Bill > A09407

This bill prohibits insurance companies, health care corporations, health care plans, and managed care providers from requiring prior authorization for cancer treatments that meet Category One or Category Two-A standards in the National Comprehensive Cancer Network (NCCN) Guidelines. While these entities cannot mandate advance approval for these specific cancer treatments, they can require healthcare providers to certify that the proposed treatment follows NCCN Guidelines. Additionally, the bill preserves the organizations' right to deny claims for treatments that are subsequently determined to be not medically necessary. The NCCN Guidelines are widely recognized standards that categorize medical treatments based on levels of evidence and professional consensus, with Category One representing uniform consensus and high-level evidence, and Category Two-A representing near-uniform consensus and lower-level evidence. The bill aims to streamline cancer treatment access by reducing administrative barriers for treatments that are considered highly recommended by medical experts. The law will take effect 180 days after becoming law, with a specific provision related to managed care providers subject to existing sunset provisions.

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https://www.nysenate.gov/legislation/bills/2025/A9407