Bill > S07918

This bill addresses reimbursement practices for anesthesia services across different types of insurance providers in New York, including private insurers, medical corporations, and medical assistance providers. The legislation prohibits arbitrary time caps on anesthesia service reimbursement during medically necessary procedures and prevents providers from denying payment solely because the duration of care exceeded a pre-set time limit. Insurers are allowed to use time-related reimbursement methodologies, but only if these methodologies are based on criteria established by an independent organization, such as the Centers for Medicare and Medicaid Services (CMS). When using such a methodology, providers must establish a process for submitting additional medical records and sharing electronic medical records to potentially justify increased reimbursement. The bill requires reimbursement to be determined based on medical necessity, taking into account the complexity of the procedure as evidenced by medical records submitted by the attending anesthesiologist or licensed anesthesia provider. The legislation will take effect on January 1, 2026, and applies to hospital, medical, and surgical expense insurance across different types of healthcare providers and insurance systems.

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https://www.nysenate.gov/legislation/bills/2025/S7918