New York 2025-2026 Regular Session

New York Assembly Bill A09659

Introduced

1/21/26

Refer

1/21/26

Caption

Requires health insurance policies to cover costs for pediatric acute-onset neuropsychiatric syndrome rehabilitation treatment.

Impact

If enacted, this bill would introduce a critical provision in health insurance coverage that currently does not exist for this particular syndrome. It compels insurance providers to recognize pediatric acute-onset neuropsychiatric syndrome as a valid condition requiring treatment, essentially expanding insurance obligations under state law. The bill underscores the growing recognition of mental health issues in pediatrics, potentially leading to improved health outcomes for affected children and easing families' financial burdens associated with treatment.

Summary

Bill A09659 proposes amendments to New York's insurance law, mandating that health insurance policies cover costs associated with pediatric acute-onset neuropsychiatric syndrome. This bill specifically targets group health plans and requires that any participant or beneficiary diagnosed with this condition receives rehabilitative treatment, as certified by their attending physician. The inclusion of this coverage marks a significant step in enhancing the mental health support available to children, aiming to address both the medical and therapeutic needs stemming from this complex syndrome.

Contention

While the bill is aimed at improving care for children with a specific mental health condition, it may also raise discussions regarding the broader implications of mandated coverage in health insurance. Some stakeholders could argue that such mandates may lead to increased insurance premiums or could be viewed as the state overstepping in its role in health care provision. Additionally, the need to define what constitutes 'medical necessity' could lead to further debates, as this determination can vary significantly across different medical professionals and facilities.

Companion Bills

NY S02655

Same As Requires health insurance policies to cover costs for pediatric acute-onset neuropsychiatric syndrome rehabilitation treatment.

NY S10208

Same As Requires health insurance policies to cover costs for pediatric acute-onset neuropsychiatric syndrome rehabilitation treatment.

Previously Filed As

NY S10208

Requires health insurance policies to cover costs for pediatric acute-onset neuropsychiatric syndrome rehabilitation treatment.

NY S02655

Requires health insurance policies to cover costs for pediatric acute-onset neuropsychiatric syndrome rehabilitation treatment.

NY HB408

Requires health insurance coverage relative to pediatric acute-onset neuropsychiatric syndrome and related conditions (EN INCREASE GF EX See Note)

NY A03362

Requires health insurance policies to cover costs for pediatric acute-onset neuropsychiatric syndrome rehabilitation treatment.

NY HB2549

Mandating insurance coverage of pediatric acute-onset neuropsychiatric syndrome (PANS) and pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS).

NY H5625

Removes the sunset provision of all statutory law requiring coverage for the treatment of pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections and pediatric acute onset neuropsychiatric syndrome.

NY HB587

Creates the Pediatric Acute-onset Neuropsychiatric Syndrome specialty license plate

NY S0473

Extends coverage for treatment of pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections and pediatric acute onset neuropsychiatric syndrome by removing the sunset date of December 31, 2025, and mandating such coverage.

NY SB205

Insurance; pediatric autoimmune neuropsychiatric disorders; require coverage for healthcare services

NY HB124

Insurance; require coverage for healthcare services for pediatric autoimmune neuropsychiatric disorders; provisions

Similar Bills

No similar bills found.