Capital Update May 22, 2026
Click to Enlarge
The State Legislature this week began passing some of the bills necessary to enact a State Budget, with the rest – including the Health/Mental Hygiene Budget bill – expected to be considered this Tuesday, May 26th. With several State Budget items that have been under discussion still without ultimate determination, please continue to take action on the following issues:
Urge Your Legislators to Protect Access to a Fair Dispute Resolution Process.
Please urge the rejection of the Executive Budget 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. Protect Fair IDR Process.
Urge Your Legislators to Reject Steep Increases in Medical Liability Costs.
Please urge the Legislature to reject 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. Reject Physician Cost-Share.
Urge Your Legislators to Preserve Physician-Led Team Care.
Please urge the rejection of the Executive Budget 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. Preserve Physician-led Care.
We will follow up with a comprehensive summary of the State Budget next week after all the Budget bills have been adopted.
One of the Budget bills A10005C/S9005C passed this week by the State Legislature contains significant reforms to New York’s Workers’ Compensation (WC) system relating to the availability of physicians and other care providers to deliver care to injured workers.
The legislation contains a positive reform to reduce some WC administrative burdens by increasing from $1,000 to $1,500 the cost of care threshold which triggers a requirement on a physician or other care provider to receive prior authorization from a WC carrier prior to healthcare services being delivered to an injured worker.
Most notably, the WC component also contains a provision establishing a “universal approval” system for physicians to participate in the WC program, which eliminates the long-standing requirement for a physician’s application to be approved by the WC Board including receiving a recommendation from the county medical society where the physician practices. While lauding the intent to increase physician participation in the WC program, MSSNY and county medical societies across the State raised serious concerns with this profound change. In addition to eliminating an important credentialing process applicable with other forms of insurance, the Budget measure does very little to address the litany of claims administration and payment hassles – including payment delays that can last months or even years – that is the chief reason physicians are deterred from participating in the WC program.
The implementation date for these new provisions is January 1, 2028. MSSNY will follow up with additional information regarding the implementation of these new provisions. MSSNY will also continue to advocate for measures to address the rampant payment delays in the WC program.
Despite widely publicized promises made last summer by more than 60 health insurers — including UnitedHealthcare, Aetna, Cigna, Humana, Elevance Health, and Blue Cross Blue Shield Association plans — to voluntarily reform the prior authorization process by reducing barriers to patient access and easing long-standing administrative burdens on physicians, new data released by the American Medical Association (AMA) last week shows that physicians remain skeptical, reflecting years of unfulfilled commitments. Several targeted reforms supported by MSSNY responding to these concerns were proposed in this year’s Executive Budget, as well as in stand-alone legislation (A.3789, Weprin/S.9651, Rivera) that has advanced to the floor of both Houses.
Last week, MSSNY President Dr. Mark Adams issued a statement highlighting the new survey results, noting that prior authorizations place overwhelming burdens on physicians and create unnecessary delays for patients in obtaining needed treatment and medications. Some of the startling survey results include:
- Delayed Care. 95% of responding physicians report that prior authorization delays access to necessary care.
- Poor Outcomes. 92% say prior authorization negatively affects clinical outcomes.
- Disrupted Care. 79% report that patients abandon treatment because of authorization challenges.
- Patient Harm. 26% report that prior authorization has resulted in a serious adverse event, including hospitalization, permanent impairment, or death.
MSSNY continues its advocacy to address a longstanding gap in New York law affecting physicians’ participation in health insurance networks. Legislation currently under consideration—A.8052-A (Lavine) / S.1911-B (Rivera)—would extend existing due process protections to situations in which a physician’s contract is not renewed.
Under current law, health insurers are required to provide physicians with a written explanation and an opportunity for a hearing before terminating a contract. However, these protections do not apply when an insurer elects not to renew a contract, allowing similar outcomes to occur without the same procedural safeguards. The proposed legislation seeks to align these two circumstances by applying the same due process standards to non-renewal decisions, an issue MSSNY has identified for many years as a significant gap in existing protections.
MSSNY continues to work closely with legislative sponsors and leadership to advance the bill during the current session, including efforts to move the Assembly legislation to the Active List for consideration.
Governor Hochul recently signed two bills into law supported by MSSNY to protect vaccine availability and coverage for New Yorkers. The first bill (A.10711, Paulin/S.9598, Stavisky) ensures the continued availability of vaccinations for children and newborns using standards established by the New York State Commissioner of Health, instead of the Advisory Committee on Immunization Practices (ACIP). The standards would be based on widely accepted medical guidelines and take into consideration recommendations from the American Academy of Pediatrics (AAP), the American Academy of Family Physicians (AAFP), the American College of Obstetricians and Gynecologists (ACOG), the American College of Physicians (ACP), and other nationally recognized medical organizations, as well as the ACIP. The second bill (A.10710, Dilan/S.9599, Bailey) ensures continued health insurance coverage for vaccinations based upon the recommendations of ACIP or the NYS Commissioner of Health, which would also be based on recommendations of AAP, AAFP, ACOG or ACP.
The new laws are responding to the concern that previous New York State laws relative to vaccine availability and coverage were tied to recommendations made by the ACIP. These new laws will ensure that various vaccines available in New York State and covered under health insurance are not solely based on ACIP recommendations but also on recommendations of the New York State Commissioner of Health.
Both laws went into effect the day they were signed.
Assembly Committee Advances Chiropractic Scope Legislation Opposed by Several Physician Associations
Physicians are urged to contact their legislators to oppose legislation (A4706C/S5860C) that significantly expands the scope of services that could be provided by a chiropractor. The bill presents significant patient safety risks due to its numerous vague provisions, failure to identify appropriate educational standards for ensuring the expanded services can be provided safely, and expanding authorization to conduct detailed diagnostic testing without a defined pathway for treating conditions identified through these tests.
The bill was amended over the weekend, and this week was advanced from the Assembly Higher Education Committee to the Codes Committee. In addition to MSSNY, the bill is also opposed by the New York State Society of Orthopedic Surgeons, the New York State Neurological Society, the American Association of Neuromuscular & Electrodiagnostic Medicine and the American Medical Association. Specifically, the groups’ concerns with this legislation include:
- Expanding chiropractic authority beyond the vertebral column to include “other articular segments” and the broad treatment of neuromusculoskeletal conditions without adequate training. Orthopedic surgeons possess years of specialty training including 4 years of medical school, a 5-year residency, all specifically directed at diagnosing and managing pathology of the extremities. By comparison, the standard chiropractic doctoral program has no mandatory post-graduate residency of comparable depth, does not provide equivalent preparation to evaluate and manage structural joint pathology, ligamentous injury, tendon avulsion, articular fracture, or complex instability patterns.
- Authorizing chiropractors to perform and interpret electrodiagnostic tests, subject only to departmental approval of vague and unspecified “appropriate education standards.” Electrodiagnostic findings may reveal diagnoses that carry significant implications entirely beyond chiropractic scope. The bill provides no advanced training specific to electrodiagnosis, no competency examination, no mandatory referral obligation, no minimum supervised case volume requirement, and no competency standard. Permitting chiropractors to independently conduct these procedures risks missed diagnoses, delayed treatment of serious neurologic disease, and unnecessary or inappropriate care.
- Authorizing chiropractors to order clinical laboratory testing, including methods assessing nutritional and metabolic factors that impact musculoskeletal health, subject to departmental approval. Granting laboratory ordering authority without demonstrating minimal competency or a corresponding framework for managing abnormal results creates a diagnostic gap with potential patient harm consequences.
- Fails to identify steps to ensure that chiropractors possess reliably uniform competency for these expanded services. This legislation contains no provision distinguishing practitioners who have pursued rigorous post-graduate training from those who have not, no requirement that expanded diagnostic authority be conditioned on demonstrated specialty competency, and no mechanism for the public or referring providers to ascertain the educational pedigree of the chiropractor performing an electrodiagnostic study or ordering a metabolic laboratory panel.
Moreover, it defers critical competency determinations to the NYS Department of Education. If a patient is harmed due to a misinterpreted EMG or an unrecognized laboratory finding, the statutory standard is so vague as to provide little meaningful recourse framework.
Again, physicians are urged to contact their legislators to oppose this legislation.
