Healthcare (Children's Health)

Includes the recommendations of the American Academy of Pediatrics, the American Academy of Family Physicians, the American College of Obstetricians and Gynecologists, the American College of Physicians and/or other similar nationally or internationally recognized scientific organizations in the establishment of immunization administration regulations.

Eliminates the prospective enrollment waiting period for children under the age of nineteen enrolling in the child health insurance plan program by enrolling a child retroactively to the first day of the month in which they are approved for coverage under such program.

Requires the administration of certain vaccines for children in accordance with regulations issued by the commissioner, utilizing generally accepted medical standards and based on recommendations of the American Academy of Pediatrics, the American Academy of Family Physicians, the American College of Obstetricians and Gynecologists, the American College of Physicians, the Advisory Committee on Immunization Practices, and/or other similar nationally or internationally recognized scientific organizations; removes certain requirements for vaccines to be administered under federal guidance.

This bill expands support for medically fragile children by requiring health insurance plans to adjust how they review and approve medical services for this group. It mandates that utilization review decisions consider children's unique developmental needs rather than applying adult standards, and ensures coverage for services like private duty nursing, therapy, and home care that help children reach their maximum functional capacity. The legislation also requires insurers to maintain networks of providers with specialized expertise in medically fragile care, accommodate prolonged discharge plans when needed, and consider family circumstances such as employment and caregiving capacity when arranging care. Additionally, it prohibits medical necessity reviews for certain critical private duty nursing services and allows payment for hospital stays when specialized home care is unavailable during discharge transitions.

This bill expands Medicaid coverage to include seizure-detecting monitors for infants diagnosed with epilepsy, other seizure disorders, or those with a family history of seizures. The legislation specifically limits this benefit to one monitor per eligible infant to manage costs within the standard coverage plan. By amending the Social Services Law, the bill ensures these medical devices are available to qualifying families starting on January 1st of the following year.

Directs the department of health to establish and administer a program for the certification, operation, and oversight of two prescribed pediatric extended care centers to provide supportive services to medically stable and medically complex children who require continual care.

Enacts the "pediatric palliative care act" to establish pediatric palliative care centers to provide palliative care to individuals who are under twenty-one years of age, have been diagnosed with a chronic, complex, life-threatening illness that is expected to shorten their life expectancy, and is not expected to survive past twenty-one years of age.

Enacts into law major components of legislation necessary to implement the state health and mental hygiene budget for the 2026-2027 state fiscal year; extends provisions requiring the quarterly assessment of known and projected department of health state fund Medicaid expenditures (Part A); extends certain health provisions (Part B); extends certain provisions of law relating to the health care reform act; extends provisions relating to the distribution of pool allocations and graduate medical education; extends provisions relating to health care initiative pool distributions; extends payment provisions for general hospitals; extends provisions relating to assessments on covered lives; extends the personal care services worker recruitment and retention program (Part C); relates to insurance coverage for medical malpractice paid for by funds from the hospital excess liability pool; extends portions of the New York Health Care Reform Act of 1996 (Part D); makes technical corrections to certain provisions of law relating to the New York State Dental Foundation and other provisions of law (Part F); relates to automated external defibrillators (AEDs) (Part G); extends certain provisions relating to payments from the New York state medical indemnity fund (Part I); relates to temporary health care services agencies and protecting individuals engaged to provide health care services by such agencies (Part J); restores capital rate reductions for nursing homes (Part L); limits the amount payable for certain services provided to certain eligible persons who are also beneficiaries under part B of title XVII of the federal social security act or are also qualified Medicare beneficiaries; clarifies Medicaid requirements for biomarker testing (Part M); relates to hospital and nursing home fee-for-service reimbursement rates and reductions in hospital capital rate add-ons (Part O); directs the commissioners of the office of mental health, office for people with developmental disabilities, office of addiction services and supports, office of temporary and disability assistance, office of children and family services and the director of the state office for the aging to establish a state fiscal year 2026-2027 targeted inflationary increase for projecting for the effects of inflation upon rates of payments, contracts, or any other form of reimbursement for certain programs and services; requires such commissioners and director to provide funding to support a 2.7% targeted inflationary increase for such programs and services (Part P); changes "substance use" to substance-related and addictive disorder claims for purposes of the insurance law and public health law (Part R); relates to the effectiveness of provisions of law relating to Medicaid management; removes certain provisions providing for lower minimum amounts of certain state aid for the city of New York than the rest of the state (Part T); extends certain government rates for behavioral services referencing the office of addiction services and supports and relates to the effectiveness thereof (Part U); relates to the effectiveness of certain provisions of law relating to the closure or transfer of a state-operated individualized residential alternative (Part V); extends the care demonstration program (Part W); relates to medical assistance for needy persons age sixty-five or older and who are eligible for medical assistance but for their immigration status through the fee-for-service program (Part X); provides for an amended New York managed care organization provider tax at a rate of 0.35% effective January 1, 2027 (Part Y); provides that services provided in school-based health centers shall not be provided to medical assistance recipients through managed care programs (Part Z); extends provisions of law relating to reimbursement rates for medically fragile children and pediatric diagnostic and treatment centers (Part AA); amends provisions for dispute resolution for emergency services and surprise bills; provides for benchmarking of amounts allowed for health care services provider in the same or similar specialty and provided in the same geographical area (Part BB).

Requires the administration of certain vaccines for children in accordance with regulations issued by the commissioner, utilizing generally accepted medical standards and based on recommendations of the American Academy of Pediatrics, the American Academy of Family Physicians, the American College of Obstetricians and Gynecologists, the American College of Physicians, the Advisory Committee on Immunization Practices, or other similar nationally or internationally recognized scientific organizations.

Enacts into law major components of legislation necessary to implement the state health and mental hygiene budget for the 2026-2027 state fiscal year; extends provisions requiring the quarterly assessment of known and projected department of health state fund Medicaid expenditures (Part A); extends certain health provisions (Part B); extends certain provisions of law relating to the health care reform act; extends provisions relating to the distribution of pool allocations and graduate medical education; extends provisions relating to health care initiative pool distributions; extends payment provisions for general hospitals; extends provisions relating to assessments on covered lives; extends the personal care services worker recruitment and retention program (Part C); relates to insurance coverage for medical malpractice paid for by funds from the hospital excess liability pool; extends portions of the New York Health Care Reform Act of 1996 (Part D); makes technical corrections to certain provisions of law relating to the New York State Dental Foundation and other provisions of law (Part F); relates to automated external defibrillators (AEDs) (Part G); extends certain provisions relating to payments from the New York state medical indemnity fund (Part I); relates to temporary health care services agencies and protecting individuals engaged to provide health care services by such agencies (Part J); restores capital rate reductions for nursing homes (Part L); limits the amount payable for certain services provided to certain eligible persons who are also beneficiaries under part B of title XVII of the federal social security act or are also qualified Medicare beneficiaries; clarifies Medicaid requirements for biomarker testing (Part M); relates to hospital and nursing home fee-for-service reimbursement rates and reductions in hospital capital rate add-ons (Part O); directs the commissioners of the office of mental health, office for people with developmental disabilities, office of addiction services and supports, office of temporary and disability assistance, office of children and family services and the director of the state office for the aging to establish a state fiscal year 2026-2027 targeted inflationary increase for projecting for the effects of inflation upon rates of payments, contracts, or any other form of reimbursement for certain programs and services; requires such commissioners and director to provide funding to support a 2.7% targeted inflationary increase for such programs and services (Part P); changes "substance use" to substance-related and addictive disorder claims for purposes of the insurance law and public health law (Part R); relates to the effectiveness of provisions of law relating to Medicaid management; removes certain provisions providing for lower minimum amounts of certain state aid for the city of New York than the rest of the state (Part T); extends certain government rates for behavioral services referencing the office of addiction services and supports and relates to the effectiveness thereof (Part U); relates to the effectiveness of certain provisions of law relating to the closure or transfer of a state-operated individualized residential alternative (Part V); extends the care demonstration program (Part W); relates to medical assistance for needy persons age sixty-five or older and who are eligible for medical assistance but for their immigration status through the fee-for-service program (Part X); provides for an amended New York managed care organization provider tax at a rate of 0.35% effective January 1, 2027 (Part Y); provides that services provided in school-based health centers shall not be provided to medical assistance recipients through managed care programs (Part Z); extends provisions of law relating to reimbursement rates for medically fragile children and pediatric diagnostic and treatment centers (Part AA); amends provisions for dispute resolution for emergency services and surprise bills; provides for benchmarking of amounts allowed for health care services provider in the same or similar specialty and provided in the same geographical area (Part BB).