New York legislation · 2025-2026 General Assembly
New York S9651: Relates to utilization review program standards and pre-authorization for certain health care services
Status: In committee, June 5, 2026
Relates to utilization review program standards; requires use of evidence-based and peer reviewed clinical review criteria; relates to prescription drug formulary changes and pre-authorization for certain health care services.
What the bill says
An act to amend the public health law and the insurance law, in relation to utilization review program standards and pre-authorization of health care services.
From the introduced text, March 31, 2026:
AN ACT to amend the public health law and the insurance law, in relation to utilization review program standards and pre-authorization of health care services THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS: Section 1. Paragraph (c) of subdivision 1 of section 4902 of the public health law, as added by chapter 705 of the laws of 1996, is amended to read as follows: (c) Utilization of written clinical review criteria developed pursuant to a utilization review plan. SUCH CLINICAL REVIEW CRITERIA SHALL UTILIZE RECOGNIZED EVIDENCE-BASED AND PEER REVIEWED CLINICAL REVIEW CRITERIA THAT TAKE INTO ACCOUNT THE NEEDS OF A TYPICAL PATIENT POPULATIONS AND DIAGNOSES; § 2. Paragraph (a) of subdivision 2 of section 4903 of the public health law, as separately amended by section 13 of part YY and section 3 of part KKK of chapter 56 of the laws of 2020, is amended to read as follows: (a) A utilization review agent shall make a utilization review determination involving health care services which require pre-authorization and provide notice of a determination to the enrollee or enrollee's designee and the enrollee's health care provider by telephone and in writing within [three business days] SEVENTY-TWO HOURS of receipt of the necessary information, WITHIN TWENTY-FOUR HOURS OF THE RECEIPT OF NECESSARY INFORMATION …
Sponsors
- Gustavo Rivera (D, 33) · primary sponsor
- Joseph Addabbo (D, 15)
- April Baskin (D, 63)
- Cordell Cleare (D, 30)
- Patrick Gallivan (R, 60)
- Kristen Gonzalez (D, 59)
- John Liu (D, 16)
Latest actions
- : COMMITTED TO RULES
- : ADVANCED TO THIRD READING
- : 2ND REPORT CAL.
- : 1ST REPORT CAL.815
- : REFERRED TO HEALTH
Votes
- Senate Health Committee: COMMITTEE Vote (April 21, 2026): 15 yea, 0 nay, passed
- Health Committee Vote (April 21, 2026): 15 yea, 0 nay, passed
Subjects: Public Health Law
Common questions
- What is S9651?
- S9651 is a bill in the New York Legislature (2025-2026 General Assembly): Relates to utilization review program standards and pre-authorization for certain health care services.
- What does S9651 do?
- In its own words: An act to amend the public health law and the insurance law, in relation to utilization review program standards and pre-authorization of health care services.
- What is the status of S9651?
- In committee as of June 5, 2026. Latest action: COMMITTED TO RULES (June 5, 2026).
- Who sponsored S9651?
- Gustavo Rivera (D, 33), with 6 co-sponsors.
- Where is the official record for S9651?
- On the New York Legislature website: https://www.nysenate.gov/legislation/bills/2025/S9651
Source: official New York record. Tracked by Delilah, AI for legislation across all 50 states and Congress.