New York A 6586: Requires health insurance policies and Medicaid to cover patient navigation services

Bill Text

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A06586 Summary:

BILL NOA06586 

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SAME ASSAME AS S05565

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SPONSORWeprin

&nbsp

COSPNSRSteck, Buttenschon, Simone, Lavine, Bronson, Meeks, Shimsky, Burdick, Santabarbara, Epstein,
 Hevesi, Dinowitz, Brabenec, Zaccaro, Slater, Reyes, Simon, Kassay, Novakhov

&nbsp

MLTSPNSR

&nbsp

Amd §§3216, 3221 & 4303, Ins L; amd §365-a, Soc Serv L

&nbsp

Requires health insurance policies and Medicaid to cover patient navigation services.

Go to top A06586 Actions:

BILL NOA06586 

&nbsp

03/06/2025referred to insurance

01/07/2026referred to insurance

Go to topA06586 Committee&nbspVotes:

Go to topA06586 Floor&nbspVotes:

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

Go to topA06586 Text:

 STATE OF NEW YORK
 ________________________________________________________________________

 6586

 2025-2026 Regular Sessions

 IN ASSEMBLY

 March 6, 2025
 ___________

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

 AN ACT to amend the insurance law and the social services law, in
 relation to requiring health insurance policies and Medicaid to cover
 patient navigation services

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

 1 Section 1. Subsection (i) of section 3216 of insurance law is amended
 2 by adding a new paragraph 40 to read as follows:
 3 (40) (A) Every policy which provides medical, major medical, or simi-
 4 lar comprehensive-type coverage shall provide coverage for patient navi-
 5 gation services to improve access to care for individuals who are eligi-
 6 ble for screening, follow-up or treatment services. Eligibility for
 7 patient navigation services coverage includes individuals with a serious
 8 condition that is expected to last at least three months and places the
 9 individual at high risk for one or more of the following:
 10 (i) Hospitalization;
 11 (ii) Nursing home placement;
 12 (iii) A sudden worsening of preexisting symptoms;
 13 (iv) Physical or mental decline; or
 14 (v) Death.
 15 (B) Patient navigation services shall include, but not be limited to:
 16 (i) Screening for nonclinical and social needs that do not require a
 17 licensed healthcare provider to complete;
 18 (ii) Referrals and follow-up to connect individuals to services
 19 including, but not limited to transportation, employment, job training,
 20 food insecurity, childcare, housing, language or health literacy
 21 support;
 22 (iii) Help with enrollment or maintaining enrollment in government
 23 programs or other assistance programs;

 EXPLANATION--Matter in italics (underscored) is new; matter in brackets
 [ ] is old law to be omitted.
 LBD08151-01-5

 A. 6586 2

 1 (iv) Arranging for and accompaniment to in-person and virtual health-
 2 care visits; or
 3 (v) Other prevention, screening and treatment health education, health
 4 navigation, health advocacy, or individual supports including transition
 5 of care supports.
 6 (C) Reimbursement shall be provided to individuals who are trained and
 7 have completed a national patient navigation certification or creden-
 8 tialing program, or other certification or training program approved by
 9 the department of health. Approved individuals shall be employed by or
 10 in consultation with facilities certified under article twenty-eight of
 11 the public health law, diagnostic and treatment centers, federally qual-
 12 ified health centers, clinics, physicians or other licensed healthcare
 13 providers, to provide patient navigation services. Individuals author-
 14 ized to provide patient navigation services shall do so under the gener-
 15 al supervision of a licensed physician or other licensed healthcare
 16 provider.
 17 § 2. Subsection (l) of section 3221 of insurance law is amended by
 18 adding a new paragraph 23 to read as follows:
 19 (23) (A) Every insurer delivering a group or blanket policy or issuing
 20 a group or blanket policy for delivery in this state that provides
 21 coverage for medical, major medical or similar comprehensive-type cover-
 22 age shall provide coverage for patient navigation services to improve
 23 access to care for individuals who are eligible for screening, follow-up
 24 or treatment services. Eligibility for patient navigation services
 25 coverage includes