New York 2025-2026 Regular Session

New York Assembly Bill A11025

Introduced
4/23/26  

Caption

Requires periodic reviews of pending applications for material change in the coverage status of certain matters relative to new health technology assessment or medical evidence.

Impact

If enacted, A11025 will significantly enhance the procedural framework for assessing health technologies and the evidence supporting their coverage. It mandates that the Department of Health publish receipt of applications and the scheduling of reviews on its website, fostering greater public awareness and accountability. Additionally, it implies a structured approach to evidence collection and assessment, clarifying the grounds for coverage changes and ensuring that stakeholders can participate in the review process.

Summary

A11025 is a bill introduced in the New York State Assembly aimed at amending the social services law to require periodic reviews of pending applications for material changes in the coverage status related to new health technology assessments or medical evidence. The bill obligates the commissioner to conduct these reviews in consultation with a committee and ensures that applicants are notified of any deficiencies within thirty days of submission. This process seeks to enhance transparency and efficiency in the evaluation of health technologies and services for coverage decisions.

Contention

Potential points of contention may arise from the added bureaucracy and potential delays that critics may argue could be introduced by the periodic review requirement. Stakeholders, such as health care providers and technology manufacturers, may have differing views on the adequacy of the proposed processes and timelines for review. Proponents of the bill might advocate that increased scrutiny through systematic evidence-based assessments will ultimately lead to better patient outcomes and more prudent coverage decisions, while opponents may caution against bureaucratic overreach that might stifle innovation or delay access to beneficial health technologies.

Companion Bills

NY S01225

Same As Requires periodic reviews of pending applications for material change in the coverage status of certain matters relative to new health technology assessment or medical evidence.

Previously Filed As

NY S01225

Requires periodic reviews of pending applications for material change in the coverage status of certain matters relative to new health technology assessment or medical evidence.

NY S07297

Relates to utilization review program standards; requires use of evidence-based and peer reviewed clinical review criteria; relates to prescription drug formulary changes and pre-authorization for certain health care services.

NY A03789

Relates to utilization review program standards; requires use of evidence-based and peer reviewed clinical review criteria; relates to prescription drug formulary changes and pre-authorization for certain health care services.

NY S09651

Relates to utilization review program standards; requires use of evidence-based and peer reviewed clinical review criteria; relates to prescription drug formulary changes and pre-authorization for certain health care services.

NY S3760

Requires certain law enforcement officers be periodically vetted for evidence of personal bias.

NY SB2694

Health insurance; require coverage for biomarker testing for certain purposes when supported by medical and scientific evidence.

NY A09312

Ensures Medicaid spending results in real access to medical care by increasing transparency in Medicaid managed care network adequacy reviews and safeguarding continuity of care in light of recent major provider network withdrawals.

NY HB87

Insurance; require health benefit policy coverage for medically necessary orthotic and prosthetic devices and their materials and components

NY S08045

Requires the office for the prevention of domestic violence provide informational materials on removing an abuser's access to a smart home and the use of other technology for harassment.

NY A05455

Requires the office for the prevention of domestic violence provide informational materials on removing an abuser's access to a smart home and the use of other technology for harassment.

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