S 10232 NY

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Bill No.: Summary Actions Committee&nbspVotes Floor&nbspVotes Memo Text LFIN Chamber&nbspVideo/Transcript S10232 Summary: BILL NO S10232 &nbsp SAME AS SAME AS A09407

&nbsp SPONSOR HARCKHAM &nbsp COSPNSR &nbsp MLTSPNSR &nbsp Amd §§3217-b & 4325, Ins L; amd §4406-c, Pub Health L; amd §364-j, Soc Serv L &nbsp Relates to not requiring a prior authorization determination for certain categories of cancer treatments based on National Comprehensive Cancer Network Guidelines.

Go to top S10232 Text:

STATE OF NEW YORK ________________________________________________________________________

10232

IN SENATE

May 7, 2026 ___________

Introduced by Sen. HARCKHAM -- read twice and ordered printed, and when printed to be committed to the Committee on Insurance

AN ACT to amend the insurance law, the public health law and the social services law, in relation to not requiring prior authorization for certain cancer treatments

The People of the State of New York, represented in Senate and Assem- bly, do enact as follows:

1 Section 1. Section 3217-b of the insurance law is amended by adding a 2 new subsection (p) to read as follows: 3 (p) No insurer subject to this article shall require a prior authori- 4 zation determination for cancer treatment meeting category one or cate- 5 gory two-A of the National Comprehensive Cancer Network's Categories of 6 Evidence and Consensus, provided that such insurer may require a health 7 care provider to certify that the course of treatment for the oncology 8 patient meets National Comprehensive Cancer Network Guidelines. Nothing 9 in this subsection shall prohibit an insurer from denying a claim for 10 such services if the services are subsequently determined not medically 11 necessary. 12 § 2. Section 4325 of the insurance law is amended by adding a new 13 subsection (p) to read as follows: 14 (p) No corporation organized under this article shall require a prior 15 authorization determination for cancer treatment meeting category one or 16 category two-A of the National Comprehensive Cancer Network's Categories 17 of Evidence and Consensus, provided that such corporation may require a 18 health care provider to certify that the course of treatment for the 19 oncology patient meets National Comprehensive Cancer Network Guidelines. 20 Nothing in this subsection shall prohibit a corporation from denying a 21 claim for such services if the services are subsequently determined not 22 medically necessary. 23 § 3. Section 4406-c of the public health law is amended by adding a 24 new subdivision 14 to read as follows: 25 14. No health care plan shall require a prior authorization determi- 26 nation for cancer treatment meeting category one or category two-A of 27 the National Comprehensive Cancer Network's Categories of Evidence and

EXPLANATION--Matter in italics (underscored) is new; matter in brackets [ ] is old law to be omitted. LBD14275-01-5

S. 10232 2

1 Consensus, provided that such health care plan may require a health care 2 provider to certify that the course of treatment for the oncology 3 patient meets National Comprehensive Cancer Network Guidelines. Nothing 4 in this subdivision shall prohibit a health care plan from denying a 5 claim for such services if the services are subsequently determined not 6 medically necessary. 7 § 4. Section 364-j of the social services law is amended by adding a 8 new subdivision 26-d to read as follows: 9 26-d. Managed care providers shall not require a prior authorization 10 determination for cancer treatment meeting category one or category 11 two-A of the National Comprehensive Cancer Network's Categories of 12 Evidence and Consensus, provided that the managed care plan may require 13 a health care provider to certify that the course of treatment for the 14 oncology patient meets National Comprehensive Cancer Network Guidelines. 15 Nothing in this subdivision shall prohibit a managed care plan from 16 denying a claim for such services if the services are subsequently 17 determined not medically necessary. 18 § 5. This act shall take effect on the one hundred eightieth day after 19 it shall have become a law; provided, however, that the amendments to 20 section 364-j of the social services law made by section four of this 21 act shall be subject to the expiration and repeal of such section and 22 shall expire and be deemed repealed therewith.

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