Healthcare (Insurance)

in committee · New York · Senate Apr 20, 2026

S 868: Requires certain health insurance policies to include coverage for the cost of certain infant and baby formulas

Bill S 868 requires most health insurance plans covering prescription drugs to include coverage for medically necessary infant and baby formulas. It directly affects insured individuals with specific medical conditions like metabolic disorders, severe allergies, Crohn's disease, or gastrointestinal motility issues, as determined by a physician's written order. The bill mandates that coverage must be provided for formulas proven effective for these conditions (including amino acid-based or modified solid foods), with a minimum annual coverage of $3,000 per person. It distinguishes required medical formulas from elective nutritional supplements and applies to policies already covering prescription drugs.

Topics ✓ HealthcareSupports HealthcareMandates insurance coverage for medically necessary infant formulas, expanding access for patients with specific conditions like metabolic disorders and allergies.95% confidence

Sub-Topics Children's Health Insurance Prescription Drugs

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in committee · New York · Assembly Jan 7, 2026

A 1657: Relates to requiring health insurers to offer coverage of health care provided by out-of-network providers

This bill requires health insurers to offer out-of-network coverage as an optional add-on to policies and provide at least one standard plan that includes this coverage. It directly affects health insurers and their policyholders by expanding access to care from doctors or facilities outside an insurer's approved network. Key provisions mandate that insurers make these options available both inside and outside the state's health insurance marketplace. The law applies to all new health insurance policies issued after its effective date, ensuring coverage choices for consumers seeking out-of-network care.

Topics ✓ HealthcareSupports HealthcareMandates insurers to offer out-of-network coverage as a standard plan option, expanding patient access to care outside provider networks.90% confidence

Sub-Topics Insurance

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in committee · New York · Senate Jan 7, 2026

S 6675: Requires insurance coverage for the cost of donated breast milk

This bill requires health insurance policies covering prescription drugs to also cover the cost of donated breast milk. It directly affects individuals, particularly mothers and infants in medical settings (like NICUs), who rely on donated breast milk but previously faced coverage gaps. The law amends specific sections of the insurance code to mandate this coverage inclusion in all relevant policies, effective immediately. The change applies to standard prescription drug coverage, not separate health plans.

Topics ✓ HealthcareSupports HealthcareMandates insurance coverage for donated breast milk, expanding access to critical healthcare for infants and mothers in medical settings like NICUs.95% confidence

Sub-Topics Insurance Prescription Drugs

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died · New York · Senate Jan 7, 2026

S 1773: Prohibits state contracts with contractors who do not provide health insurance which covers supplemental breast cancer screenings

Prohibits state contracts with contractors who do not provide health insurance which covers supplemental breast cancer screenings; authorizes the comptroller to promulgate any necessary rules and regulations.

Topics ✓ HealthcareSupports HealthcareMandates state contractors provide health insurance covering supplemental breast cancer screenings, expanding coverage and improving access to preventive care.95% confidence ✓ Labor & EmploymentSupports Labor & EmploymentBill requires contractors to provide health insurance covering supplemental breast cancer screenings, enhancing worker benefits and employment standards as a condition for state contracts.90% confidence

Sub-Topics Insurance

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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 · 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 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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