New York Health Policy Monitor (September 15, 2026)
Emergency rules standardize dispute resolution for surprise bills. Pending legislation proposes removing income caps for child health coverage.
Prepared by Isaac Michaels, DrPH · September 15, 2026
The Department of Financial Services adopted an emergency rule regarding the independent dispute resolution process for emergency services and surprise medical bills. The regulation conforms state regulatory codes to the statutory amendments enacted via recent legislative sessions. The emergency adoption makes the updated arbitration and dispute frameworks immediately applicable to contested claims involving health insurers and out-of-network providers.
In the state legislature, Senate Bill 10698 proposes to overhaul eligibility requirements for children’s health insurance. The measure aims to remove household income as a qualifying factor for health care coverage, effectively establishing a universal eligibility standard starting in 2028. Additionally, the legislation extends the continuous coverage period for children transitioning to medical assistance from three months to six months, ensuring continuity of care during enrollment shifts.
If enacted, the legislative measure would require the Department of Health to submit applicable federal waivers to secure federal financial participation for the expanded eligibility. The bill mandates temporary enrollment periods for children while official eligibility determinations are processed by social services agencies. These structural shifts in enrollment and dispute resolution represent mechanical changes to operational compliance and state healthcare financing models.
Priority Items
Affected Entities and Corresponding Policies
- Health Insurers: DFS-36-26-00004-E
- Health Plans: S10698
- Hospitals: DFS-36-26-00004-E
- Out-of-Network Providers: DFS-36-26-00004-E
- Pediatric Providers: S10698
- Social Services Agencies: S10698