New York S 9219: Relates to Medicaid accountability

Bill Text

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S09219 Summary:

BILL NOS09219 

&nbsp

SAME ASSAME AS A10464

&nbsp

SPONSORSTEC

&nbsp

COSPNSRGALLIVAN, HELMING, MATTERA, RHOADS

&nbsp

MLTSPNSR

&nbsp

Add §§37, 38 & 39, amd §35, Pub Health L; amd §364-j, Soc Serv L

&nbsp

Relates to improving Medicaid accountability; verifies Medicaid enrollment data; audits certain Medicaid program areas; creates managed care payment safeguards; establishes a biometric verification pilot program.

Go to top S09219 Actions:

BILL NOS09219 

&nbsp

02/17/2026REFERRED TO HEALTH

Go to topS09219 Committee&nbspVotes:

Go to topS09219 Floor&nbspVotes:

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

Go to topS09219 Text:

 STATE OF NEW YORK
 ________________________________________________________________________

 9219

 IN SENATE

 February 17, 2026
 ___________

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

 AN ACT to amend the public health law and the social services law, in
 relation to Medicaid accountability

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

 1 Section 1. Legislative findings and intent. 1. The legislature finds
 2 that audits and reviews conducted by the state comptroller, the office
 3 of the Medicaid inspector general, and other oversight entities have
 4 repeatedly identified improper Medicaid payments arising from enrollment
 5 inaccuracies, delayed eligibility verification, claims processing weak-
 6 nesses, and inconsistent follow-through after audit findings. Such
 7 improper payments include payments made on behalf of individuals who are
 8 deceased, duplicatively enrolled, not a resident of New York State, no
 9 longer eligible, or otherwise inaccurately reflected in program records.
 10 2. The legislature further finds that improving payment accuracy
 11 requires clear statutory expectations, predictable administrative proc-
 12 esses, and timely corrective action, while maintaining continuity of
 13 care for eligible beneficiaries and operational clarity for managed care
 14 plans and providers.
 15 3. The purpose of this act is to strengthen Medicaid payment account-
 16 ability by requiring routine eligibility verification cross-checks,
 17 mandating audits in defined high-risk areas, establishing structured
 18 payment safeguards with notice and response periods, and authorizing
 19 limited verification tools to confirm service delivery, while preserving
 20 existing eligibility standards, benefits, and due process protections.
 21 § 2. The public health law is amended by adding three new sections 37,
 22 38 and 39 to read as follows:
 23 § 37. Routine eligibility and enrollment verification. 1. The depart-
 24 ment, in coordination with the office and the office of temporary and
 25 disability assistance, shall conduct cross-checks of Medicaid enrollment
 26 data no less than once annually, for the purpose of verifying ongoing
 27 eligibility and enrollment accuracy.
 28 2. Such cross-checks shall include, but not be limited to:

 EXPLANATION--Matter in italics (underscored) is new; matter in brackets
 [ ] is old law to be omitted.
 LBD14878-02-6

 S. 9219 2

 1 (a) state and federal death records;
 2 (b) duplicative or multiple active enrollments across eligibility
 3 categories or geographic jurisdictions;
 4 (c) residency indicators relevant to Medicaid eligibility and managed
 5 care program enrollment pursuant to section three hundred sixty-four-j
 6 of the social services law;
 7 (d) lawfully available federal eligibility verification data, includ-
 8 ing immigration-related eligibility information, to the extent permitted
 9 under federal law and solely for the purpose of verifying Medicaid
 10 eligibility or enrollment category; and
 11 (e) such other data sources as the commissioner determines necessary
 12 to confirm eligibility accuracy.
 13 3. Nothing in this section shall be construed to:
 14 (a) alter Medicaid eligibility standards;
 15 (b) expand the use of immigration-related information beyond eligibil-
 16 ity verification purposes permitted under federal law; or
 17 (c) permit the denial, suspension or termination of coverage without
 18 appropriate notice, opportunity to respond, and due process as otherwise