Healthcare (Insurance)

in committee · New York · Assembly Jan 7, 2026

A 1360: Expands health care plan contract coverage for any health care provider for one hundred twenty days after the termination of such contract

This bill requires health insurance plans to continue covering services from providers for 120 days after a contract ends, maintaining reimbursement terms during this period. It directly affects health plans, providers, and enrollees by ensuring uninterrupted access to care during the transition. Key provisions include mandating notice to affected enrollees within 15 days of the 120-day period starting, and allowing the commissioner to waive the period if termination is for cause. Exceptions include mutual written agreements between parties with 30 days' notice to enrollees.

Topics ✓ HealthcareSupports HealthcareRequires 120-day continued coverage post-contract termination, preventing care access gaps and maintaining reimbursement terms for providers and enrollees.95% confidence

Sub-Topics Insurance

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in committee · New York · Senate Jan 7, 2026

S 5361: Provides for a minimum reimbursement rate for ambulatory behavioral health services

This bill (S 5361) requires health insurers in New York to reimburse licensed behavioral health providers (under public health or mental hygiene laws) for ambulatory behavioral health services at a minimum rate equivalent to what the state's Medicaid program (Medical Assistance) pays for similar services. It applies to all health insurance policies covering medical, major medical, or comprehensive coverage, including group plans and health maintenance organizations. Insurers may negotiate higher rates with providers but cannot pay less than the Medicaid-equivalent rate established under the Ambulatory Patient Group (APG) methodology. The law takes effect September 1, 2025, for all new or renewed policies.

Topics ✓ HealthcareSupports HealthcareRequires insurers to reimburse behavioral health providers at Medicaid rates, improving access to mental health services and strengthening coverage under healthcare policies.95% confidence

Sub-Topics Insurance Medicaid Mental Health

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in committee · New York · Senate Jan 7, 2026

S 1737: Requires health insurance coverage for craniofacial disorders

This bill requires health insurance plans in the state to cover diagnosis and medically necessary treatment - including both surgical and nonsurgical procedures - for disorders affecting bones or joints in the face, neck, or head (such as birth defects, injuries, or developmental conditions). It applies to all health insurance policies offering physician or major medical coverage, mandating that this coverage be equivalent to coverage for other musculoskeletal disorders in the body. Policies may require a referral from a contracted healthcare provider, but the bill explicitly excludes coverage for routine dental services related to teeth, gums, or jaw issues. This directly affects insurers and policyholders seeking treatment for these specific facial/head/joint conditions.

Topics ✓ HealthcareSupports HealthcareMandates insurance coverage for craniofacial disorders, expanding access to treatment equivalent to musculoskeletal care, directly advancing health coverage for specified conditions.95% confidence

Sub-Topics Insurance

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passed · New York · Senate Jan 27, 2026

S 4497: Requires certain insurance policies to provide coverage for fertility preservation services

S 4497 requires certain health insurance policies to cover fertility preservation services, such as egg or sperm freezing, for individuals facing medical treatments that may cause infertility (like cancer therapy). This directly affects patients undergoing procedures with known fertility risks and the insurance companies offering those plans. The bill mandates coverage for these services before treatment begins, ensuring individuals can preserve fertility options without excessive out-of-pocket costs. It applies to standard health insurance policies, not just specialized plans, aiming to make these services accessible during critical medical care.

Topics ✓ HealthcareSupports HealthcareMandates insurance coverage for fertility preservation, expanding patient access to essential healthcare services before fertility-risk treatments like cancer therapy.95% confidence

Sub-Topics Insurance

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passed · New York · Senate May 29, 2025

S 2000: Relates to mandatory health insurance coverage for follow-up screening or diagnostic services for lung cancer

Requires that health insurance policies shall provide coverage for follow-up screening or diagnostic services for lung cancer; provides that no patient cost sharing shall be imposed for follow-up screening or diagnostic services for lung cancer.

Topics ✓ HealthcareSupports HealthcareMandates insurance coverage for lung cancer follow-up screening without cost sharing, expanding access and removing financial barriers for patients.95% confidence

Sub-Topics Insurance

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in committee · New York · Assembly Jan 7, 2026

A 7100: Requires the provision of additional insurance coverage for pre-term labor hospitalizations, monitoring and counseling

This bill requires health insurance plans in New York to cover specific pre-term labor care. It mandates coverage for home nursing visits to monitor expectant mothers diagnosed with pre-term labor (between 20-36 weeks of pregnancy), administration of Makena medication by nurses, and counseling services for emotional support. These services are required for individuals who have experienced pre-term labor, miscarriage, stillbirth, or infant loss within a month of birth. The law applies to all health insurance policies providing hospital, surgical, or medical coverage, directly affecting insurers and pregnant people with these specific needs.

Topics ✓ HealthcareSupports HealthcareMandates insurance coverage for pre-term labor care, expanding patient access to maternal health services and counseling as required benefits.95% confidence

Sub-Topics Hospitals Insurance Women's Health

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in committee · New York · Assembly Jan 7, 2026

A 3697: Requires providers of insurance policies to maintain a database of health care providers offering foreign language services

This bill requires health insurance providers covered under the Affordable Care Act to create and maintain a publicly accessible database. The database must list healthcare providers (doctors, physicians, etc.) enrolled in their plans who offer foreign language services, including each provider's name, location, specialty, and languages spoken. It directly affects insurance companies and their policyholders by making it easier for non-English speakers to find linguistically accessible care. The requirement applies to all insurers mandated to provide foreign language services under federal law. The bill does not create new language service obligations but ensures existing provider information is organized and available to customers.

Topics ✓ HealthcareSupports HealthcareRequires insurers to list linguistically accessible providers, directly improving access for non-English speakers per ACA coverage requirements.90% confidence

Sub-Topics Insurance

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in committee · New York · Senate Jan 7, 2026

S 2164: Requires health insurance policies to include coverage of optional anesthesia for certain contraceptive and menstrual health procedures

Requires health insurance policies to include coverage of optional anesthesia for certain contraceptive and menstrual health procedures including, but not limited to, loop electrosurgical excision procedure, colposcopy, ablation, and intrauterine device insertion.

Topics ✓ HealthcareSupports HealthcareBill mandates health insurance coverage for optional anesthesia during specific contraceptive and menstrual procedures, expanding coverage and improving patient access to reproductive healthcare services.95% confidence

Sub-Topics Insurance

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in committee · New York · Senate Jan 7, 2026

S 5456: Requires providers to share electronic health records with plans for purposes of improving patient care and reducing administrative delays

S 5456 requires hospitals to share complete electronic health records (EHRs) electronically with health plan reviewers (utilization review agents) to verify medical necessity for individual patient care decisions, directly affecting hospitals, health plans, and patients. Key provisions mandate that shared records cannot be used for billing audits or historical pattern analysis, must include full medical history without excluding admission/discharge details, and prevent health plans from requesting redundant information already in the EHR. The bill also updates rules to limit unnecessary data requests during reviews and requires health plans to prioritize data security, including pursuing HITRUST certification for privacy compliance. These changes aim to streamline coverage determinations while protecting patient privacy and reducing administrative delays.

Topics ✓ HealthcareSupports HealthcareBill mandates sharing complete EHRs for verifying medical necessity to improve patient care and reduce delays, prohibiting misuse for billing. Strengthens care coordination and protects patient rights per healthcare topic definition.90% confidence

Sub-Topics Hospitals Insurance

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in committee · New York · Assembly Jan 7, 2026

A 2681: Requires residents to maintain minimum essential coverage health insurance in the state of New York or pay a tax for failing to do so

Requires residents to maintain minimum essential coverage health insurance in the state of New York or pay a tax for failing to do so; provides that such funds be used for the NY State of Health marketplace.

Topics ✓ Budget & TaxesSupports Budget & TaxesImposes tax on uninsured residents to fund NY State of Health marketplace, directly advancing public health program funding.95% confidence ✓ HealthcareSupports HealthcareMandates health insurance coverage with tax penalty, directing funds to NY State of Health marketplace to expand access and enrollment95% confidence

Sub-Topics Insurance

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