NY S01634

Requires health insurance plans and payors to spend at least 12.5% of their total physical and mental health expenditures on primary care services

Mandates annual reporting to the Department of Financial Services beginning April 1, 2026, showing the percentage of overall healthcare spending dedicated to primary care

Plans spending less than 12.5% on primary care must submit improvement plans starting April 1, 2027, increasing primary care spending by at least 1% annually until reaching the threshold

Applies to both commercial insurers and Medicaid managed care providers, with parallel requirements under the Insurance Law and Social Services Law

Prohibits plans from raising premiums or cost-sharing to comply with the spending requirements; spending shifts must come from improving value and quality without increasing total medical expenditures