What's happening
This bill requires insurers to respond to oncology pre-authorization claims within five business days or automatically approve coverage.
Why it matters
Reduces delays in cancer care. By requiring insurers (including Medicaid and private plans) to respond within five business days, the bill aims to ensure oncology patients get quicker access to potentially life-saving tests and treatments, minimizing harmful wait times that could impact outcomes.
Shifts risk to insurers. If an insurer fails to respond within the five-day window, coverage is automatically approved, making insurers financially responsible for the prescribed oncology care even if they haven’t actively authorized it. This creates a strong incentive for timely processing of pre-authorization requests.
Empowers physicians and patients. Physicians can proceed with recommended cancer care without fear of insurance denial due to administrative delays, giving patients more certainty and reducing the emotional and logistical burdens of waiting for approvals during critical treatment periods.
Albany, before your first meeting.
Every bill that moved yesterday, summarized in a sentence and ranked by impact. The Albany Scorecard follows on Sundays.
Free. Unsubscribe in one click. Want alerts on specific bills? Create an account.
Who cares
Oncology patients
The bill would allow their treating physician to proceed with lifesaving testing, treatment or procedures at the insurer’s expense if a pre-authorization decision and notice do not arrive within five business days of filing.
Physicians treating oncology patients
They would gain authority to provide the prescribed lifesaving care if the insurer fails to decide and notify them within the five-business-day window.
Private insurers and Medicaid
They would face a five-business-day deadline to decide physicians’ oncology pre-authorization requests and notify them, with payment liability for prescribed care if they miss that deadline.
Headline styles
Speed Up Cancer Care Approval
Plain English, a few words. Used as the page title.
Sponsors
4 Co-sponsors
History
- Referred to insurance
- Referred to insurance
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.
Faster Cancer Treatment Approvals
In Senate Committee · Insurance · Sponsor Roxanne J. Persaud
Full text
1 pageUnderlined is new[Struck] is removedOfficial text on nysenate.gov ↗
STATE OF NEW YORK
1462
2025-2026 Regular Sessions
IN ASSEMBLY
January 9, 2025
Introduced by M. of A. HUNTER, PAULIN -- read once and referred to the Committee on Insurance
AN ACT to amend the insurance law, in relation to establishing a mandated window of five business days for both Medicaid and private insurers to respond to pre-authorization claims for testing and/or treatments made by physicians on behalf of oncology patients
The People of the State of New York, represented in Senate and Assembly, do enact as follows:
Section 1. Subsection (a) of section 3238 of the insurance law is amended by adding a new paragraph 7 to read as follows:
(7) with regard to claims of pre-authorization filed by a physician with private insurers and/or Medicaid on behalf of an oncology patient, it is hereby mandated that a waiting period of five business days be established in which an insurer must respond to such a claim. If in such a case the insurer does not render a decision and notify the physician within the period of five business days following the filing of a preauthorization claim, the physician deemed responsible for treating the patient is authorized to conduct the lifesaving testing, treatment, or procedure and as such, the insurer will be made liable for payment covering the prescribed method of care.
§ 2. This act shall take effect immediately.
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD02191-01-5
Reflowed for reading: line numbers and page breaks removed. Cite the official text.
Summaries, headlines and scores are AI-generated from the official bill text. How we score bills. Source: NYS Open Legislation.