New York S 4163: Enacts the "health insurance preauthorization disclosure act"

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 
S04163 Summary:

BILL NOS04163 

&nbsp

SAME ASSAME AS A09103

&nbsp

SPONSORBAILEY

&nbsp

COSPNSR

&nbsp

MLTSPNSR

&nbsp

Add §§4242 & 4905-a, Ins L; add §4905-a, Pub Health L

&nbsp

Enacts the "health insurance preauthorization disclosure act"; requires health insurance companies to provide participating health care providers with a list of health care treatments and services that require preauthorization from the health insurance company.

Go to top S04163 Actions:

BILL NOS04163 

&nbsp

02/03/2025REFERRED TO INSURANCE

01/07/2026REFERRED TO INSURANCE

Go to topS04163 Committee&nbspVotes:

Go to topS04163 Floor&nbspVotes:

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

Go to topS04163 Text:

 STATE OF NEW YORK
 ________________________________________________________________________

 4163

 2025-2026 Regular Sessions

 IN SENATE

 February 3, 2025
 ___________

 Introduced by Sen. BAILEY -- read twice and ordered printed, and when
 printed to be committed to the Committee on Insurance

 AN ACT to amend the insurance law and the public health law, in relation
 to enacting the "health insurance preauthorization disclosure act"

 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 insurance preauthorization disclosure act".
 3 § 2. The insurance law is amended by adding a new section 4242 to read
 4 as follows:
 5 § 4242. Health insurance companies; preauthorization for health care
 6 services. Every health care insurance company shall be required to
 7 provide participating physicians and health care providers, as defined
 8 in subdivision seven of section twenty-nine hundred eighty of the public
 9 health law, with an updated list of health care treatments and services
 10 that require preauthorization or precertification from such health care
 11 insurance company. Such list shall be developed based upon consultation
 12 with medical guidelines developed by the relevant medical specialty
 13 organization and in consultation with appropriately trained physicians
 14 practicing within the region the health care insurance company serves.
 15 Such list shall be updated annually or more frequently as appropriate.
 16 Only those health care services which are contained on such list shall
 17 be subject to pre-authorization or precertification by the health care
 18 insurance company. No health care treatment or service shall be added to
 19 the list of services requiring pre-authorization or precertification
 20 unless the health care insurance company provides a minimum of ninety
 21 days notice to participating physicians and health care providers.
 22 § 3. The public health law is amended by adding a new section 4905-a
 23 to read as follows:
 24 § 4905-a. Pre-authorized services. Every health care plan shall be
 25 required to develop and provide to participating health care providers a

 EXPLANATION--Matter in italics (underscored) is new; matter in brackets
 [ ] is old law to be omitted.
 LBD08438-01-5

 S. 4163 2

 1 list of health care services that require pre-authorization or precer-
 2 tification from such health care plan. Such list shall be developed
 3 based upon consultation with medical guidelines developed by the rele-
 4 vant medical specialty organization and in consultation with appropri-
 5 ately trained physicians practicing within the region the health care
 6 plan serves. Such list shall be updated annually or more frequently as
 7 appropriate. Only those health care services which are contained on such
 8 list shall be subject to pre-authorization or precertification by the
 9 health care plan. No health care service shall be added to the list of
 10 services requiring pre-authorization or precertification unless the
 11 health care plan provides a minimum of ninety days notice to participat-
 12 ing health care providers.
 13 § 4. The insurance law is amended by adding a new section 4905-a to
 14 read as follows:
 15 § 4905-a. Pre-authorized services. Every health care plan shall be
 16 required to develop and provide to participating health care providers a
 17 list of health care services that require pre-authorization or precer-
 18 tification from such health care plan.