New York Senate bill in Session 2025-2026.
Status: in_committee. Latest action: January 7, 2026.
Relates to downcoding on initial review and audits reversing or altering medical necessity determinations.
Ensures the decision to downcode an insurance claim is recognized as an adverse determination; prohibits health plans from reversing or altering medical necessity determinations made by a utilization review agent or external appeals agent as a result of an audit of claims.
| Date | Event | Detail |
|---|---|---|
| 2025-02-13 | Introduced | Bill introduced |
| 2026-01-07 | Status | in_committee |
| 2026-01-07 | Latest Action | In Senate Committee |