Bill > A01657

This bill requires health insurers, health maintenance organizations (HMOs), and health insurance corporations in New York to offer out-of-network coverage as an optional insurance rider and to provide at least one policy or contract option that includes out-of-network care. These coverage options must be made available both through the statewide health benefit exchange (a marketplace where individuals and small businesses can purchase health insurance) and outside of the exchange. Additionally, the bill maintains existing provisions that allow insured individuals to choose their primary care provider, including permitting parents to select a pediatric physician as a child's primary care provider if that provider is part of the insurer's network. The new requirements aim to give consumers more flexibility in choosing healthcare providers and accessing medical services. The bill will take effect on the first day of January following its enactment and will apply to health insurance contracts and policies that are issued, renewed, modified, or amended on or after that date.

Business and Industry

https://www.nysenate.gov/legislation/bills/2025/A1657