Capital Update April 17, 2026
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With the State Legislature having passed multiple State Budget extenders until April 20, negotiations are beginning to intensify towards the Senate, Assembly and Governor arriving at an agreement for a State Budget technically due on April 1. Therefore, physicians must continue to advocate to their legislators on the several pressing State Budget health care policy issues under negotiation that will exacerbate the significant challenges facing physician practice across the State if they are adversely decided.
Urge Your Legislators to Reject Steep Increases in Medical Liability Costs.
Both the Senate and Assembly recommended rejection of the Governor’s proposal to impose $40 million in new costs to the 16,000 physicians who receive Excess Medical Malpractice Insurance coverage by requiring them to pay 50% of the coverage cost. This short-sighted proposal will hit physicians with thousands of dollars in additional new costs when they can least absorb it, and New York physicians already pay far and away the highest liability costs in the country.
Please continue to urge your legislators to continue to OPPOSE this measure. Reject Physician Cost-Share.
Urge Your Legislators to Protect Access to a Fair Dispute Resolution Process.
Both the Senate and Assembly recommended rejection of the Governor’s proposal that threatens immediate specialty care availability in Emergency Departments across New York State by upending New York’s innovative IDR payment resolution process for non-participating provider claims, altering the criteria to make it one-sided towards health insurer interests and eliminating ability to appeal out of network Medicaid Managed Care disputes to IDR. Essentially, this would enable the health insurer to “put its thumb on the scale” in what is supposed to be an INDEPENDENT dispute resolution process.
For more information on this issue, please see these op-eds from MSSNY President Dr. Mark Adams PressReader.com and MSSNY Immediate Past-President Dr. David Jakubowicz Newsday.
Please continue to urge your legislators to continue to OPPOSE this measure Protect Fair IDR Process.
Urge Your Legislators to Preserve Physician-Led Team Care.
Both the Senate and Assembly recommended rejection of the Governor’s proposal to permit many Physician Assistants (PAs) to practice without any defined physician supervision after 8,000 hours practice, despite a law implemented last year giving PAs significantly more care responsibilities.
Urge your legislators to continue to OPPOSE this proposal. Preserve Physician-led Care.
Urge Your Legislators to Preserve County Medical Society Peer Review.
The State Assembly recommended rejection of the Governor’s proposal to eliminate the historical vetting role of the county medical society in recommending physicians to participate in the Workers’ Compensation program. Unfortunately, the Senate included this proposal in its one-House Budget proposal as part of a larger reform package that also included measures seeking to reduce some of hassles physicians experience in the WC system.
This proposal would eliminate an important community review role that helps to ensure injured workers are treated by qualified physicians. The problem with Workers’ Compensation is not the application process, but its low payments relative to the enormous hassles of claim submissions and non-payment months and years after providing complex care to injured workers. Please continue to urge your legislators to OPPOSE elimination of the important vetting role of county medical societies. Preserve Workers’ Compensation Peer Review
Urge Your Legislators to Enact Meaningful Reduction in Prior Authorization Hassles.
The Senate included the Executive Budget proposal supported by MSSNY to: prohibit health insurers from requiring a prior authorization more than once per year for treating a chronic health condition; requiring greater transparency of health plan formularies; requiring greater transparency of prior authorization denials; and to provide a 90-day transition period for a patient to continue to be treated by that patient’s physician if the patient changes their health plan coverage.
The Assembly largely included the Governor’s prior authorization proposal but did include some substantive limitations on the “once per year” limitation, permitting plans to impose additional prior authorization requirements based upon “nationally recognized clinical practice guidelines” for evaluating possible side effects from an approved treatment, or substantive changes in nationally recognized treatment guidelines. MSSNY together with several other groups have expressed concerns these additional provisions could undermine the benefit of this “once per year” rule by empowering health plans to continue to impose unreasonable prior authorization requirements.
At the same time, MSSNY continues to urge that the State Budget include far-reaching prior authorization reform legislation (A.3789, Weprin/S.9651, Rivera – before the Senate Health Committee next week) that would reduce the time for receiving prior authorization requests and prohibit altogether repeat prior authorization requirements from health plans. More information here: 2026 Budget Prior Auth Fact Sheet.
Building on a 2024 CMS rule, which addressed prior authorization for non-medication healthcare services, this proposal creates a streamlined process for medications as is the case with other covered, non-pharmaceutical services. Specifically, the proposed rule modernizes prior authorization for medications by establishing clear deadlines for insurance company decisions of no later than 24 hours for urgent requests and 72 hours for non-emergencies. The proposed policy would also increase transparency by requiring full disclosure of claims denials and appeals outcomes. The proposal also calls for expansion of electronic prior authorization requirements to include medications.
To read the full statement from CMS: CMS Proposes Major Reforms to Speed Up Patient Access to Drugs, Increase Transparency, and Reduce Administrative Burden | CMS
To view the complete proposed rule on the Federal Register: https://www.federalregister.gov
To view the CMS fact sheet:
https://www.cms.gov/newsroom/fact-sheets/2026-cms-interoperability-standards-prior-authorization-drugs-proposed-rule
The US House Judiciary Committee recently released an interim staff report raising significant concerns with the U.S. medical residency market.
Based on a review of more than 1,500 documents and physician interviews, the Committee concluded in its interim report that the National Residency Match Program (NRMP) “constrains competition”. The Committee concluded in its report that these structures significantly limit residents’ basic employment rights. Examples identified include applicants being prohibited from securing binding pre‑Match commitments, and those who decline an assigned placement risk being labeled “Match violators.” Employment terms are offered on a take‑it‑or‑leave‑it basis, with little transparency or opportunity for negotiation. Even unmatched applicants remain subject to NRMP control through the Supplemental Offer and Acceptance Program (SOAP).
Based on these findings, the Committee identified several areas for possible future congressional action, including reconsideration of the NRMP’s 2004 antitrust exemption, increasing competition and flexibility in residency recruitment, and closer scrutiny of centralized wage‑setting and limits on bargaining rights. The report frames residency hiring reform as a necessary component of addressing physician shortages and safeguarding patient access to care.
Because of its importance to the physicians of our future, MSSNY will continue to monitor developments on this investigation and possible legislation.
