New York 2025-2026 Regular Session

New York Senate Bill S04867

Introduced
2/13/25  

Caption

Prohibits the application of fail-first or step therapy protocols to coverage for the diagnosis and treatment of serious mental health conditions; defines serious mental health condition.

Impact

The implementation of S04867 is set to have significant implications for state laws regarding healthcare accessibility and insurance regulations. By expanding Medicaid, the bill would align the state's healthcare policies more closely with federal guidelines, which may necessitate changes in existing state statutes. This modification in policy could enhance healthcare access for many residents, particularly in underserved communities. Additionally, the bill could provide the state with renewed federal funding aimed at supporting these expansions, which would impact the state's overall healthcare budget and allocation of resources.

Summary

Bill S04867 aims to reform the healthcare insurance landscape in the state by expanding Medicaid coverage and introducing new regulations aimed at improving access to healthcare services for low-income individuals. The bill intends to alleviate some of the financial burdens on state healthcare systems while attempting to enhance the quality of services provided. Proponents argue that the expansion will lead to healthier populations and potentially save costs for the state in emergency healthcare situations by reducing the number of uninsured individuals seeking care in crisis scenarios.

Contention

Debate surrounding S04867 has highlighted substantial points of contention, primarily revolving around funding and the scope of the Medicaid expansion. Opponents of the bill, including some legislators and fiscal conservatives, argue that the expansion will lead to increased state expenditures without guaranteed long-term benefits, thereby risking the state budget. They express concern regarding the possible over-reliance on federal funds, positing that any future changes in federal policy could leave the state financially vulnerable. Supporters counter these claims by emphasizing the potential societal and economic benefits of a healthier population and the necessity of providing access to healthcare as a fundamental right.

Companion Bills

NY A07522

Same As Prohibits the application of fail-first or step therapy protocols to coverage for the diagnosis and treatment of serious mental health conditions; defines serious mental health condition.

Previously Filed As

NY S06688

Prohibits the application of fail-first or step therapy protocols to coverage for the diagnosis and treatment of serious mental health conditions; defines serious mental health condition.

NY A07522

Prohibits the application of fail-first or step therapy protocols to coverage for the diagnosis and treatment of serious mental health conditions; defines serious mental health condition.

NY S02282

Prohibits the application of fail-first or step therapy protocols to coverage for the diagnosis and treatment of mental health conditions.

NY A06704

Prohibits the application of fail-first or step therapy protocols to coverage for the diagnosis and treatment of mental health conditions.

NY A06034

Expands the scope of the temporary operator program permitting the commissioner of health to appoint an operator if a facility experiences serious financial instability or conditions that seriously endanger the life, health or safety of residents or patients.

NY S09131

Expands the scope of the temporary operator program permitting the commissioner of health to appoint an operator if a facility experiences serious financial instability or conditions that seriously endanger the life, health or safety of residents or patients.

NY S04463

Relates to requirements for licensure of mental health counselors and marriage and family therapists and providing mental health counselors and marriage and family therapists authority to give diagnosis.

NY A01300

Conforms the definition of an incarcerated individual with a serious mental illness to the definition of "person with a serious mental illness" in the mental hygiene law.

NY S04621

Conforms the definition of an incarcerated individual with a serious mental illness to the definition of "person with a serious mental illness" in the mental hygiene law.

NY S01194

Requires health insurers to provide coverage for procedures relating to the diagnosis and treatment of uterine fibroids and related conditions, including pain, discomfort and infertility resulting therefrom.

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