New York legislation · 2025-2026 General Assembly
New York A11673: Prohibits the termination of coverage for rehabilitation services solely because of a failure to demonstrate measurable improvement in the applicable condition
Status: In committee, September 2, 2026
Provides that a utilization review agent shall not issue an adverse determination denying, reducing, or terminating coverage for medically necessary skilled rehabilitation services solely because the insured or enrollee has failed to demonstrate measurable improvement in the insured's or enrollee's condition.
What the bill says
An act to amend the insurance law, in relation to prohibiting the termination of coverage for rehabilitation services solely because of a failure to demonstrate measurable improvement in the applicable condition.
From the introduced text, September 2, 2026:
AN ACT to amend the insurance law, in relation to prohibiting the termination of coverage for rehabilitation services solely because of a failure to demonstrate measurable improvement in the applicable condition THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS: Section 1. Section 4903 of the insurance law is amended by adding a new subsection (j) to read as follows: (J) (1) A UTILIZATION REVIEW AGENT SHALL NOT ISSUE AN ADVERSE DETERMINATION DENYING, REDUCING, OR TERMINATING COVERAGE FOR MEDICALLY NECESSARY SKILLED REHABILITATION SERVICES SOLELY BECAUSE THE INSURED OR ENROLLEE HAS FAILED TO DEMONSTRATE MEASURABLE IMPROVEMENT IN THE INSURED'S OR ENROLLEE'S CONDITION. (2) FOR PURPOSES OF THIS SUBSECTION, MEDICALLY NECESSARY SKILLED REHABILITATION SERVICES MAY INCLUDE PHYSICAL THERAPY, OCCUPATIONAL THERAPY, SPEECH-LANGUAGE PATHOLOGY SERVICES, PULMONARY REHABILITATION, CARDIAC REHABILITATION, AND OTHER REHABILITATIVE SERVICES PERFORMED BY A LICENSED HEALTH CARE PROFESSIONAL ACTING WITHIN THE SCOPE OF THEIR PRACTICE. (3) A UTILIZATION REVIEW AGENT SHALL CONSIDER WHETHER CONTINUED SKILLED SERVICES ARE REASONABLY EXPECTED (II) PREVENT OR SLOW DETERIORATION IN FUNCTIONAL CAPACITY; (III) REDUCE PAIN OR OTHER SYMPTOMS THAT IMPAIR ACTIVITIES OF DAILY LIVING; (IV) PREVENT HOSPITALIZATION, INSTITUTIONALIZATION, SURGERY, OR OTHER MORE INTENSIVE MEDICAL INTERVENTION; OR (V) PERMIT THE SAFE PERFORMANCE OF A MAINTENANCE PROGRAM REQUIRING THE SPECIALIZED CLINICAL JUDGMENT OR SKILLS OF A LICENSED HEALTH CARE PROFESSIONAL. (4) …
Sponsors
- David Weprin (D, 24) · primary sponsor
Latest actions
- : REFERRED TO INSURANCE
Subjects: Insurance Law
Common questions
- What is A11673?
- A11673 is a bill in the New York Legislature (2025-2026 General Assembly): Prohibits the termination of coverage for rehabilitation services solely because of a failure to demonstrate measurable improvement in the applicable condition.
- What does A11673 do?
- In its own words: An act to amend the insurance law, in relation to prohibiting the termination of coverage for rehabilitation services solely because of a failure to demonstrate measurable improvement in the applicable condition.
- What is the status of A11673?
- In committee as of September 2, 2026. Latest action: REFERRED TO INSURANCE (September 2, 2026).
- Who sponsored A11673?
- David Weprin (D, 24).
- Where is the official record for A11673?
- On the New York Legislature website: https://www.nysenate.gov/legislation/bills/2025/A11673
Source: official New York record. Tracked by Delilah, AI for legislation across all 50 states and Congress.