New York A 1462: Establishes a mandated window of five business days for both Medicaid and private insurers to respond to pre-authorization claims for testing and/or treatments made by physicians on behalf of oncology patients

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A01462 Summary:

BILL NOA01462 

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SAME ASSAME AS S00586

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SPONSORHunter

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COSPNSRPaulin, Weprin, Steck, Hooks

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MLTSPNSR

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Amd §3238, Ins L

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Establishes a mandated window of five business days for both Medicaid and private insurers to respond to pre-authorization claims for testing and/or treatments made by physicians on behalf of oncology patients.

Go to top A01462 Actions:

BILL NOA01462 

&nbsp

01/09/2025referred to insurance

01/07/2026referred to insurance

Go to topA01462 Committee&nbspVotes:

Go to topA01462 Floor&nbspVotes:

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

Go to topA01462 Text:

 STATE OF NEW YORK
 ________________________________________________________________________

 1462

 2025-2026 Regular Sessions

 IN ASSEMBLY

 January 9, 2025
 ___________

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

 AN ACT to amend the insurance law, in relation to establishing a
 mandated window of five business days for both Medicaid and private
 insurers to respond to pre-authorization claims for testing and/or
 treatments made by physicians on behalf of oncology patients

 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 3238 of the insurance law is
 2 amended by adding a new paragraph 7 to read as follows:
 3 (7) with regard to claims of pre-authorization filed by a physician
 4 with private insurers and/or Medicaid on behalf of an oncology patient,
 5 it is hereby mandated that a waiting period of five business days be
 6 established in which an insurer must respond to such a claim. If in such
 7 a case the insurer does not render a decision and notify the physician
 8 within the period of five business days following the filing of a pre-
 9 authorization claim, the physician deemed responsible for treating the
 10 patient is authorized to conduct the lifesaving testing, treatment, or
 11 procedure and as such, the insurer will be made liable for payment
 12 covering the prescribed method of care.
 13 § 2. This act shall take effect immediately.

 EXPLANATION--Matter in italics (underscored) is new; matter in brackets
 [ ] is old law to be omitted.
 LBD02191-01-5

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