New York S 10268: Requires insurers and health plans to grant automatic preauthorization approvals to eligible health care professionals in certain circumstance

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S10268 Summary:

BILL NOS10268 

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SAME ASNo Same As

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SPONSORSKOUFIS

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COSPNSR

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MLTSPNSR

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Amd §4902, Ins L; amd §4902, Pub Health L

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Requires insurers and health plans to grant automatic preauthorization approvals to eligible health care professionals in certain circumstances.

Go to top S10268 Actions:

BILL NOS10268 

&nbsp

05/11/2026REFERRED TO INSURANCE

Go to topS10268 Committee&nbspVotes:

Go to topS10268 Floor&nbspVotes:

There are no Assembly votes for this bill in this legislative session.

Go to topS10268 Text:

 STATE OF NEW YORK
 ________________________________________________________________________

 10268

 IN SENATE

 May 11, 2026
 ___________

 Introduced by Sen. SKOUFIS -- read twice and ordered printed, and when
 printed to be committed to the Committee on Insurance

 AN ACT to amend the insurance law and the public health law, in relation
 to requiring insurers and health plans to grant automatic preauthori-
 zation approvals to eligible health care professionals in certain
 circumstances

 The People of the State of New York, represented in Senate and Assem-
 bly, do enact as follows:

 1 Section 1. Subsection (a) of section 4902 of the insurance law is
 2 amended by adding a new paragraph 17 to read as follows:
 3 (17) Establishment of automatic preauthorization approval requirements
 4 for insurers to provide to health care professionals providing health
 5 care services which shall include that:
 6 (i) an insurer that uses a preauthorization process for health care
 7 services shall provide an automatic preauthorization approval to a
 8 health care professional for a particular health care service, as
 9 defined under this title including but not limited to health care proce-
 10 dures, treatments, services, pharmaceutical products, services or dura-
 11 ble medical equipment if, in the most recent six-month evaluation peri-
 12 od, the insurer has approved not less than ninety percent of the
 13 preauthorization requests submitted by such health care professional for
 14 the particular health care service. For the purposes of this require-
 15 ment, a preauthorization request submitted during the evaluation period
 16 shall be considered and counted as a single request and single approval
 17 if the request was approved at any point between the date the request
 18 was submitted by the health care professional and the final determi-
 19 nation by the insurer, including any re-review or appeal process. Each
 20 insurer shall complete its initial evaluation and issue its determi-
 21 nation to each health care professional in its network no later than one
 22 hundred eighty days after the effective date of this paragraph. The
 23 automatic preauthorization approval shall become effective two hundred
 24 twenty-five days after the effective date of this paragraph;
 25 (ii) after the initial evaluation has been completed the insurer shall
 26 annually thereafter evaluate whether a health care professional quali-

 EXPLANATION--Matter in italics (underscored) is new; matter in brackets
 [ ] is old law to be omitted.
 LBD01540-02-5

 S. 10268 2

 1 fies for an automatic preauthorization approval under subparagraph (i)
 2 of this paragraph for additional health care services. Each year, the
 3 evaluation shall review preauthorization determinations made in the
 4 first six months of the year. Each insurer shall issue its determination
 5 to each health care professional in its network no later than November
 6 fifteenth to be effective January first of the following year;
 7 (iii) the insurer may continue the automatic preauthorization approval
 8 under subparagraph (i) of this paragraph without evaluating whether the
 9 health care professional qualifies for automatic preauthorization
 10 approval for a particular evaluation period;
 11 (iv) a health care professional shall not be required to request an
 12 automatic preauthorization approval to qualify for such approval;
 13 (v) a health care professional's automatic preauthorization approval
 14 under subparagraph (i) of this paragraph shall remain in effect until
 15 the thirtieth calendar day after:
 16 (A) the date the insurer notifies the health care professional of the
 17 insurer's determination to rescind the automatic preauthorization
 18 ap