Bill > A01915

This bill requires health care plans and payors (including insurance companies, Medicaid managed care providers, and other health coverage entities) to allocate at least 12.5% of their total healthcare expenditures to primary care services, which are defined as outpatient medical services provided by physicians, nurse practitioners, physician assistants, or midwives in fields like family practice, pediatrics, internal medicine, and primary care obstetrics or gynecology. Starting in April 2026, these entities will be required to annually report their primary care spending to state health departments, with a requirement to submit a plan to incrementally increase primary care spending if they fall below the 12.5% threshold. The bill mandates that this spending increase should not result in higher premiums or increased cost-sharing for patients, and it encourages plans to improve care value through strategies like upgrading technology, providing technical assistance, and implementing value-based payment arrangements. For Medicaid providers, the bill includes additional provisions ensuring compliance with federal regulations and allowing the state to seek necessary federal approvals to implement these requirements. The goal is to strengthen primary care infrastructure by ensuring a consistent and meaningful investment in these essential healthcare services.

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https://www.nysenate.gov/legislation/bills/2025/A1915