New York 2025-2026 Regular Session

New York Senate Bill S04689

Introduced
2/11/25  
Refer
2/11/25  

Caption

Requires disclosure, in such form as the superintendent shall require, of non-confidential information regarding step therapy override requests and determinations on a website that is readily accessible to the public.

Summary

Bill S04689 aims to enhance transparency in the step therapy process by requiring health care plans and utilization review agents to disclose detailed information regarding step therapy override requests and determinations. The bill mandates annual reporting to the relevant state department, including data on the number of requests received, the medical specialties of the providers submitting these requests, and the outcomes of these requests, such as approvals and denials. Furthermore, it requires that this information be made publicly accessible via a website or web-based tool, ensuring that patients and healthcare professionals can easily access relevant data.

Impact

If enacted, this bill will amend existing insurance and public health laws in New York, specifically enhancing the regulatory framework surrounding step therapy protocols. It will impose new reporting requirements on health care plans and utilization review agents, thereby increasing accountability and transparency in the decision-making processes related to medication access. This could potentially lead to improved patient outcomes by providing clearer pathways for patients and providers to understand and navigate the step therapy process.

Sentiment

The sentiment surrounding Bill S04689 appears to be generally supportive, as it addresses concerns about the lack of transparency in step therapy protocols. Stakeholders, including healthcare providers and patient advocacy groups, have expressed a need for clearer information regarding the decision-making processes of insurers. However, there may be some opposition from insurance companies concerned about the administrative burden of increased reporting requirements.

Contention

Notable points of contention include the potential administrative burden placed on health care plans and utilization review agents due to the new reporting requirements. Insurance representatives have raised concerns about the feasibility of implementing these changes, while advocates for patient rights argue that the benefits of increased transparency and accountability outweigh these concerns. The balance between regulatory oversight and operational efficiency is likely to be a key topic of discussion as the bill progresses.

Companion Bills

NY A02327

Same As Requires disclosure, in such form as the superintendent shall require, of non-confidential information regarding step therapy override requests and determinations on a website that is readily accessible to the public.

Previously Filed As

NY A01384

Requires disclosure, in such form as the superintendent shall require, of non-confidential information regarding step therapy override requests and determinations on a website that is readily accessible to the public.

NY S02800

Requires disclosure, in such form as the superintendent shall require, of non-confidential information regarding step therapy override requests and determinations on a website that is readily accessible to the public.

NY A02327

Requires disclosure, in such form as the superintendent shall require, of non-confidential information regarding step therapy override requests and determinations on a website that is readily accessible to the public.

NY S09607

Requires agencies subject to FOIL requirements to promulgate rules and regulations regarding to whom a requestor may appeal a denial and how to request records from or appeal a denial; makes certain provisions relating to publication of contact information for FOIL requests and appeals.

NY A11143

Requires agencies subject to FOIL requirements to promulgate rules and regulations regarding to whom a requestor may appeal a denial and how to request records from or appeal a denial; makes certain provisions relating to publication of contact information for FOIL requests and appeals.

NY S2867

Amends provisions relative to confidentiality of health care communications and the process for requesting records and/or confidential health care information.

NY S0700

Amends provisions relative to confidentiality of health care communications and the process for requesting records and/or confidential health care information.

NY H5500

Amends provisions relative to confidentiality of health care communications and the process for requesting records and/or confidential health care information.

NY HCR95

Requesting The Department Of Education To Post Publicly Accessible Information On Its Website Pertaining To Changes To Gun Safety And Storage Laws.

NY A10960

Requires the board of elections to notify victims of domestic violence whose registration is maintained as confidential of the expiration of the confidentiality of such registration records; requires such notice to include information on a new application for confidentiality of records.

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