Healthcare (Insurance)

in committee · New York · Assembly Jan 7, 2026

A 3903: Relates to including certain out of home services such as transition from a hospital, nursing facility or other institutional setting to the home within home care insurance coverage

Includes certain out of home services such as transition from a hospital, nursing facility or other institutional setting to the home within home care insurance coverage.

Topics ✓ HealthcareSupports HealthcareExpands home care insurance coverage to include post-hospital/nursing facility transition services, improving patient access to care after institutional stays.95% confidence

Sub-Topics Hospitals Insurance Long-Term Care

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in committee · New York · Senate Jan 7, 2026

S 6161: Relates to reducing pharmacy benefit manager costs

This bill (S 6161) requires pharmacy benefit managers (PBMs) to charge health insurers and health plans only for actual drug costs, pharmacy dispensing fees, and a fair administrative fee - passing through all rebates, discounts, and other financial benefits directly to the health plan. It bans "spread pricing" (where PBMs keep the difference between what they pay pharmacies and charge plans) and mandates full disclosure of all income sources to the state department. PBMs must provide quarterly refunds for any excess amounts kept under the old pricing model. The bill directly affects health insurers, health plans, and PBMs operating in New York, aiming to reduce prescription drug costs for consumers through transparency and cost accountability.

Topics ✓ HealthcareSupports HealthcareBans PBM spread pricing, requiring rebates pass directly to health plans, lowering costs for insurers and patients while improving transparency in drug pricing.90% confidence

Sub-Topics Insurance Prescription Drugs

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in committee · New York · Senate Jan 7, 2026

S 4072: Relates to insurance coverage of certain procedures to detect breast cancer

Requires insurance coverage of sonograms and other diagnostic procedures used to detect breast cancer for covered persons with a prior history of breast cancer or who have a first degree relative with a prior history of breast cancer.

Topics ✓ HealthcareSupports HealthcareRequires insurance coverage for breast cancer detection procedures, expanding access to critical screenings for at-risk patients.95% confidence

Sub-Topics Insurance

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in committee · New York · Assembly Sep 8, 2025

A 3362: Relates to insurance coverage for pediatric acute-onset neuropsychiatric syndrome

This bill requires health insurance plans to cover rehabilitation services for children diagnosed with pediatric acute-onset neuropsychiatric syndrome (PANS) when a doctor certifies the treatment is medically necessary. It directly affects children with PANS and all health insurance providers offering coverage in New York, including group plans. The law mandates coverage without requiring prior authorization beyond a physician's written certification of medical necessity. The bill references the definition of PANS from Public Health Law §207, ensuring consistent application across all health plans.

Topics ✓ HealthcareSupports HealthcareMandates insurance coverage for PANS rehabilitation services without prior authorization, expanding access to necessary medical care for children with this condition.95% confidence

Sub-Topics Children's Health Insurance Public Health

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in committee · New York · Assembly Jan 7, 2026

A 3835: Creates an educational pamphlet regarding the importance of prostate-specific antigen testing

This bill requires New York's health commissioner to create an educational pamphlet explaining prostate cancer symptoms, risk factors, detection methods (including PSA testing accuracy), insurance coverage for screening, and treatment options. The pamphlet must be written in plain language, available in English and six common non-English languages, and provided free to healthcare providers. Providers may then give it to adult patients with a prostate who are at risk for prostate cancer or have been diagnosed, to help inform their treatment decisions. The bill does not mandate specific medical actions but ensures accessible information is available.

Topics ✓ HealthcareSupports HealthcareBill mandates educational pamphlet on PSA testing including insurance coverage details, enhancing patient access to screening information and promoting preventive care.95% confidence

Sub-Topics Insurance

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in committee · New York · Senate Jan 7, 2026

S 7987: Ensures continuity of care for cancer patients during insurance contract negotiations

Ensures continuity of care for cancer patients during insurance contract negotiations by requiring insurance coverage and treatment continue until the conclusion of care.

Topics ✓ HealthcareSupports HealthcareBill mandates uninterrupted cancer patient coverage during insurance negotiations, protecting access to treatment and continuity of care per summary.95% confidence

Sub-Topics Insurance

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in committee · New York · Senate Jan 7, 2026

S 4732: Prohibits the diminution of health insurance benefits of certain public employee retirees

Prohibits the diminution of health insurance benefits of public employee retirees and their dependents or reducing the employer's contributions for such insurance; defines employers to include the state, municipalities, school districts, and public authorities and commissions.

Topics ✓ Budget & TaxesSupports Budget & TaxesPrevents reduction in employer contributions for retiree health benefits, protecting existing budget allocations for public employee healthcare spending.90% confidence ✓ HealthcareSupports HealthcareProhibits reducing health insurance benefits for public employee retirees, protecting existing coverage and preventing benefit cuts per bill summary.95% confidence ✓ Labor & EmploymentSupports Labor & EmploymentProhibits reduction of health insurance benefits for public employee retirees, directly protecting post-employment benefits under labor/employment standards.95% confidence

Sub-Topics Pensions Insurance Public Employees

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in committee · New York · Senate Jan 7, 2026

S 517: Creates an educational pamphlet regarding the importance of prostate-specific antigen testing

This bill requires New York's health commissioner to create a plain-language educational pamphlet about prostate cancer. The pamphlet must cover symptoms, risk factors, detection methods (including PSA testing), insurance coverage for screening, and treatment options. It will be provided free to healthcare providers for distribution to adult patients with a prostate who are at risk or diagnosed with prostate cancer, available in English and six common non-English languages in New York. The bill does not mandate screening or treatment, only provides information to support informed discussions.

Topics ✓ HealthcareSupports HealthcareBill mandates free educational pamphlet on PSA testing with insurance coverage details, improving patient access to preventive care information and screening options.90% confidence

Sub-Topics Insurance

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in committee · New York · Assembly Jan 7, 2026

A 4545: Provides expanded enrollment through New York state of health through tax returns, expands New York state of health navigator program; creates the New York health benefit and cost commission; repealer

Provides expanded enrollment through New York state of health through tax returns (Part A); allows for enrollment through the New York state of health at any time for first-time enrollees; expands New York state of health navigator program (Part B); creates the New York health benefit and cost commission (Part C); establishes New York health care savings accounts to expand and incentivize purchasing private health insurance (Part D).

Topics ✓ HealthcareSupports HealthcareExpands health coverage access via tax return enrollment, navigator program, and health savings accounts for private insurance95% confidence

Sub-Topics Insurance

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in committee · New York · Senate Jan 24, 2025

S 310: Relates to insurance coverage of certain procedures to detect breast cancer

Requires insurance coverage of sonograms and other diagnostic procedures used to detect breast cancer for covered persons with a prior history of breast cancer or who have a first degree relative with a prior history of breast cancer.

Topics ✓ HealthcareSupports HealthcareRequires insurance coverage for breast cancer detection procedures, expanding patient access to critical diagnostics for high-risk individuals.95% confidence

Sub-Topics Insurance

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