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NY A07239

Bill

Status

Introduced

3/21/2025

Primary Sponsor

Monique Chandler-Waterman

Click for details

Origin

Assembly

2025-2026 General Assembly

AI Summary

  • Requires Medicaid managed care providers to approve "single patient agreements" allowing patients to continue seeing out-of-network health care professionals with whom they have established long-term relationships

  • Defines "long term relationship" as a treatment relationship of 90 days or longer during which the provider delivered medical assistance to the patient at least 10 times

  • Out-of-network providers under these agreements must be paid at the managed care plan's in-network rates

  • Excludes coverage if the health care professional has any reported allegations of fraud, abuse, or malpractice that the managed care provider has been notified of

  • Takes effect 90 days after becoming law, with coverage available at time of application for medical assistance or on coverage anniversary dates, subject to deductibles and co-insurance as determined by the Commissioner of Health

Legislative Description

Requires Medicare and Medicaid managed care providers to provide coverage for certain out-of-network health care when the patient has a long term relationship with a medical professional who is not a recurring provider under the managed care provider's network.

Last Action

referred to health

1/7/2026

Committee Referrals

Health3/21/2025

Full Bill Text

No bill text available