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Bill > S00586


NY S00586

NY S00586
Establishes a mandated window of five business days for both Medicaid and private insurers to respond to pre-authorization claims for testing and/or treatments made by physicians on behalf of oncology patients.


summary

Introduced
01/08/2025
In Committee
01/07/2026
Crossed Over
Passed
Dead

Introduced Session

2025-2026 General Assembly

Bill Summary

AN ACT to amend the insurance law, in relation to establishing a mandated window of five business days for both Medicaid and private insurers to respond to pre-authorization claims for testing and/or treatments made by physicians on behalf of oncology patients

AI Summary

This bill establishes a mandatory five-business-day response window for both Medicaid and private insurers when physicians submit pre-authorization claims for oncology patients' testing or treatments. Specifically, if an insurer does not respond to a pre-authorization claim within five business days, the physician is automatically authorized to proceed with the recommended lifesaving testing, treatment, or procedure, and the insurer will be required to cover the cost of care. The bill aims to expedite critical medical care for cancer patients by creating a clear timeline for insurers to review and approve physicians' proposed treatments, reducing potential delays that could negatively impact patient health. The legislation would amend the New York insurance law to add this new requirement, and it is set to take effect immediately upon enactment.

Committee Categories

Business and Industry

Sponsors (3)

Last Action

REFERRED TO INSURANCE (on 01/07/2026)

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