New York A 9360: Relates to requiring Medicaid coverage of FDA-approved GLP-1 receptor agonist medications for certain purposes

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A09360 Summary:

BILL NOA09360 

&nbsp

SAME ASNo Same As

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SPONSORSantabarbara

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COSPNSR

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MLTSPNSR

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Amd §365-a, Soc Serv L

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Relates to requiring Medicaid coverage of FDA-approved GLP-1 receptor agonist medications for obesity, metabolic disorders, and autism-related compulsive eating behaviors.

Go to top A09360 Actions:

BILL NOA09360 

&nbsp

12/19/2025referred to health

01/07/2026referred to health

Go to topA09360 Committee&nbspVotes:

Go to topA09360 Floor&nbspVotes:

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

Go to topA09360 Text:

 STATE OF NEW YORK
 ________________________________________________________________________

 9360

 2025-2026 Regular Sessions

 IN ASSEMBLY

 December 19, 2025
 ___________

 Introduced by M. of A. SANTABARBARA -- read once and referred to the
 Committee on Health

 AN ACT to amend the social services law, in relation to requiring Medi-
 caid coverage of FDA-approved GLP-1 receptor agonist medications for
 obesity, metabolic disorders, and autism-related compulsive eating
 behaviors

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

 1 Section 1. Subdivision 2 of section 365-a of the social services law
 2 is amended by adding a new paragraph (oo) to read as follows:
 3 (oo) (i) Federal food and drug administration approved GLP-1 receptor
 4 agonist medications for the following medically indicated purposes:
 5 (1) obesity treatment in individuals with a body mass index of thirty
 6 or greater, or individuals with a body mass index of twenty-seven or
 7 greater with a related comorbidity;
 8 (2) metabolic disorders, including prediabetes, type two diabetes and
 9 metabolic syndrome; and
 10 (3) clinically verified autism-related compulsive eating behaviors
 11 with certification from a qualified clinician, which shall include a
 12 developmental pediatrician, neurologist, psychiatrist, psychologist, or
 13 other licensed provider.
 14 (ii) The department of health is authorized to require the following:
 15 (1) step therapy protocols for such medications, where clinically
 16 appropriate;
 17 (2) prior authorization of such medications to ensure medical necessi-
 18 ty of such medications;
 19 (3) income-based eligibility prioritization for high-need, low-income
 20 Medicaid recipients to receive coverage for such medications; and/or
 21 (4) documentation requirements for clinician certification in cases of
 22 autism-related need for such medications pursuant to clause three of
 23 subparagraph (i) of this paragraph.

 EXPLANATION--Matter in italics (underscored) is new; matter in brackets
 [ ] is old law to be omitted.
 LBD14216-01-5

 A. 9360 2

 1 (iii) The department of health shall:
 2 (1) develop clear rules and clinical criteria for coverage of GLP-1
 3 receptor agonist medications within one hundred eighty days of the
 4 effective date of this paragraph;
 5 (2) streamline prior authorization forms and timelines;
 6 (3) evaluate health outcomes and potential Medicaid cost savings
 7 related to the coverage of such medications; and
 8 (4) submit an annual report to the legislature detailing utilization,
 9 costs and measurable health outcomes related to the coverage of such
 10 medications.
 11 (iv) The provisions of this paragraph shall apply to GLP-1 receptor
 12 agonist medications approved by the federal food and drug administration
 13 on or before the effective date of this paragraph, and shall also apply
 14 to emerging GLP-1 receptor agonist medications as such medications are
 15 approved by the federal food and drug administration after the effective
 16 date of this paragraph.
 17 § 2. This act shall take effect immediately.

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