NY A05375

Prohibits insurers and health corporations from imposing arbitrary time caps on reimbursement for anesthesia services provided during medically necessary procedures

Requires reimbursement decisions for anesthesia to be based on medical necessity, considering procedure complexity as documented by the attending anesthesiologist or licensed anesthesia provider

Bars insurers from denying payment for anesthesia services solely because care duration exceeded a pre-set time limit

Permits use of time-related reimbursement methodologies if based on criteria from independent organizations, including Centers for Medicare and Medicaid Services standards, with an established process for submitting additional medical records to justify increased reimbursement

Extends the same anesthesia reimbursement protections to Medicaid recipients, including those in managed care programs, effective January 1, 2026