New York Health Policy Monitor

New York Health Policy Monitor (August 04, 2026) New legislative proposals advance Medicaid coverage mandates for school-based behavioral health and establish standardized electronic prior authorization. New York Health Policy Monitor · August 4, 2026

Prepared by Isaac Michaels, DrPH · August 04, 2026 About New York Health Policy Monitor is published by I.H. Michaels, LLC, an independent health policy and data analytics practice. The publication is informational and does not constitute legal or policy advice. For questions, pricing for organizations, or data services inquiries, contact: info@ihmichaelsllc.com New legislative proposals advance Medicaid coverage mandates for school-based behavioral health and establish standardized electronic prior authorization. Lawmakers have introduced a series of legislative proposals focused on expanding Medicaid coverage mandates and standardizing utilization review processes. The active bills currently sit in the Assembly Health Committee and propose structural alterations to coverage parameters and operational standards for health care plans. Key measures include a proposed mandate for Medicaid to cover applied behavior analysis therapy when delivered during school hours, expanding access points for autism spectrum disorder treatment. Concurrently, new legislation would require the Department of Health and the Department of Financial Services to establish standardized electronic prior authorization protocols for all health care plans, aiming to codify utilization review pathways. Additionally, legislators proposed a rare kidney disease screening pilot program that would operate in at least two geographic regions to target at-risk populations. If implemented, this program would direct the state to utilize community-based outreach and specific diagnostic screening tools to evaluate the scalability of broader permanent initiatives. Past Week at a Glance 3 Health Bills Referred to Assembly Committee Priority Items Coverage Expansions & Utilization Standards Driven by: A11624, A11623 Why it matters: These proposals would simultaneously expand Medicaid coverage requirements for behavioral health therapies in schools while imposing new technological standardization mandates on prior authorization processes for insurers. Suggested action: Evaluate existing prior authorization software platforms for adaptability to potential new state standards and model the financial impact of expanded school-based applied behavior analysis coverage. Topics: Medicaid & Managed Care, Behavioral Health / Substance Use Affected Entities and Corresponding Policies ABA Providers: A11624 Clinical Laboratories: A11655 Community Health Centers: A11655 Department of Health: A11655 Health Care Plans: A11623 Health Care Providers: A11623 Medicaid Managed Care Organizations: A11624 School Districts: A11624 Key Policy Actions Assembly Committee A11624: Mandates Medicaid coverage of applied behavior analysis therapy for autism spectrum disorder rendered during school hours Topics: Public Health / Prevention Sponsor: Kalman Yeger (Assembly — Democrat, New York City) Co-sponsors: 0 Status: Assembly Committee Action Date: July 29, 2026 Summary: Requires Medicaid coverage of applied behavior analysis therapy for the treatment of autism spectrum disorder rendered during school hours in certain schools. Affected Entities: Medicaid Managed Care Organizations; ABA Providers; School Districts Practical Implications: If enacted, this measure would mandate Medicaid reimbursement for applied behavior analysis therapy for the treatment of autism spectrum disorder delivered during the school day. Medicaid Managed Care Organizations would need to adjust coverage policies, while ABA Providers could see expanded service utilization and billing opportunities within educational settings. Source: https://www.nysenate.gov/legislation/bills/2025/A11624/ A11623: Requires the development of standards for an electronic prior authorization program for health care services Topics: Public Health / Prevention Sponsor: Kalman Yeger (Assembly — Democrat, New York City) Co-sponsors: 0 Status: Assembly Committee Action Date: July 29, 2026 Summary: Requires the commissioner of health and the superintendent of financial services to develop standards for an electronic prior authorization program for the utilization review of health care services. Affected Entities: Health Care Plans; Health Care Providers Practical Implications: If enacted, this measure would require health care plans and providers to adapt to new standardized electronic prior authorization processes for utilization review. Organizations could face initial administrative integration burdens but may ultimately experience streamlined coverage determinations. Source: https://www.nysenate.gov/legislation/bills/2025/A11623/ A11655: Establishes a rare kidney disease screening pilot program for at-risk populations Topics: Public Health / Prevention Sponsor: Yudelka Tapia (Assembly — Democrat, New York City) Co-sponsors: 0 Status: Assembly Committee Action Date: July 29, 2026 Summary: Establishes a rare kidney disease screening pilot program within the department of health to operate in at least two counties or regions in the state, targeting at-risk populations, to improve early diagnosis of RKD, connect patients with treatments and care, and evaluate the effectiveness and scalability of state-based RKD screening initiatives. Affected Entities: Department of Health; Community Health Centers; Clinical Laboratories Practical Implications: If enacted, this bill would direct the Department of Health to launch a screening pilot program for rare kidney diseases in at least two regions. Clinical Laboratories and Community Health Centers in selected areas could see increased demand for urinalysis and genetic testing services as outreach initiatives target at-risk populations. Source: https://www.nysenate.gov/legislation/bills/2025/A11655/ Methodology: This newsletter is generated from structured legislative and regulatory data (as of August 03, 2026) and reviewed for completeness, internal consistency, and non-speculative language. Co-sponsor counts reflect the total number of legislators listed as co-sponsors across both the Assembly and Senate. Click to Subscribe to this newsletter. This publication is informational and does not constitute legal or policy advice. © 2026 I.H. Michaels, LLC 3100 Rosendale Road, Niskayuna, NY 12309