S 10268 New York Senate · 2025 Regular Session

Requires insurers and health plans to grant automatic preauthorization approvals to eligible health care professionals in certain circumstance

This bill requires health insurers to automatically approve preauthorization requests for doctors and other providers who have a high success rate with specific services. Under the new rules, a provider becomes eligible for automatic approval if their preauthorization requests for a particular service were approved at least 90% of the time in the last six months. Once a provider qualifies, the insurer must grant immediate approval for future requests without requiring additional paperwork, and the service is treated as medically necessary for payment purposes. Insurers can rescind this automatic status only once a year if the provider's approval rate drops below 90% or if they fail to meet other criteria, and they must provide a 30-day notice before making such changes. The legislation aims to streamline administrative processes for providers with strong track records while maintaining oversight through annual evaluations.
Bill status in committee 1 of 4 stages cleared
Introduction
May 2026
Committee Review
Floor Vote
Governor
Introduced May 11, 2026 Last action May 11, 2026
Floor votes

How they voted

No floor votes recorded yet.
Full legislative history

Actions timeline

Total actions
1
Key actions
0
Committee
1
May 11, 2026
Committee
REFERRED TO INSURANCE
upper
1 primary · 0 co-sponsors

Sponsors

Role
Legislator
Party
State
District
P
Photo of James Skoufis
James Skoufis
DDemocratic
NY
42