New York S 5204: Enacts the Health Care Nondiscrimination Act of 2025

Bill Text

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S05204 Summary:

BILL NOS05204 

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SAME ASSAME AS A04262

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SPONSORSCARCELLA-SPANTON

&nbsp

COSPNSRCLEARE, HARCKHAM, SUTTON

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MLTSPNSR

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&nbsp

Enacts the Health Care Nondiscrimination Act; requires insurance coverage and health plans to implement equality and non-discrimination between licensed health care providers; requires fee parity between different classes of licensed providers providing the similar or like-kind services; requires practitioners to discuss and refer or prescribe non-pharmacological treatment alternatives before prescribing an opioid treatment; allows any licensed health care provider to perform certain services, including certifying disability and employment by school districts; provides for enforcement and penalties.

Go to top S05204 Actions:

BILL NOS05204 

&nbsp

02/19/2025REFERRED TO HEALTH

01/07/2026REFERRED TO HEALTH

Go to topS05204 Committee&nbspVotes:

Go to topS05204 Floor&nbspVotes:

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

Go to topS05204 Text:

 STATE OF NEW YORK
 ________________________________________________________________________

 5204

 2025-2026 Regular Sessions

 IN SENATE

 February 19, 2025
 ___________

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

 AN ACT to enact the Health Care Nondiscrimination Act of 2025

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

 1 Section 1. Short title. This act shall be known and may be cited as
 2 the "Health Care Nondiscrimination Act of 2025".
 3 § 2. Legislative findings. All residents should have freedom to seek
 4 the care, treatment and provider of their choosing with respect to their
 5 healthcare if treatment of a health condition is within a licensed
 6 healthcare provider's scope of practice. Given the historic bias against
 7 nonpharmacological-based healthcare in New York, it shall be the policy
 8 of the state to redress this imbalance by removing barriers and enhanc-
 9 ing access to such services. First, a health insurance plan or health
 10 benefit should not discriminate against licensed, nonpharmacological-
 11 based healthcare providers regarding fee reimbursement or payment for
 12 the provision of similar or like-kind healthcare services. Second, to
 13 further reverse this bias and promote the public health, the state
 14 should promote licensed, nonpharmacological-based healthcare services to
 15 ensure that the public has full and unfettered access to the evidence-
 16 based benefits of such services, including the treatment of substance
 17 abuse disorders to combat the opioid crisis. Third, all residents should
 18 have equal access to nonpharmacological-based healthcare alternatives,
 19 whether through self-funded healthcare plans or plans which are fully
 20 funded through insurance, or other contracts, when making personal
 21 healthcare decisions. Finally, to better ensure compliance and enforce-
 22 ment, the departments of health, financial services and labor should
 23 have the ability to impose substantial fines and penalties against
 24 insurers, healthcare plans and healthcare organizations that continue to
 25 deny patients' freedom of choice regarding their healthcare.

 EXPLANATION--Matter in italics (underscored) is new; matter in brackets
 [ ] is old law to be omitted.
 LBD01263-01-5

 S. 5204 2

 1 § 3. Definitions. For the purposes of this act, the following terms
 2 shall have the following meanings:
 3 1. "Licensed health care provider or providers" shall mean any person
 4 duly licensed under articles 132, 136, 153, 155, 156 or 160 of the
 5 education law.
 6 2. "Managed care product" shall mean: (a) a policy which requires that
 7 medical or other health care services covered under the policy, other
 8 than emergency care services, be provided by, or pursuant to, a referral
 9 from a primary care provider and that services provided pursuant to such
 10 a referral be rendered by a licensed health care provider participating
 11 in the insurer's managed care provider network; (b) the in-network
 12 portion of a contract which requires that medical or other health care
 13 services covered under the contract, other than emergency care services,
 14 be