This bill updates how New York State sets payment rates for residential health care facilities (like nursing homes). It requires the state to adjust rates using specific components - direct/indirect price changes, facility-specific costs - and mandates updates by April 1, 2026, and every five years after. Special rate provisions apply to facilities providing specialized care (e.g., for brain injury rehab, AIDS units, or pediatric services), with inflation adjustments starting in 2026. The bill also creates a workgroup of experts to advise on rate-setting and includes funding mechanisms to support facility quality improvements.
S 6918, the "Keep Kids Covered Act," ensures children under age six who qualify for medical assistance remain continuously enrolled without interruption. It requires the state to establish an automated system that prevents coverage gaps during annual renewals for these children, directly affecting families with young children previously eligible for Medicaid or Child Health Plus. Key provisions mandate automatic enrollment through age five, eliminate income-based eligibility reviews during this period, and require departments to notify parents of extended coverage rights. The law aims to maintain consistent healthcare access for vulnerable children without requiring additional applications or paperwork from families.
S 2655 requires health insurance plans to cover rehabilitation treatment for children diagnosed with pediatric acute-onset neuropsychiatric syndrome (PANS). Insurance companies must provide this coverage when a child's doctor certifies in writing that the treatment is medically necessary. The bill applies to all health insurance policies, including group plans, directly affecting families with children who have PANS and the insurance providers. It references an existing definition of PANS from New York's public health law to ensure consistent application.
This bill creates a special payment for pediatric practices that use the HealthySteps model, which supports families with young children. It requires the state health commissioner to establish an add-on payment rate to help cover costs for services like developmental screenings, behavioral health support, and prevention programs for children from birth to age six. Eligible practices must meet specific HealthySteps quality standards. The payment would be added to existing reimbursements for federally qualified health centers and rural clinics, without affecting other payment calculations. The policy takes effect April 1, 2026.
Prohibits approved organizations providing coverage under the child health insurance plan from discriminating against health care providers which do not participate in the organization's health care network.
Expands coverage for pregnant and postpartum individuals and their children; establishes a health expense account program for pregnant and postpartum individuals; requires the creation of informative pamphlets on maternal depression.
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.
Requires Medicaid managed care, and Child Health Plus plans to adopt the procedural protections of the Preferred Drug Program, including "prescriber prevails", for all drugs.
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.
This bill requires health care providers to report the number of vaccine exemptions they grant for children to the state's immunization tracking system. It directly affects health care providers who issue exemptions from required childhood vaccines. The key provision mandates that this exemption data be entered into New York's statewide immunization information system and NYC's citywide registry, allowing officials to search and access exemption counts per provider. This creates a standardized way to track exemption rates across different health care settings. The policy change focuses on improving data collection for public health monitoring, not on altering exemption eligibility rules.
