What's happening
This bill requires Medicaid in New York to cover both blood and skin prick allergy tests as medically necessary.
Why it matters
Ensures that Medicaid beneficiaries have access to both blood (serologic-specific IgE) and skin prick allergy tests. , treating them as equally valid and medically necessary when supported by current medical literature—helping to eliminate barriers to the most appropriate diagnostic method for individual patients.
Requires the New York State Department of Health to keep allergy testing policies up-to-date with the latest national and professional guidelines. , potentially leading to faster adoption of emerging medical best practices and improving patient care quality over time.
Expands coverage to a broad range of allergy-related conditions—including inhalant, food, venom (stinging insect), certain parasitic diseases, drug allergies, and allergic bronchopulmonary aspergillosis—. meaning more people with complex or less common allergies can access the right diagnostic tests under Medicaid.
Mandates timely regulatory action and provider communication. , which could reduce confusion or delays in coverage for both providers and patients, supporting more consistent access to allergy testing services statewide.
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Who cares
Headline styles
Cover Allergy Tests With Medicaid
Plain English, a few words. Used as the page title.
Sponsors
1 Co-sponsor
History
- Vetoed memo.183
- Delivered to governor
- Returned to senate
- Passed assembly
- Ordered to third reading cal.260
- Substituted for A807
- Referred to ways and means
- Delivered to assembly
- Passed senateVote 59–4
- Advanced to third reading
- 2nd report cal.
- 1st report cal.740
Show 2 earlier actions
- Reported and committed to finance
- Referred to health
Companion bill
The same bill in the other chamber. A bill becomes law when one version passes both houses and the governor signs it, so either number can carry it.
Cover Allergy Tests with Medicaid
Assembly Floor Calendar · Sponsor N. Nick Perry
Full text
1 pageUnderlined is new[Struck] is removedOfficial text on nysenate.gov ↗
STATE OF NEW YORK
1222
2017-2018 Regular Sessions
IN SENATE
January 6, 2017
Introduced by Sens. RIVERA, LATIMER -- read twice and ordered printed, and when printed to be committed to the Committee on Health
AN ACT to amend the social services law, in relation to requiring Medicaid coverage of both blood testing and skin prick testing for allergies
The People of the State of New York, represented in Senate and Assembly, do enact as follows:
Section 1. The social services law is amended by adding a new section 365-o to read as follows:
§ 365-o. Allergy testing coverage. The commissioner shall establish standards and guidelines, consistent with National Institutes of Health guidelines and other current medical professional guidance and literature, including updating its provider bulletins, as necessary, to reference the most current professional literature and guidance related to allergy testing for the provision of allergy testing under the medical assistance program. Consistent with such professional literature and guidance, such standards, guidelines and coverage policies shall treat serologic-specific IgE tests and percutaneous skin tests as equivalent confirmatory tests in terms of their sensitivity and accuracy, and shall treat them as medically necessary for those individuals with a medical history consistent with any of the following:
(a) an inhalant allergy;
(b) a food allergy;
(c) hymenoptera venom allergy or an allergy to stinging insects;
(d) allergic bronchopulmonary aspergillosis (ABPA);
(e) certain parasitic diseases; and
(f) allergies to specific drugs.
§ 2. This act shall take effect the first of July next succeeding the date upon which it shall become a law; provided that, effective immediately, the commissioner of health shall promulgate all rules and regulations deemed necessary and desirable to implement the provisions of this act on or before its effective date.
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD02159-01-7
Reflowed for reading: line numbers and page breaks removed. Cite the official text.
Sponsor's memo
Title of bill
An act to amend the social services law, in relation to requiring Medicaid coverage of both blood testing and skin prick testing for allergies
Purpose
:
To ensure that the Medicaid program provides access to blood allergy testing in parity with skin prick testing, as the tests are clinically equivalent, cost equivalent, and would expand access to testing, which would be an important step in addressing health disparities.
Summary of provisions
:
Section 1 creates a new section of the Social Services Law entitled "blood allergy testing," which would require the department to treat serologic-specific IgE allergy tests (blood allergy tests) and percutaneous skin allergy tests (skin prick tests) as equivalent in their sensitivity and accuracy for confirming the existence of an allergy in a patient, and to treat those tests as medically necessary for those individuals with a medical history consistent with specified conditions. The bill would require the department to update its provider bulletins, as necessary, to reference the most current professional literature and guidance related to allergy testing.
Section 2 is the effective date of the bill.
Justification
Historically, allergies were diagnosed by an allergist who used a percutaneous, or "skin-prick," test to infect the skin of a patient with varying allergens for the purpose of determining the patient's reaction to those allergens. This procedure required the patient to be referred by his or her primary care physician to an allergist, and required the patient to undergo a series of pricks to his or her skin.
Advances in blood testing technology using serologic-specific IgE quantitative testing allow a patient to be diagnosed without a referral to a specialist. Professional literature and guidance from the National Heart, Lung, and Blood Institute at the National Institutes of Health has determined that blood tests and skin tests for allergies are equal in their diagnostic value, and that blood testing is preferred in the case of testing for food allergies. Medicaid coverage decisions must be based on the latest and most current medical literature and studies.
Private health care insurance plans recognize the professional literature and guidelines regarding the efficacy of blood testing and cover blood testing for the diagnosis of allergies. New York State Medicaid does not cover blood testing for allergies at all; only skin prick testing is covered. Due to an insufficient number of allergists available to diagnose and treat Medicaid patients, the diagnosis of many patients covered by Medicaid is delayed or never occurs. Creating access to this blood test would help improve population health and address health care disparities, particularly in underserved communities.
Legislative history
:
2016: S7450
Fiscal implications
:
Because blood allergy testing is cost-equivalent to skin prick testing, it is not anticipated that this bill will have a significant fiscal impact.
Effective date
:
This act shall take effect the first of July next succeeding the date upon which it shall become law, effective immediately, the commissioner of health shall promulgate all rules and regulations deemed necessary and desirable to implement the provisions of this act on or before its effective date.
Summaries, headlines and scores are AI-generated from the official bill text. How we score bills. Source: NYS Open Legislation.