Healthcare (Medicaid)

in committee · New York · Assembly Jan 7, 2026

A 4650: Relates to reimbursement by Medicaid for services required by state law

Relates to reimbursement for Medicaid for services required by state law; provides department of health must pay 100% of the non-federal share for services required by state law, not federal.

Topics ✓ HealthcareSupports HealthcareRequires 100% state funding for Medicaid services mandated by state law, preventing defunding and ensuring continued coverage for required health services.95% confidence

Sub-Topics Medicaid

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in committee · New York · Senate Jan 7, 2026

S 4247: Provides Medicaid reimbursement for interpretation services provided by hospital inpatient and outpatient departments

Provides Medicaid reimbursement for interpretation services provided by hospital inpatient, outpatient and emergency department settings and in diagnostic treatment centers; provides further that time frames for notice, approval or certification of rates of payment and to the requirement of prior notice of rates of payment are suspended, deemed without any force and effect from and after February 1, 2027 for such rates effective for the period April 1, 2027 through March 31, 2028.

Topics ✓ HealthcareSupports HealthcareProvides Medicaid reimbursement for interpretation services, expanding access to healthcare for non-English speakers and improving patient access to hospital services.95% confidence

Sub-Topics Hospitals Medicaid

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in committee · New York · Senate Jun 12, 2025

S 5534: Prohibits Medicaid from requiring prior authorization for certain HIV medications

Prohibits Medicaid service providers from requiring prior authorization for antiretroviral prescription drugs for the treatment or prevention of the human immunodeficiency virus (HIV) or acquired immunodeficiency syndrome (AIDS).

Topics ✓ HealthcareSupports HealthcareRemoves prior authorization barriers for HIV medications, improving patient access to essential treatments under Medicaid, aligning with healthcare access and patient rights indicators.95% confidence

Sub-Topics Medicaid

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in committee · New York · Senate Jan 7, 2026

S 4178: Establishes a workgroup to conduct analysis on the ambulatory patient group rates and commercial insurance rates for behavioral health services

S 4178 creates a workgroup to analyze reimbursement rates for behavioral health services under Medicaid and commercial insurance. The workgroup, including providers, insurers, consumers, and experts, will study current rates versus actual care costs and develop recommendations for fairer payment models. It specifically focuses on clinics licensed under mental health laws (Articles 31/32) and child health programs, requiring a final report to lawmakers by October 1, 2027. This bill does not change current rates but sets up a review process to inform future policy.

Topics ✓ HealthcareSupports HealthcareBill establishes workgroup to analyze and improve reimbursement rates for behavioral health services, aiming for fairer payment models to strengthen mental health provider access and coverage.85% confidence

Sub-Topics Children's Health Medicaid Mental Health

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in committee · New York · Senate Jan 7, 2026

S 6323: Determines the amount paid to a pharmacy for certain high cost drugs

This bill caps payments to pharmacies for certain high-cost drugs. It requires that pharmacies receive no more than 2.5% of a drug’s total cost (including federal benchmark pricing) plus any authorized dispensing fees, but only for drugs with a federal cost benchmark exceeding $670. The rule directly affects pharmacies dispensing these specific high-cost medications under New York’s Medicaid program. It aims to standardize reimbursement without altering existing dispensing fee structures.

Topics ✗ HealthcareOpposes HealthcareCaps Medicaid pharmacy reimbursements for high-cost drugs, limiting provider payments under healthcare program.85% confidence

Sub-Topics Medicaid Prescription Drugs

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in committee · New York · Senate Jan 7, 2026

S 1266: Establishes the incontinence supplies insurance program for Medicaid beneficiaries

Establishes the incontinence supplies insurance program for Medicaid beneficiaries who are also residents of the state of New York and obtain a note from a physician indicating a need for an item.

Topics ✓ HealthcareSupports HealthcareExpands Medicaid coverage to include incontinence supplies, improving access to necessary medical items for beneficiaries.95% confidence

Sub-Topics Medicaid

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in committee · New York · Assembly Jan 7, 2026

A 5397: Relates to Medicaid reimbursement rates for inpatient psychiatric care

Requires Medicaid reimbursement rates for inpatient psychiatric care to remain consistent and uniform throughout the duration of the patient's hospitalization, regardless of length of stay.

Topics ✓ HealthcareSupports HealthcareEnsures consistent Medicaid reimbursement for psychiatric care, preventing payment fluctuations that could hinder access to mental health services.95% confidence

Sub-Topics Medicaid Mental Health

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in committee · New York · Senate Apr 4, 2025

S 7110: Relates to establishing a remote maternal health services pilot program for Medicaid recipients

Relates to establishing a remote maternal health services pilot program for Medicaid recipients; provides that such program shall be established during fiscal years 2025-2026, 2026-2027 and 2027-2028 to provide: remote maternal health services to eligible Medicaid recipients, medically necessary remote maternal health services to such eligible recipients for up to 12 months postpartum and payment to healthcare providers who provide remote maternal health services.

Topics ✓ Budget & TaxesSupports Budget & TaxesBill allocates state funds for Medicaid provider payments to establish a maternal health pilot program, directly advancing public health spending within state budget framework.90% confidence ✓ HealthcareSupports HealthcareExpands Medicaid coverage for remote maternal health services, including 12-month postpartum care, and funds provider payments to improve access and strengthen maternal healthcare access.95% confidence

Sub-Topics Medicaid Women's Health

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in committee · New York · Senate Jan 7, 2026

S 3602: Ensures that temporary protected status beneficiaries continue to receive Medicaid benefits

S 3602 prevents New York's Medicaid program from ending benefits for Temporary Protected Status (TPS) and DACA recipients if the federal government terminates these programs. It ensures current beneficiaries retain coverage and extends eligibility to former TPS/DACA recipients who meet all requirements except immigration status. The law takes effect immediately upon enactment. This applies solely to New York State's Medicaid program, not federal benefits.

Topics ✓ HealthcareSupports HealthcarePrevents Medicaid coverage loss for TPS/DACA recipients, maintaining healthcare access under NY Medicaid program as required by bill's explicit intent to retain benefits.95% confidence ✓ ImmigrationSupports ImmigrationBill protects and extends Medicaid benefits for TPS and DACA recipients, directly providing immigrant services and protections at the state level.95% confidence

Sub-Topics Medicaid DACA & Dreamers

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in committee · New York · Assembly Jan 7, 2026

A 4748: Relates to plans for safety net hospitals to increase revenue

This bill (A 4748) requires designated "safety net hospitals" to submit annual plans to the state health department outlining specific strategies to increase revenue. Safety net hospitals are defined as public hospitals, critical access hospitals, or facilities serving high percentages of Medicaid, uninsured, or dual-eligible patients (e.g., 35% outpatient volume or 30% inpatient volume). The plan must detail concrete actions like attracting private insurance patients, retaining patients moving from Medicaid to private insurance, offering profitable procedures, enrolling eligible patients in Medicaid, collecting payments from able-to-pay patients, and developing underutilized land. The law mandates annual follow-up reports to track progress toward these revenue goals.

Topics ✓ HealthcareSupports HealthcareRequires safety net hospitals serving Medicaid/uninsured patients to develop revenue plans, ensuring continued access to care and financial stability for critical healthcare providers.95% confidence

Sub-Topics Hospitals Medicaid

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