Bill > A09312

This bill aims to improve Medicaid network adequacy and protect patient access to healthcare by introducing several key provisions. The legislation requires the state health commissioner to annually update network adequacy guidelines and quarterly publish detailed, de-identified results of managed care organization network surveys on their website. Healthcare organizations withdrawing from Medicaid or Medicare Advantage networks must now provide 90 days' advance notice to state departments and affected patients. The bill extends patient protections by increasing the transitional care period from 90 to 180 days when a healthcare provider leaves a health maintenance organization's network, allowing patients with ongoing treatments, life-threatening conditions, or pregnant patients to continue seeing their current providers. Additionally, the bill mandates that new enrollees with existing providers not in their network can continue treatment for up to 180 days under certain medical conditions, provided the provider agrees to the health maintenance organization's reimbursement and quality assurance requirements. The legislation is motivated by concerns about limited healthcare access in rural and suburban regions, recent provider network withdrawals, and the need to ensure that Medicaid spending translates into meaningful patient care.

Health and Social Services

https://www.nysenate.gov/legislation/bills/2025/A9312