Legislative Memos

2026 LEGISLATIVE MEMOS

Health Insurance Coverage Mandates

• A.10893 (Jackson) / S.7280 (Martinez)- Mammogram Age
• A.10030-B (Weprin) / S.8969-B (Bailey)- Speech Therapy for Stuttering
• A.1158-A (Seawright) / S.4850 (Ryan)- Additional Breast Cancer Screening
• A.580 (Paulin) / S.3559 (Cleare) – Dense Breast Tissue
• A.2449 (Cruz) / S.868 (Bailey) – Coverage of Infant and Baby Formula
• A.6484-A (Weprin) / S.5045-A (Bailey) – Copay Limits
• S.5263 (Ashby) – Prohibit preauthorization on SUD
• A.6586 (Weprin) / S.5565 (Bailey) – Patient Navigation Services
• A.3919-B (Weprin) / S.6254-B (Skoufis) – Specialized Dental Benefit Plans
• A.771-A (Rosenthal) / S.7915 (Gounardes) – Egg and Peanut Allergen Supplements
• S.8969-A (Bailey) – Therapy for Stuttering
• A.5140 (Solages) / S.6494 (Cleare) – Doula Coverage
• A.6919 (Woerner) / S.2648 (Addabbo) – Dental Night Guards
• A.7953 (Forrest) / S.2334 (Rivera) – Lead Screenings
• A.7384 (Reyes) / S.7731 (Webb) – Parent Interhospital Transport
• A.7562-A (Reyes) / S.3820-B (Rivera) – Anesthesia for Duration of Procedure
• A.10030-A (Weprin) / S.8969-A (Bailey) – Speech Therapy for Stuttering
• A.622-C (Kim) / S.5955-B (Parker) – Acupuncture
• A.1158-A (Seawright) / S.4850 (Ryan) – Additional Breast Cancer Screenings – Second Degree Relative
• A.4677-B (Jackson) / S.1670-B (Salazar) – Lactation Consultant Services
• A.9519 (McDonald) / S.8869 (Skoufis) – Pharmacist Reimbursement for Contraceptives
• A.8349 (Septimo) / S.3155 (Cooney) – In Vitro Fertilization Mandate
• A.7339 (Rozic) / S.4497 (Hinchey) – Fertility Preservation Services
• A.885 (Paulin) / S.8866 (Salazar) – Equity in Fertility Treatment Act
• A.7562-A (Reyes) / S.3820-B (Rivera) – Anesthesia for Duration of Procedure
• A.3767 (Weprin) / S.2644 (Addabbo) – Prohibits Retrospective Denials for SUD Treatment
• A.3148-A (Gonzalez-Rojas) / S.1763-A (Fernandez) – Outpatient SUD Cost Sharing
• A.1206-B (Kim) / S.634-B (Liu) – Diabetes Screening
• A.686 (Solages) / S.520 (Persaud) – Genetic Testing for Ovarian Cancer

Health Insurance Plan Management and Operations

• A.6648 (Hunter) / S.5241 (Fernandez)- Utilization Review for MH-SUD Services
• A.8839 (Simon) / S.8426-A (Brouk)- Codification of MHPAEA
• A.1257 (Paulin)/S.3358 (Rivera)- Home Care Denials
• A.3767 (Weprin) / S.2644 (Addabbo)- Prohibits Retroactive Denials of SUD treatments
• A.3789 (Weprin) / S.9651 (Rivera)- UR and Preauthorization Restrictions
• A.10357 (Rosenthal) / S.9269 (Krueger)- NY Health Information Privacy Act
• A.10576 (Lucas) / S.8838-A (Rivera)- DME Parity
• A.3789 (Weprin) / S.9651 (Rivera) – UR and preauthorization restrictions
• A.8052 (Lavine) / S.1911-A (Rivera) – Termination of Providers
• A.2044 (Paulin) / S.6266 (Salazar) – Quality Incentive Program (Support)

Pharmaceuticals

• A.5882-C (McDonald) / S.5939-C (Skoufis)- PBM Payments
• A.1428 (Forrest) / S.9497 (Fernandez) – Substitution of Drugs
• A.1428 (Forrest) / S.9497 (Fernandez) – Substitution of Drugs
• S.4867 (Fahy) – Step Therapy Serious MH Conditions
• A.5882-B (McDonald) / S.5939-B (Skoufis) – PBM Payments
• A.7142 (Walker) / S.2128 (Jackson) – Prescription Drug Rebates

Miscellaneous

• A.6522-A (Lee) / S.2113-A (Cooney)- Allows ACOs to purchase Experience Rated Health Insurance

2025 LEGISLATIVE MEMOS

Health Insurance Coverage Mandates

• S.6499 (Cleare) – Obstetric and Gynecological Care – Oppose
• A.2520 (McDonald) / S.1616 (Rivera) – Complex Rehab Tech Benchmark – Oppose
• A.885 (Paulin) / S.5545 (Hoylman-Sigal) – Fertility Treatment – Oppose
• A.5255 (Reyes) / S.3100 (Rivera) – Coverage for Asthma – Oppose
• A.1158-A (Seawright) / S.4580 (Ryan) – Breast Cancer Screening – Oppose
• S.2000 (Addabbo) / A. 1195 (Peoples-Stokes) – Lung Cancer Diagnostic Testing – Oppose
• S.868 (Bailey) / A.2449 (Cruz) – Coverage of Infant and Baby Formula – Oppose
• S.4867 (Fahy) – Step Therapy MH Conditions – Oppose

Health Insurance Plan Management and Operations

• A.8004 (Pretlow) / S.5812 (Sepulveda) – Prohibiting CHP Plans from Requiring Providers Join Other Networks – Oppose
• A.8052 (Lavine) / S.1911-A (Rivera) – Termination of Providers – Oppose
• A.6484 (Weprin) / S.5045 (Bailey) – PT-OT Co-Pay Limits – Oppose
• S.1634 (Rivera) / A.1915-A (Paulin) – Primary Care Investment – Oppose
• A.2526 (Paulin) – Provider Collective Negotiations – Oppose

Pharmaceuticals

• A.7142 (Walker) / S.2128 (Jackson) – Prescription Drug Rebates – Oppose
• S.4867 (Fahy) – Step Therapy MH Conditions – Oppose

Miscellaneous

2024 LEGISLATIVE MEMOS

Health Insurance Coverage Mandates

• S.3227-A (Hoylman-Sigal) – Prohibit Preauthorization on PrEP – Oppose

• A.1696 (Hunter) / S.2465 (Persaud) – Addition Breast Cancer Screening – Oppose

• A.4141-A (Rivera) / S.504-A (Forrest) – Insulin Cap

• S.4889 (Rivera) – Coverage for Asthma

• A2516 (Paulin)/S2917 (Cleare) – Oppose Senate Health

Health Insurance Plan Management and Operations

• S.4922-A (Sepulveda) – Prohibiting Child Health Plus plans from requiring that participating health care providers accept all products offered by that health plan. – Oppose

• A.5750 (Paulin) / S.6123 (Rivera) – Home Care Claims – Oppose

• A.6019 (Paulin) / S.4785 (Rivera) – Provider Collective Negotiations – Oppose

• A.901 (McDonald) / S.1267 (Breslin) – Step Therapy UR Protocol

• A.1777 (Lavine) / S.3282 (Rivera) – Termination of Providers

• A.1619 (Rosenthal) / S.1001 (Hoylman-Sigal) – Prohibits Preauth and Step Therapy on HIV drugs

• S3400 (Breslin) – Oppose Senate Health

• A6898 (Weprin)/S3402 (Breslin) – Oppose Senate Health

Pharmaceuticals

Miscellaneous

• A.8592 (Paulin) / S.1197-B (Rivera) – Primary Care Investment

2023 LEGISLATIVE MEMOS

Health Insurance Coverage Mandates

• S.200 – Obstetric and Gynecological Care 
• A.4713/S.2568 – Coverage of Medical Marijuana
• A.3408/S.3468 – Complex Rehab Tech
• S.4889 – Coverage for Asthma
• A.2516 – Dense Beast Tissue
• A.4232/S.3433 – Complex Rehab Tech
• A.6898/S.3402 – Utilization Review Automatic Approval
• A.859/S.2680 – Gold Carding
• A.1696/S.2465 – 120-Day Window for Additional Breast Exams
• A.2898A – Coverage for Neuropsych Exams for Dyslexia
• A.1673A/S.1196A – Coverage of Biomarker Testing
• A.250A/S.1466 – Non-Par Ambulance Reimbursement

Health Insurance Plan Management and Operations

• A.901/S.1267 – Step Therapy UR Protocol
• A.1777/S.3282 – Termination of Providers 
• A.848 – EHR Sharing
• S.4922 – Prohibiting Approved Organizations in the Child Health Insurance Plan From Limiting the Participation of Certain Health Care Providers
• A.7268/S.3400 – UR and Pre-Authorization Restrictions
• A.5129/S.6576 – Disaffiliated Provider Coverage
• A.6019/S.4785 – Collective Negotiations with Plans
• A.7393/S.7477 – MCO Excess Reserves Extender
• A.5381/S.6075 – Actuarial Review of Rates

Pharmaceuticals

• S.504 – Insulin Cap

Miscellaneous

• S.1197 – Primary Care Reform

2022 LEGISLATIVE MEMOS

Government Programs

• A.6058/S.5474 – New York Health Act

Health Insurance Coverage Mandates

• A.3132/S.1832 – Complex Rehabilitation Technology
• S.4934/A.2451 – Coverage for Asthma
• A.242/S.8837 – Coverage for Medical Marijuana
• A.9150/S.8156 – Additional Breast Cancer Screenings
• A.9054-B/S.8549 – Coverage for Fibroids

Health Insurance Plan Management and Operations

• A.879/S.8113 – Clinical Peer Reviewer
• S.2121B/A.289B – Medically Fragile Coverage
• A.832A/S.3231 – HMO In Network Referrals
• A.3276/S.5909 – Step Therapy
• S.5299/A.1741 – Copay Accumulator
• S.7263/A.2519 – Request for Alternative Contact
• S.6920 – Utilization Review Automatic Renewal
• A.7129-A/S.6435.B – Utilization Review and Prior-Authorization Restrictions

Pharmaceuticals

• S.4532/A.4667 – Opioid Abuse Deterrent
• S.1413/A.2383 – Insulin Cost Cap
• S.431-A/A.187 – Medicaid Prescription Synchronization
• A.372/S.5960 – Prohibit Opioid Treatment Program Copay

Provider Rights and Reimbursement

• S.5505/A.6256 – Telehealth Payment Parity
• A.7320/S.6534A – Primary Care Reform
• A.5368A – DME Reimbursement Parity
• A.4177/S.2528 – Termination of Providers
• A.1316/S.1573 – Behavioral Health Contracts
• A.9908-A/S.8299 – “Gold Carding”
• A.1309 – Non Par Ambulance Reimbursement

2021 LEGISLATIVE MEMOS

Health Insurance Coverage Mandates

• A.242 – Coverage for Medical Marijuana
• A.2085A/S.906B – Colorectal Cancer Screenings

Health Insurance Plan Management and Operations

• A.879/S.599 – Clinical Peer Reviewer
• A.4668/S.4111 – Prohibit Mid-Year Drug Formulary Changes
• S.2008 – Notice of Partial Approval
• S.5299/A.1741 – Copay Accumulator
• S.21210-B/A.289-B – Medically Fragile Children

Pharmaceuticals

• S.3566/A.5854A – Mail Order Pharmacy
• S.4532/A.4667 – Opioid Abuse Deterrent
• S.7252 – “White Bagging”
• S.6603/A.7598 – Managed Care Organizations and Pharmacy Benefit Manager Fees
• A.372/S.5960 – Prohibit Opiod Treatment Program Copay
• S.1413/A.2382 – Capping Cost Sharing for Insulin

Provider Rights and Reimbursement

• A.1523/S.2212 – CHP Discrimination Against Non-Par Providers
• A.1316/S.1573 – Behavioral Health Contracts
• A.5185/S.2533 – Home Care Prompt Pay
• S.5505/A.6256 – Telehealth Payment Parity
• A.5368A – Durable Medical Equipment Reimbursement Parity
• S.3556 – Non Participating Ambulance Reimbursement 

Miscellaneous

• A.2294/S.2019 – Scope of Practice of Podiatry

2020 LEGISLATIVE MEMOS

Health Insurance Plan Management and Operations

• A.9086/S.7525 – Nursing Home Eligibility Determinations
• A.9085/S.7159 – Notice of Partial Approval
• A.2832/S.67 – Domestic Violence Victim Request for Alternative Contact
• A.3076/S.8844 – Clinical Peer Review
• A.9003/S.7569 – Complex Rehabilitation Technology for Medicaid
• S.1408A – Municipality to Join County Self-Insured Plan

Pharmaceuticals

• S.7115/A.9034 – Partial Fill Authorization
• A.10821/S.8255 – $30 Insulin Out of Pocket Cap
• A.8665/S.6646 – Online EPIC Application
• S.6397 – Abuse Deterrent Formulations for Opioids
• S.7109/A.9012 – Medicaid Prescription Synchronization
• S.6492A/A.8533 – $100 Insulin Out of Pocket Cap
• A.9634/S.7699 – Medicaid Managed Care Coverage of Medication Assisted Treatment
• A.9902/S.7828 – Pharmacy Benefit Manager Fiduciary and Licensure 

Provider Rights and Reimbursement

• A.3077/S.4335 – Universal Credentialing for Newly Licensed Providers
• A.6211/S.3526 – Out-Of-Network Ambulance Reimbursement 
• A.3654/S.6760 – All Products Exemption