Bill > A08500

This bill clarifies and strengthens provisions related to the New York state health insurance program, specifically addressing out-of-network health care service reimbursements. The bill requires that health benefits include reimbursement for out-of-network health care services at a level of at least 80% of the "usual and customary cost," which is defined as the eightieth percentile of all charges for a particular health care service performed by a provider in the same or similar specialty within the same geographical area, as reported in a benchmarking database maintained by a specified nonprofit organization. Additionally, the bill ensures that when the state provides health benefits through agreements with employee organizations, any extended benefits cannot diminish current existing benefits. The goal is to provide clarity and protection for state employees regarding their health insurance coverage, ensuring consistent and fair reimbursement for out-of-network medical services and maintaining the integrity of existing health benefit packages.

Labor and Employment

https://www.nysenate.gov/legislation/bills/2025/A8500