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S 10208 NY

Relates to insurance coverage for pediatric acute-onset neuropsychiatric syndrome

NY · session 2025-2026 · Senate · bill

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Introduced May 5, 2026

Latest action (May 5, 2026) REFERRED TO INSURANCE

Summary

This bill requires health insurance policies in New York to cover rehabilitation treatment for pediatric acute-onset neuropsychiatric syndrome. Coverage must be provided when an attending physician certifies in writing that the rehabilitative treatment is medically necessary for a participant or beneficiary. The requirement applies to health plans and health insurance issuers offering coverage in connection with group health plans. The bill defines pediatric acute-onset neuropsychiatric syndrome using the same definition found in New York's Public Health Law. The bill takes effect January 1 following enactment and applies to policies issued, renewed, modified, altered, or amended on or after that date.

AI-generated plain-language summary of the bill text — neutral, and may be imperfect. See the full text below for the exact wording.

Official abstract

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

Sponsor (1)

2 coauthors / cosponsors

Action history (1)

  1. May 5, 2026 REFERRED TO INSURANCE · upper

Text versions (2)

The published texts of this bill as it moves through the legislature. Each links to the official document on the state legislature site. Data from OpenStates.

  • S10208 · HTML
  • S10208 · PDF

Full text

Full text imported from assembly.state.ny.us

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New York State Assembly Speaker Carl E. Heastie

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Bill No.: Summary Actions Committee&nbspVotes Floor&nbspVotes Memo Text LFIN Chamber&nbspVideo/Transcript S10208 Summary: BILL NO S10208 &nbsp SAME AS SAME AS A09659-A

&nbsp SPONSOR HARCKHAM &nbsp COSPNSR STEC, BASKIN &nbsp MLTSPNSR &nbsp Amd §§3216, 3221 & 4303, Ins L &nbsp Requires health insurance policies to cover costs for pediatric acute-onset neuropsychiatric syndrome rehabilitation treatment.

Go to top S10208 Text:

STATE OF NEW YORK ________________________________________________________________________

10208

IN SENATE

May 5, 2026 ___________

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

AN ACT to amend the insurance law, in relation to requiring certain health insurance policies to cover costs for pediatric acute-onset neuropsychiatric syndrome

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

1 Section 1. Subsection (i) of section 3216 of the insurance law is 2 amended by adding a new paragraph 42 to read as follows: 3 (42)(A) Every health plan, and health insurance issuer offering health 4 insurance coverage in connection with a group health plan, shall provide 5 coverage for a participant or beneficiary who has pediatric acute-onset 6 neuropsychiatric syndrome if the attending physician of the participant 7 or beneficiary certifies in writing the medical necessity of that 8 proposed course of rehabilitative treatment. 9 (B) As used in this paragraph, the term "pediatric acute-onset neurop- 10 sychiatric syndrome" shall have the same meaning as such term is used in 11 paragraph (n) of subdivision one of section two hundred seven of the 12 public health law. 13 § 2. Subsection (k) of section 3221 of the insurance law is amended by 14 adding a new paragraph 24 to read as follows: 15 (24) (A) Every health plan, and health insurance issuer offering 16 health insurance coverage in connection with a group health plan, shall 17 provide coverage for a participant or beneficiary who has pediatric 18 acute-onset neuropsychiatric syndrome if the attending physician of the 19 participant or beneficiary certifies in writing the medical necessity of 20 that proposed course of rehabilitative treatment. 21 (B) As used in this paragraph, the term "pediatric acute-onset neurop- 22 sychiatric syndrome" shall have the same meaning as such term is used in 23 paragraph (n) of subdivision one of section two hundred seven of the 24 public health law. 25 § 3. Section 4303 of the insurance law is amended by adding a new 26 subsection (yy) to read as follows:

EXPLANATION--Matter in italics (underscored) is new; matter in brackets [ ] is old law to be omitted. LBD06726-05-6

S. 10208 2

1 (yy)(1) Every health plan, and health insurance issuer offering health 2 insurance coverage in connection with a group health plan, shall provide 3 coverage for a participant or beneficiary who has pediatric acute-onset 4 neuropsychiatric syndrome if the attending physician of the participant 5 or beneficiary certifies in writing the medical necessity of that 6 proposed course of rehabilitative treatment. 7 (2) As used in this subsection, the term "pediatric acute-onset 8 neuropsychiatric syndrome" shall have the same meaning as such term is 9 used in paragraph (n) of subdivision one of section two hundred seven of 10 the public health law. 11 § 4. This act shall take effect on the first of January next succeed- 12 ing the date on which it shall have become a law and shall apply accord- 13 ing to its terms to all policies, contracts and certificates issued, 14 renewed, modified, altered or amended on or after such effective date.

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