Prohibits medical assistance providers from refusing to furnish care, services or supplies to any person for whom Medicaid is secondary insurance

2025 Regular Session Introduced by Rodneyse Bichotte Hermelyn and 3 co-sponsors

Prohibits medical providers from denying care when Medicaid is secondary, protecting access for patients with other primary coverage and Medicaid.

REFERRED TO HEALTH

Basic Information

Bill Number: A 4908

Title/Purpose (as introduced): Prohibits medical assistance providers from refusing to furnish care, services or supplies to any person for whom Medicaid is secondary insurance

Status: Refer red to Health (February 10, 2025)

Introduced: February 10, 2025

Classification: Bill

Sponsors:

Primary: Rodneyse Bichotte Hermelyn
Cosponsors: Eddie Gibbs, William Colton, Ron Kim

Related Bills: A 10072 (prior-session), A 6982 (prior-session), A 1928 (prior-session); Senate companion: S 5173

Purpose and Intent

The bill seeks to ensure that individuals who have Medicaid as a secondary insurance payer are not refused medical care, services, or supplies by medical assistance providers. In other words, if a patient has another primary insurance and Medicaid is secondary, providers would be prohibited from denying treatment or necessary goods/services on the basis of Medicaid’s secondary status.

Key Provisions (as introduced)

The bill’s title indicates a prohibition on refusal to furnish care, services, or supplies when Medicaid is not the primary payer.

The text of specific requirements (definitions, scope of care, enforcement mechanisms, exceptions, penalties, effective date) are not provided in the summary. The precise operational details, including how “refusal” and “medical assistance” are defined, would be found in the full bill text.

Who Would Be Affected

Patients/Beneficiaries: Individuals eligible for Medicaid who also carry a secondary (primary) insurance plan and require medical care, services, or supplies.

Medical Providers: Hospitals, clinics, doctors, and suppliers who bill Medicaid and/or other insurers and who would be constrained from denying care based on Medicaid’s secondary status.

Payers: Primary insurers and Medicaid program, given potential changes to billing practices and payer coordination.

Procedural and Timeline Considerations

The bill has been referred to the Health Committee (February 10, 2025). Movement would depend on committee hearings and potential amendments before advancing to a floor vote.

The presence of multiple related prior-session bills and a Senate companion (S 5173) suggests there may be an ongoing policy interest and possible refinement of language over time.

Potential Impacts and Considerations

Access to Care: May improve access for Medicaid beneficiaries who rely on secondary coverage, reducing barriers to treatment.

Billing and Administration: Could require providers to manage coordination between primary payers and Medicaid, potentially affecting billing workflows and claim denials.

Enforcement and Compliance: Details on enforcement, remedies, and any explicit exemptions would shape practical impact; those would be clarified in the full bill text.

Fiscal Implications: Any cost or savings to the Medicaid program or providers would depend on the bill’s specifics and any accompanying fiscal note.

Next Steps for Readers

Review the full text of A 4908 to confirm definitions, scope, exceptions, enforcement provisions, and effective dates.

Monitor committee activity in the Health Committee for hearings, amendments, and potential passage.

Compare with related bills (A 10072, A 6982, A 1928, and S 5173) to understand similarities, differences, and broader legislative intent.

Bill