NY S09508

Part A: Establishes basic health program buy-in allowing individuals and eligible small groups (100 or fewer employees) to purchase coverage through basic health plans, with premium assistance for those earning up to 500% of federal poverty line and premium supplements required for those above 800% of poverty line.

Part B: Requires health plans to reimburse non-participating providers at median in-network rates; establishes annual limits on consumer out-of-pocket health care expenditures based on household income; caps hospital reimbursement at 240% of Medicare benchmark rates; prohibits hospitals and health professionals from placing liens on primary residences or imposing income executions for medical debt; effective January 1, 2024.

Part C: Creates chronic disease demonstration program eliminating cost-sharing (copays, coinsurance, deductibles) for targeted high-value services treating diabetes, asthma, COPD, hypertension, heart disease, opioid use disorder, bipolar disorder, and schizophrenia; requires evaluation every five years; effective January 1, 2023.

Part D: Requires commercial insurers to reimburse safety net hospitals at no less than 80th percentile of their commercial rates; hospitals with over $3 billion annual revenue must contribute 2% of revenue to health equity pool; revises indigent care pool distribution to prioritize safety net hospitals with greatest financial need; effective January 1, 2024.

Part E: Authorizes Department of Health to require healthcare providers and payers to report additional claim and price data; requires annual public reports on health care costs, price variation, utilization, provider consolidation, and cost growth trends; mandates annual public hearing with testimony from providers and payers.