Bill > S02113

This bill allows Medicaid accountable care organizations (ACOs) comprised of private physician practices to purchase experience-rated health insurance under specific conditions. The bill modifies insurance law to permit these ACOs to buy group health insurance policies that can cover their members and employees, with several important requirements: the ACO must have been issued a certificate of authorization, have been in active existence for at least two years, and be organized primarily for purposes other than obtaining insurance. The policy must cover at least 100 individuals at the time of issue, with premiums potentially paid from organizational funds, member funds, or a combination of both. The bill also specifies that for an ACO to qualify, it must have at least 150 member employers, insure over 500 individuals, have all employers enrolled as Medicaid providers, and demonstrate that Medicaid represents at least 60% of their annual revenues. By creating this new insurance category, the bill provides more flexible health insurance options for Medicaid ACOs composed of healthcare professionals, potentially helping such organizations manage their insurance needs more effectively. The provisions will take effect 180 days after becoming law.

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https://www.nysenate.gov/legislation/bills/2025/S2113