New York Senate Bill S07577

New York 2025-2026 Regular Session

• Introduced: 4/22/25
• Refer: 4/22/25
• Refer: 1/7/26

Caption

Prohibits an insurer or health maintenance organization from including certain requirements in insurance contracts.

Summary

This bill would amend the Insurance Law and Public Health Law to prohibit certain contract terms in agreements between health insurers or health maintenance organizations and health care providers when the insurer offers a managed care product or other comprehensive policy using a provider network. The bill bars provisions that would require an insurer to include all members of a provider group in its network, place all members in the same tier, include them in all products, or prevent the insurer from using benefit designs that steer members toward higher-value providers. It also prohibits most-favored-nation clauses and restrictions on disclosing fees or allowed amounts to insureds or their providers. The bill further provides that, beginning January 1, 2026, any contract, policy, procedure, or agreement containing a prohibited clause will be null and void to that extent, while the rest of the contract remains in effect. The same restrictions are added both to commercial insurance contracts under the Insurance Law and to HMO contracts under the Public Health Law, so the measure applies broadly across network-based managed care arrangements in New York.

Impact

The bill would directly limit the kinds of network and reimbursement terms insurers and HMOs may negotiate with provider groups, reducing the enforceability of all-or-nothing network participation requirements, tiering mandates, most-favored-nation pricing clauses, and confidentiality provisions that restrict disclosure of fees or allowed amounts. It would affect insurers, HMOs, provider groups, medical practices, facilities, and insured consumers by preserving insurer flexibility in network design and price steering while increasing transparency around charges and allowed amounts. Existing contracts would not be wholly invalidated, but prohibited clauses would be void after the effective date of January 1, 2026.

Sentiment

No committee transcript or vote record is provided, so there is no documented floor or committee debate to gauge formal sentiment. Based on the bill text, the measure appears oriented toward insurer flexibility, network competition, and transparency, suggesting likely support from those concerned about anti-competitive contracting practices and consumer price visibility. At the same time, provider groups that prefer broader network inclusion or stronger pricing protections may view the bill less favorably.

Contention

The main points of contention are likely the bill’s prohibition on provider-group-wide contracting requirements and its ban on most-favored-nation clauses. Insurers may support the bill because it prevents providers from forcing broader network inclusion or limiting tiered benefit design, while some health care providers may oppose it because it weakens their leverage in negotiations and could reduce their ability to secure uniform participation or favorable reimbursement terms. Another likely dispute is over transparency provisions, since the bill prohibits contract terms that restrict disclosure of fees and allowed amounts to patients and providers.