients prescribed opioids, insurers, and healthcare providers by mandating equitable coverage for abuse-deterrent formulations. The policy applies to all opioid analgesics approved by the FDA with abuse-deterrent labeling.

Topics ✓ HealthcareSupports HealthcareMandates insurance coverage of abuse-deterrent opioids, prevents higher patient costs, and ensures access to safer FDA-approved options - improving patient access and safety in pain management.95% confidence

Sub-Topics Insurance Substance Abuse

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in committee · New York · Senate Jan 7, 2026

S 987: Limits the substitution of abuse-deterrent analgesic opioid drug products for analgesic opioids lacking such technology

This bill (S 987) requires health insurance plans to cover at least one abuse-deterrent opioid pain medication per active ingredient, ensuring patients can access FDA-approved options designed to reduce misuse. It prohibits higher copays or deductibles for these medications compared to standard opioids and bans prior authorization rules that force patients to try non-abuse-deterrent opioids first. The law applies to all insurance plans covering opioid pain medications, directly affecting patients, insurers, and healthcare providers. Key provisions mandate equal cost-sharing for abuse-deterrent and non-abuse-deterrent versions and prevent insurers from adding financial barriers to access these medications. The bill takes effect 120 days after enactment for new or renewed insurance policies.

Topics ✓ HealthcareSupports HealthcareRequires insurance coverage of abuse-deterrent opioids without higher costs or prior authorization, improving patient access to safer pain medication options per bill summary.95% confidence

Sub-Topics Insurance Prescription Drugs Substance Abuse

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in committee · New York · Assembly Mar 18, 2026

A 8824: Relates to insurance reimbursement for vaccination for severe acute respiratory syndrome coronavirus 2

This bill requires health insurance plans in New York to cover the full cost of the SARS-CoV-2 (COVID-19) vaccine, adding it to the list of mandatory immunizations insurers must reimburse. It directly affects insurance companies, healthcare providers, and patients by mandating coverage for this specific vaccine alongside others like measles, polio, and tetanus. The key mechanism amends insurance law to explicitly include "severe acute respiratory syndrome coronavirus 2" in the required vaccine coverage list, meeting U.S. public health standards. It also allows certified pharmacists to administer these vaccines in pharmacies. The law applies to insurance contracts effective January 1 after enactment.

Topics ✓ HealthcareSupports HealthcareMandates full insurance coverage for COVID-19 vaccine, expanding access to essential preventive care and aligning with mandatory immunization requirements.95% confidence

Sub-Topics Insurance Public Health

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in committee · New York · Senate Jan 7, 2026

S 1792: Requires insurance companies to provide at least ninety days of rehabilitation services to an insured upon a doctor's prescription

This bill requires insurance companies to cover at least 90 days of rehabilitation services at a facility when a doctor prescribes it. It directly affects insured individuals needing rehabilitation by mandating this coverage duration in health insurance policies. Key provisions add specific language to insurance law, requiring coverage for 90 days of facility-based rehab with a doctor's referral, and apply to policies issued or renewed after the law takes effect. The requirement applies to new policies and renewals starting 90 days after enactment.

Topics ✓ Criminal JusticeSupports Criminal JusticeMandates insurance coverage for 90 days of facility-based rehabilitation, directly supporting criminal justice reform by improving access to rehabilitation services to reduce recidivism.85% confidence ✓ HealthcareSupports HealthcareMandates 90-day rehab coverage with doctor's prescription, expanding insurance benefits and improving patient access to essential services.95% confidence

Sub-Topics Insurance

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in committee · New York · Senate Jan 7, 2026

S 4123: Preserves the ability of health care providers to access the independent dispute resolution process

This bill (S 4123) ensures healthcare providers can continue using independent dispute resolution (IDR) to challenge payment rates from insurers. It directly affects doctors, hospitals, and other healthcare providers who are not contracted ("non-participating") with health insurance plans. The bill amends criteria that IDR entities must use when setting fair payment rates, requiring them to consider factors like provider qualifications, usual charges for similar services, regional rates for non-participating providers, and service complexity. These changes clarify how disputes over payment rates will be resolved, maintaining access to the IDR process.

Topics ✓ HealthcareSupports HealthcarePreserves healthcare providers' access to independent dispute resolution for fair payment rates, strengthening provider revenue and access to care.95% confidence

Sub-Topics Insurance

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in committee · New York · Senate Jan 7, 2026

S 556: Requires coverage under medicaid and health insurance plans for treatment for smoking cessation

Requires that medicaid and health insurance plans provide coverage for costs of prescription smoking cessation treatment that is ordered by a physician; establishes a coverage limit for each covered individual.

Topics ✓ HealthcareSupports HealthcareMandates Medicaid/insurance coverage for physician-prescribed smoking cessation treatment, expanding preventive healthcare access and strengthening coverage requirements.95% confidence

Sub-Topics Insurance Medicaid

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in committee · New York · Senate Apr 20, 2026

S 5565: Requires health insurance policies and Medicaid to cover patient navigation services

Bill S 5565 requires health insurance policies, including comprehensive-type coverage, and Medicaid to cover patient navigation services. This coverage is for individuals facing serious health conditions expected to last at least three months, who are at high risk for outcomes like hospitalization or physical decline. Patient navigation services include screening for nonclinical needs such as transportation or housing, connecting individuals to support services, and assisting with healthcare appointments. Reimbursement is provided to trained and certified patient navigators who work under the general supervision of a licensed healthcare provider.

Topics ✓ HealthcareSupports HealthcareMandates insurance/Medicaid coverage for patient navigation services addressing nonclinical barriers, expanding access for high-risk patients and strengthening care coordination.95% confidence

Sub-Topics Insurance Medicaid

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