Legislative Memos

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