News & Analysis as of

New York Healthcare Health Insurance

McDermott Will & Schulte

Budget reconciliation’s effect on New York’s Medicaid and Essential Plan funding

The budget reconciliation process resulting in the One Big Beautiful Bill Act, which was enacted on July 4, 2025, contains many significant changes to the Medicaid program. Many of the changes, such as those related to work...more

Troutman Pepper Locke

New York AG Intensifies Investigation and Enforcement Against Alleged Medicaid Fraud

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On June 30, 2025, New York Attorney General (AG) Letitia James announced new lawsuits, criminal charges, and settlements with 25 New York transportation companies related to alleged schemes to defraud Medicaid of millions....more

Pullman & Comley - Connecticut Health Law

Considering a Direct Primary Care Practice? Don’t Ignore State Law!

Our recent article in Physicians Practice outlines 10 Dos and Don’ts for physicians and other practitioners to take into account when deciding whether to establish a direct primary care (DPC) practice. ...more

Proskauer - Health Care Law Brief

DOH Issues Guidance on New York’s Material Health Care Transaction Law

Nearly two years ago, and as previously discussed in a Proskauer alert, New York enacted Public Health Law Article 45-A (the “Material Transactions Law”), which requires reporting of certain material health care transactions....more

Littler

NY Federal Court Issues TRO Against the NY Department of Health

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As previously reported, in April 2024, New York’s Social Services Law was amended to include a substantial change to the state’s Consumer Directed Personal Assistance Program (CDPA Program), a Medicaid-funded program allowing...more

Foley & Lardner LLP

Risk Bearing Entity Requirements: New Jersey and New York

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This blog reviews the regulatory requirements that apply to risk bearing entities (RBE) in New Jersey and New York. New Jersey and New York demonstrate distinct approaches to the registration and regulation of RBEs and...more

McDermott Will & Schulte

New York Executive Budget Proposes Amendments to MCO Provider Tax

The New York State Executive Budget for Fiscal Year (FY) 2026 proposes significant updates to the managed care organization (MCO) provider tax, aiming to enhance Medicaid funding through innovative financial strategies. The...more

DLA Piper

New York issues extensive new pharmacy benefit manager regulations

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On November 27, 2024, the New York State Department of Financial Services (DFS) will be releasing new regulations governing pharmacy benefit managers (PBMs). Beginning with legislation in 2021, New York has been active in...more

Goldberg Segalla

Defending HIMP-1 Claims: Top Things to Know

Goldberg Segalla on

In New York State, the Health Insurance Matching Program – widely known as HIMP – provides means for a claimant’s private health insurer to seek reimbursement for treatment they believe a workers’ compensation carrier or...more

Falcon Rappaport & Berkman LLP

Pooled Income Trusts for Medicaid Home Care

One of the biggest misconceptions related to Community (Home Care) Medicaid is the idea that one thinks they and/or their loved one is not eligible for services because “they make too much money.” In New York State, for one...more

Troutman Pepper Locke

New York Secures $1M Settlement With Northwell Health Related to COVID-19 Testing Charges

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On April 12, New York Attorney General (AG) Letitia James announced that her office has reached a settlement with Northwell Health, New York’s largest health care network, related to allegations of misleading billing...more

Lippes Mathias LLP

New York State Medicaid Updates for 2024

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Medicaid is a joint federal and state program that provides health coverage to millions of Americans. Federal law requires states to comply with certain minimum requirements, but New York is considered a maximum state in that...more

Robinson & Cole LLP

Health Law Diagnosis - New York OMIG Issues 2022 Annual Report

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On Monday, October 2, 2023, the New York Office of the Medicaid Inspector General (OMIG) published its Annual Report for 2022. The Report details the various efforts that New York’s Medicaid program undertook in 2022 to...more

Robinson+Cole Health Law Diagnosis

New York OMIG Issues 2022 Annual Report

On Monday, October 2, 2023, the New York Office of the Medicaid Inspector General (OMIG) published its Annual Report for 2022. The Report details the various efforts that New York’s Medicaid program undertook in 2022 to...more

Robinson+Cole Health Law Diagnosis

Two Pathways for Medicaid Self-Disclosures Announced by OMIG

The New York Office of the Medicaid Inspector General (OMIG) recently announced updates to its Self-Disclosure Program in response to feedback from Medicaid stakeholders after its revised posting in January 2023. OMIG revised...more

Polsinelli

Are You Ready? Starting August 1st, New York Imposes New Review Process for Material Transactions Involving Health Care Entities

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On May 3, 2023, New York Governor Kathy Hochul signed into law Article 45-A, amending the New York Public Health Law (“Article 45-A”). Under this new Article 45-A, health care entities in New York State are now required to...more

Lippes Mathias LLP

New Disclosure and Notice Requirements for New York Physician Practice Transactions

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The 2023-2024 New York State budget has enacted significant new mandatory disclosure and notice laws for certain transactions involving physician practices and other health care organizations. This new law – Article 45-A of...more

Rivkin Radler LLP

NY Enacts Scaled-Back Version of Hochul’s Health Care Transactions Proposal

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Following extended New York State budget negotiations, lawmakers have enacted a significantly modified version of Governor Hochul’s proposed health care transaction review bill. The bill, as originally proposed, included a...more

Robinson & Cole LLP

Health Law Diagnosis - January 2023

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New York Governor Vetoes Act Prohibiting Establishment and Expansion of For-Profit Hospices - On December 23, 2022, New York Governor Kathy Hochul vetoed Assembly Bill Number A8472 “An Act To Amend The Public Health Law,...more

Polsinelli

New York Enacts Legislation Regulating Pharmacy Benefit Managers

Polsinelli on

New York recently enacted legislation, SB 3762, requiring Pharmacy Benefit Managers (“PBMs”) doing business in New York to register and then become licensed with the New York Department of Financial Services (“DFS”).  The law...more

Proskauer - Health Care Law Brief

New York Enacts Landmark Legislation Regulating PBM

On December 31, 2021, New York Governor Kathy Hochul signed landmark legislation to increase the transparency of prescription drug pricing and to establish requirements on pharmacy middlemen. This new law is amongst 100 ...more

Epstein Becker & Green

New York State Department of Financial Services Summarizes Changes Relating to Administrative Denials, Prior Authorizations, and...

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On March 10, 2021, the New York State Department of Financial Services (“DFS”) issued Insurance Circular Letter No. 4 (“Circular Letter”), which both explains modifications to the Insurance Law and the Public Health Law...more

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