New York A 9407: Relates to not requiring prior authorization for certain cancer treatments

Bill Text

Bill Search and Legislative Information | New York State Assembly 

• 

• 

• 

• 

• 

• 

• 

• 

 Skip to main content 

 New York State Assembly

 Speaker Carl E. Heastie

 --> 
 --> 

 --> 

• 
 Assembly Members 

• 
 Legislative Info 

• 
 Public Hearings 

• 
 Speaker's Press 

• 
 Assembly Reports 

• 
 Committees & More 

• Bill Search Home
• Laws
• Legislative Calendar
• Public Hearing Schedule
• Assembly Calendars
• Assembly Committee Agenda 

 Javascript must be enabled to properly view this page. 

 Bill No.: 

• Summary 
• Actions 
• Committee&nbspVotes 
• Floor&nbspVotes 
• Memo 
• Text 
• LFIN 
• Chamber&nbspVideo/Transcript 
A09407 Summary:

BILL NOA09407 

&nbsp

SAME ASSAME AS S10232

&nbsp

SPONSORPaulin

&nbsp

COSPNSR

&nbsp

MLTSPNSR

&nbsp

Amd §§3217-b & 4325, Ins L; amd §4406-c, Pub Health L; amd §364-j, Soc Serv L

&nbsp

Relates to not requiring a prior authorization determination for certain categories of cancer treatments based on National Comprehensive Cancer Network Guidelines.

Go to top A09407 Actions:

BILL NOA09407 

&nbsp

12/19/2025referred to insurance

01/07/2026referred to insurance

Go to topA09407 Committee&nbspVotes:

Go to topA09407 Floor&nbspVotes:

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

Go to topA09407 Text:

 STATE OF NEW YORK
 ________________________________________________________________________

 9407

 2025-2026 Regular Sessions

 IN ASSEMBLY

 December 19, 2025
 ___________

 Introduced by M. of A. PAULIN -- read once and referred to the Committee
 on Insurance

 AN ACT to amend the insurance law, the public health law and the social
 services law, in relation to not requiring prior authorization for
 certain cancer treatments

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

 1 Section 1. Section 3217-b of the insurance law is amended by adding a
 2 new subsection (p) to read as follows:
 3 (p) No insurer subject to this article shall require a prior authori-
 4 zation determination for cancer treatment meeting category one or cate-
 5 gory two-A of the National Comprehensive Cancer Network's Categories of
 6 Evidence and Consensus, provided that such insurer may require a health
 7 care provider to certify that the course of treatment for the oncology
 8 patient meets National Comprehensive Cancer Network Guidelines. Nothing
 9 in this subsection shall prohibit an insurer from denying a claim for
 10 such services if the services are subsequently determined not medically
 11 necessary.
 12 § 2. Section 4325 of the insurance law is amended by adding a new
 13 subsection (p) to read as follows:
 14 (p) No corporation organized under this article shall require a prior
 15 authorization determination for cancer treatment meeting category one or
 16 category two-A of the National Comprehensive Cancer Network's Categories
 17 of Evidence and Consensus, provided that such corporation may require a
 18 health care provider to certify that the course of treatment for the
 19 oncology patient meets National Comprehensive Cancer Network Guidelines.
 20 Nothing in this subsection shall prohibit a corporation from denying a
 21 claim for such services if the services are subsequently determined not
 22 medically necessary.
 23 § 3. Section 4406-c of the public health law is amended by adding a
 24 new subdivision 14 to read as follows:

 EXPLANATION--Matter in italics (underscored) is new; matter in brackets
 [ ] is old law to be omitted.
 LBD14275-01-5

 A. 9407 2

 1 14. No health care plan shall require a prior authorization determi-
 2 nation for cancer treatment meeting category one or category two-A of
 3 the National Comprehensive Cancer Network's Categories of Evidence and
 4 Consensus, provided that such health care plan may require a health care
 5 provider to certify that the course of treatment for the oncology
 6 patient meets National Comprehensive Cancer Network Guidelines. Nothing
 7 in this subdivision shall prohibit a health care plan from denying a
 8 claim for such services if the services are subsequently determined not
 9 medically necessary.
 10 § 4. Section 364-j of the social services law is amended by adding a
 11 new subdivision 26-d to read as follows:
 12 26-d. Managed care providers shall not require a prior authorization
 13 determination for cancer treatment meeting category one or category
 14 two-A of the National Comprehensive Cancer Network's Categories of
 15 Evidence and Consensus, provided that the managed care plan may require
 16 a health care provider to certify that the course of treatment for the
 17 oncology patient meets National Comprehensive Cancer Network Guidelines.
 18 Nothing in this subdivision shall prohibit a managed care plan from
 19 denying a claim for such services if the services are subsequently
 20 determined not medically necessary.
 21 § 5. This act shall take effect on the one hundred eightieth day