Bill

A 3365

Limits the lookback period for insurance overpayment recovery from health care providers to twelve months

2025 Regular Session Introduced by Karl Brabenec and 7 co-sponsors

Limits insurers' lookback for recovering provider overpayments to 12 months, speeding recovery, reducing long-standing disputes, and guiding provider cash flow and compliance.

PRINT NUMBER 3365A

WeVote Research Nonpartisan

Bill Summary · A 3365

Summary of New York Assembly Bill A3365 (A3365A)

Overview

Purpose: Limits the lookback period for insurance overpayment recovery by health care insurers from health care providers to twelve months.
Bill number and status: A3365, amended and reprinted as A3365A. Referred to Insurance on introduction; amended and recommitted to Insurance on May 20, 2025.
Introduction date: January 27, 2025.
Related legislation: Companion Senate bill S5209; prior-session related bill A7590.

Key Provisions (as indicated by title and reprint)

Establishes a fixed lookback period of 12 months for recovering overpayments from health care providers by insurers.
The A3365A reprint indicates amendments were adopted, with the bill proceeding through the standard committee and printing steps in the 2025 session.

Note: The detailed text of the amendments and any additional provisions (e.g., definitions, exceptions, interest, dispute resolution, or applicability to particular types of plans) is not included in the provided materials. The summary reflects the bill’s stated core change.

Who Would Be Affected

Health care providers: Entities or individuals that receive payments from insurers for services and may be subject to recoupment for overpayments within the 12-month window.
Health insurers and mutuals/health plans: Agencies and companies responsible for determining, pursuing, and recouping overpayments from providers.
Administrative and compliance entities within provider organizations: Responsible for tracking payment accuracy and responding to overpayment recoveries within the new lookback limit.

Procedural and Timeline Aspects

Introduction and assignment: Introduced January 27, 2025; referred to the Assembly Committee on Insurance.
Amendments: By May 20, 2025, the bill was amended and reprinted as A3365A, with parallel actions noted as “AMEND AND RECOMMIT TO INSURANCE.”
Current status: As of the latest actions, the bill remains within the Insurance committee process in amended form (A3365A).

Related Legislation

Companion Senate bill: S5209
Prior-session related Assembly bill: A7590

Potential Impact and Considerations

Administrative effect: Insurers would have a 12-month window to identify and recover overpayments, potentially reducing disputes over longer lookback periods.
Provider cash flow: Providers may experience changes in the timing and scope of recoupment activities.
Compliance burden: Insurers and providers will need to align practices with the 12-month limit, including documentation and appeals processes.
Legal interplay: The change may interact with existing contract terms, provider agreements, and other audit/recoupment authorities.

This summary focuses on the bill’s core aim and its likely implications based on the available information. For a detailed understanding, the full text of A3365A and any fiscal notes or amendments should be reviewed.

Compiled from official sources — confirm details with the bill’s official record.