Bill > S07470

This bill requires insurers and health care plans to establish an automatic preauthorization approval process for health care professionals who consistently demonstrate high approval rates for their preauthorization requests. Under this legislation, if a health care professional has had 90% or more of their preauthorization requests approved during a six-month evaluation period, they will be granted automatic preauthorization for specific health care services. The process includes annual evaluations, with insurers and health care plans required to notify professionals of their automatic approval status, including which services are covered and the duration of the approval. The bill also prohibits insurers and health care plans from retroactively denying or reducing payments for services covered under automatic preauthorization, except in cases of knowingly fraudulent claims or failure to substantially perform a service. Health care professionals can appeal rescission of their automatic preauthorization status, and the relevant regulatory bodies (the superintendent of insurance and the commissioner of health) are tasked with developing implementation regulations. The goal of this bill is to streamline the preauthorization process, reduce administrative burden on health care professionals, and ensure more efficient healthcare service delivery.

Business and Industry

https://www.nysenate.gov/legislation/bills/2025/S7470