New York 2025 Session Status: Introduced

S4833 — Relates to downcoding on initial review and audits reversing or altering medical necessity determinations

Last action — In Senate Committee

  1. 1
    Introduced
  2. 2
    In Committee
  3. 3
    Passed Senate
  4. 4
    Passed Assembly
  5. 5
    To Executive
  6. 6
    Enacted

This bill has been introduced in the Senate. Introduced February 13, 2025. It must pass committee before a floor vote.

Next likely step: a committee referral and hearing.

Prognosis

Not enough signal yet

Where this bill stands today.

Odds of enactment

Low

How often bills like it became law.

Not enough signal yet to read this bill's trajectory — we surface a likelihood only once there's real movement (stage, sponsorship, committee, or votes) to point to.

Prognosis reads this bill's own signals — stage, sponsorship breadth, committee status, recorded votes and cross-state momentum. Odds come from a model trained on which bills have become law.

Summary

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.

Bill Text

Action History

  1. REFERRED TO INSURANCE

  2. REFERRED TO INSURANCE

Sponsors

Sponsorship breakdown

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1 sponsors · 0 co-sponsors · 218 not signed on

Sponsors (1)

Co-sponsors (0)

None.

Not signed on (218)

218 members have not signed on to this bill.

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"Not signed on" means a member has not sponsored or co-sponsored this bill — it does not imply opposition. Members flagged Voted No have a recorded No vote on this bill.

Whip count is in markup. Polling the chamber and every recorded vote this session. Only the first open is slow. It’s instant for you after this. Calling the roll · Tallying · Engrossing

Subjects

healthcare health-insurance
Cross-referencing the record. Reading this bill against every other bill in the corpus by meaning, not keywords. Only the first open is slow. It’s instant for you after this. Matching · Ranking · Engrossing

Frequently asked questions

What does S4833 do?
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.
Who sponsors S4833?
S4833 is sponsored by James Skoufis.
What is the current status of S4833?
This bill has been introduced in the Senate. Introduced February 13, 2025. It must pass committee before a floor vote.
Where can I track S4833?
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Last checked for changes 3 months ago · updated continuously

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