A 11688: Provides that no insurer, health maintenance organization, or any other entity shall, by contract, written policy, or procedure, reduce the payment of a negotiated rate for evaluation and management or procedural services furnished by a participating provider that are otherwise covered services, solely because the provider also billed other health care services.
<p> This bill amends the New York Insurance Law to address inequities in access to medical procedures by prohibiting insurers, health maintenance organizations, and other regulated entities from reducing negotiated payment rates for evaluation and management or procedural services. Specifically, the legislation forbids these entities from lowering reimbursement solely because a participating provider also billed for other health care services, such as minor procedures, on the same day. Any contractual provision or agreement that allows for such prohibited reductions in reimbursement is declared void and unenforceable. Additionally, the bill clarifies that for insured individuals enrolled in plans where the insurer only provides administrative services, the obligations under this section are limited to recommending to the third-party payor that coverage and payment be authorized in accor…
- What is the current status of A 11688?
- As of October 17, 2026, A 11688 is recorded as "Introduced": it has been introduced and is waiting for its first committee hearing or floor vote. The last recorded action, on September 2, 2026, was "referred to insurance".
- Did A 11688 pass?
- Not yet. A 11688 has been introduced and has not passed either house.
- Who wrote A 11688, and where is it now?
- A 11688 was authored by Asm. David Weprin with 1 coauthor. Its committee of record is Assembly Insurance.
| Sep. 02, 2026 | referred to insurance |
STATE OF NEW YORK ________________________________________________________________________ 11688 IN ASSEMBLY September 2, 2026 ___________ Introduced by COMMITTEE ON RULES -- (at request of M. of A. Weprin) -- read once and referred to the Committee on Insurance AN ACT to amend the insurance law, in relation to reducing inequities in access to medical procedures The People of the State of New York, represented in Senate and Assem- bly, do enact as follows: 1 Section 1. Section 3217-b of the insurance law is amended by adding a 2 new subsection (q) to read as follows: 3 (q) (1) No insurer, health maintenance organization, or any other 4 entity subject to this article shall, by contract, written policy, or 5 procedure, reduce the payment of a negotiated rate for evaluation and 6 management or procedural services furnished by a participating provider 7 that are otherwise covered services, solely because the provider also 8 billed other health care services, including but not limited to minor 9 procedures, on the same day as the evaluation and management or proce- 10 dural services. 11 (2) Any provision of a participating provider agreement that allows 12 for a reduction in reimbursement as prohibited by this subsection shall 13 be void and unenforceable. 14 (3) With respect to an insured enrolled in a health benefit plan under 15 which the insurer or utilization review organization only provides 16 administrative services, the obligations created by this subsection 17 shall be limited to recommending to the third-party payor that coverage 18 and payment should be authorized in accordance with the prohibitions set 19 forth herein. 20 § 2. This act shall take effect immediately and shall apply to all 21 contracts and policies issued, renewed, modified, or amended on or after 22 such effective date. EXPLANATION--Matter in italics (underscored) is new; matter in brackets [] is old law to be omitted. LBD16240-01-6