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NY A08500

Bill

Status

Introduced

5/20/2025

Primary Sponsor

Stacey Pheffer Amato

Click for details

Origin

Assembly

2025-2026 General Assembly

AI Summary

  • Requires the New York State health insurance program to reimburse out-of-network health care services at a minimum of 80% of the "usual and customary cost"

  • Defines "usual and customary cost" as the 80th percentile of all charges for a particular health care service by providers in the same specialty and geographic area, based on a nonprofit benchmarking database specified by the Superintendent of Financial Services

  • Prohibits extending health benefits to non-union employees if such extension would diminish current existing benefits

  • Applies to health insurance contracts entered into under the state employee health insurance program (Civil Service Law Section 162)

Legislative Description

Clarifies that the New York state health insurance program remains subject to certain provisions of the financial services law and coverage for usual and customary costs for out-of-network health care service.

Last Action

referred to governmental employees

1/7/2026

Committee Referrals

Governmental Employees5/20/2025

Full Bill Text

No bill text available