Bill > A07239

This bill requires Medicare and Medicaid managed care providers to offer coverage for out-of-network healthcare professionals with whom a patient has established a "long-term relationship," defined specifically as a treatment relationship lasting at least 90 days during which the healthcare professional has provided medical assistance to the patient at least 10 times. Under this proposed legislation, patients can request a single-patient agreement with their preferred healthcare professional, even if that professional is not typically in the managed care provider's network, and the professional would be reimbursed at the provider's in-network rates. The bill includes important safeguards, such as excluding healthcare professionals with reported allegations of fraud, abuse, or malpractice, and allowing managed care providers to apply standard annual deductibles and co-insurance. The coverage would be implemented either when a patient initially applies for medical assistance or on the anniversary date of their existing coverage, subject to verification of eligibility. The act is titled the "patient choice of health care provider protection act" and is set to take effect 90 days after becoming law.

Health and Social Services

https://www.nysenate.gov/legislation/bills/2025/A7239