Healthcare (Insurance)

in committee · New York · Assembly Jan 7, 2026

A 2695: Requires certain health insurance plans cover annual electrocardiograms for covered children under the age of nineteen

This bill requires health insurance plans to cover annual electrocardiogram (EKG) tests and their interpretation for children under 19 years old. It directly affects insured children and their families by mandating this specific preventive heart screening as part of standard pediatric care. The key provision adds EKG coverage as a required service at each well-child visit, with more frequent testing allowed if a physician orders it based on clinical judgment. This policy change ensures insurance coverage for this heart screening without requiring additional patient costs, applying to all policies issued after the bill's effective date.

Topics ✓ HealthcareSupports HealthcareMandates insurance coverage for preventive pediatric EKGs, expanding access to heart screenings for children under 19 as part of standard care.95% confidence

Sub-Topics Children's Health Insurance

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in committee · New York · Senate Apr 29, 2026

S 5263: Provides that coverage for outpatient diagnosis and treatment of substance use disorder shall not be subject to preauthorization

This bill requires health insurance plans to cover outpatient diagnosis and treatment for substance use disorder - including detoxification and rehabilitation - without preauthorization. It applies to all medical, major medical, and comprehensive insurance policies. The law prohibits insurers from applying stricter financial limits or treatment restrictions to substance use disorder care than those used for standard medical or surgical services. This change aims to reduce administrative barriers for people seeking treatment.

Topics ✓ Criminal JusticeSupports Criminal JusticeRemoves administrative barriers to substance use treatment, advancing rehabilitation programs aligned with criminal justice reform goals.85% confidence ✓ HealthcareSupports HealthcareRemoves preauthorization barriers for substance use disorder treatment, ensuring equal coverage standards and improving patient access to mental health services.95% confidence

Sub-Topics Drug Policy Insurance Substance Abuse

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in committee · New York · Senate Jan 7, 2026

S 3762: Provides for coverage for certain individuals under the 1332 state innovation program

This bill creates a New York State 1332 innovation program under a federal waiver, providing health insurance coverage for New Yorkers under age 65 with household incomes between 133% and 250% of the federal poverty level who don't qualify for Medicaid or employer-sponsored insurance. It requires coverage for essential health services, including access to cancer centers (at Medicaid reimbursement rates), dental, vision, and support for chronic illnesses. Eligibility excludes those eligible for Medicaid, the Child Health Insurance Program, or affordable employer coverage. The program is subject to federal approval and aims to fill coverage gaps for this specific income group.

Topics ✓ HealthcareSupports HealthcareExpands health coverage for uninsured NY adults (133-250% FPL) via state innovation program, mandating essential services including cancer care, dental, and chronic illness support.95% confidence

Sub-Topics Children's Health Insurance Medicaid

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passed · New York · Senate Mar 4, 2026

S 5852: Relates to insurance reimbursement for cost of vaccinations

This bill requires health insurance plans to reimburse providers for all costs associated with administering recommended vaccinations, including both vaccine acquisition costs (based on CDC private sector rates plus 21% for shipping/storage) and full administration costs (like counseling, supplies, and nursing time, using current Medicare rates). It directly affects healthcare providers (such as clinics and doctors' offices) who administer vaccines, ensuring they are compensated for the full cost of delivery. The reimbursement applies specifically to vaccines recommended by the CDC's immunization practices committee, covering standard childhood and adult vaccines like measles, polio, and flu shots. This policy change aims to remove financial barriers for providers to offer routine vaccinations under insurance coverage.

Topics ✓ HealthcareSupports HealthcareMandates full insurance reimbursement for vaccine costs and administration, ensuring providers are compensated and improving access to vaccinations under public health coverage.95% confidence

Sub-Topics Insurance Medicare

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in committee · New York · Assembly Jan 7, 2026

A 2348: Requires providers to share electronic health records with plans for purposes of improving patient care and reducing administrative delays

This bill requires hospitals and healthcare providers to share complete electronic medical records with insurance plans' utilization review agents. It mandates that records be shared electronically for individual care reviews and claim processing only, not for billing audits or historical analysis. Health plans must prioritize data security, follow privacy laws, and cannot request duplicate information already in the shared records. The law also restricts plans from routinely demanding full medical records or diagnosis codes during reviews, limiting requests to only necessary information. It directly affects hospitals, healthcare providers, and health insurance plans operating in New York.

Topics ✓ HealthcareSupports HealthcareMandates secure electronic sharing of records to reduce administrative delays and improve patient care coordination, aligning with support indicators like streamlined access and provider- insurer collaboration.95% confidence ✓ TechnologySupports TechnologyMandates data security and privacy compliance for electronic health record sharing, aligning with data privacy protections in technology policy.95% confidence

Sub-Topics Insurance Consumer Data Protection

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in committee · New York · Senate Jan 7, 2026

S 1430: Requires insurance and Medicaid coverage for inpatient and outpatient substance abuse treatment for a period of not less than forty-five days

This bill requires all health insurance plans and Medicaid to cover inpatient and outpatient substance use disorder treatment for at least 45 days, directly affecting individuals seeking addiction care. It mandates that coverage includes unlimited medically necessary treatment in residential settings for inpatient care and prohibits insurers from applying stricter financial or treatment limits (like prior authorization) to substance use disorder services than those applied to standard medical care. The law applies to both hospital and medical insurance policies, ensuring consistent coverage without extra hurdles for addiction treatment. This creates a concrete policy change by standardizing minimum coverage duration and removing discriminatory restrictions in insurance practices.

Topics ✓ Criminal JusticeSupports Criminal JusticeMandates substance abuse treatment coverage, aligning with rehabilitation-focused criminal justice reform to reduce recidivism.85% confidence ✓ HealthcareSupports HealthcareMandates 45-day coverage for substance abuse treatment, prohibits stricter limits than medical care, expanding access to addiction services.95% confidence

Sub-Topics Insurance Mental Health Substance Abuse

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in committee · New York · Senate Jan 7, 2026

S 219: Enacts the health care tax reform act

This bill eliminates multiple taxes on health insurance in New York State, directly affecting consumers and health insurance companies. It phases out four specific taxes over time, including the $1.1 billion annual "covered lives assessment" on insured individuals, a 9.63% surcharge on hospital services, a $350 million flat tax on commercial insurance policies, and a $149 million tax on insurance companies. Key provisions gradually reduce these taxes: for instance, the insurance company tax drops from 1.75% to 0.37% by 2030 and is eliminated entirely after 2031. The legislation aims to lower health insurance costs by removing these taxes, which the bill states collectively cost consumers over $5 billion annually in 2018.

Topics ✓ Budget & TaxesSupports Budget & TaxesEliminates four specific health insurance taxes, including a $1.1B annual consumer tax, providing direct tax relief to consumers and insurers per bill summary.95% confidence ✓ HealthcareSupports HealthcareEliminates multiple health insurance taxes, reducing costs for consumers and insurers, improving affordability and access to healthcare services.95% confidence

Sub-Topics Fees & Licensing Hospitals Insurance

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in committee · New York · Assembly Jan 7, 2026

A 4211: Requires comprehensive coverage for treatment of obesity

Requires comprehensive coverage for treatment of obesity, including coverage for prevention and wellness, nutrition counseling, intensive behavioral therapy, bariatric surgery, and FDA-approved anti-obesity medication.

Topics ✓ HealthcareSupports HealthcareMandates comprehensive coverage for obesity treatments including prevention, counseling, and surgery, expanding patient access to healthcare services.95% confidence

Sub-Topics Insurance

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in committee · New York · Senate Jan 7, 2026

S 499: Enacts the "ensuring access to behavioral health act"

Enacts the "ensuring access to behavioral health act"; includes mental health services, substance use disorder treatment services and recovery support services to network adequacy requirements for insurance coverage.

Topics ✓ HealthcareSupports HealthcareMandates insurance coverage for mental health and substance use disorder services, expanding access to behavioral health care.95% confidence

Sub-Topics Insurance Mental Health Substance Abuse

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in committee · New York · Assembly Jan 7, 2026

A 2449: Requires certain health insurance policies to include coverage for the cost of certain infant and baby formulas

This bill requires health insurance plans that cover prescription drugs to include coverage for specific infant and baby formulas when prescribed by a doctor for certain medical conditions. It applies to insured individuals with conditions like inherited metabolic disorders, severe food allergies, Crohn's disease, or gastrointestinal disorders, as listed in the bill. Insurance must cover at least $3,000 annually for these formulas, with a doctor's written order confirming the formula is medically necessary and proven effective for the condition. The bill distinguishes required medical coverage from routine nutritional supplements.

Topics ✓ HealthcareSupports HealthcareMandates insurance coverage for medically necessary infant formulas, expanding access for patients with specific health conditions like metabolic disorders and allergies.95% confidence

Sub-Topics Insurance

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