New York Mandates Insurer Coverage for Lung Cancer Follow-Up Screenings

Effective January 1, 2027, New York state will require health insurers to cover follow-up lung cancer screening and diagnostic services without cost sharing for members. This mandate applies to individual, group, and HMO insurance policies and is contingent upon the services being recommended by healthcare providers and aligned with nationally recognized clinical practice guidelines. These guidelines are evidence-based and developed by independent organizations or medical professional societies ensuring transparency and reliability. The legislation permits insurers to apply medical management protocols such as utilization review and prior authorization to confirm that services are consistent with clinical guidelines. Additionally, for members with high-deductible health plans, coverage remains subject to the annual deductible if waiving cost sharing would affect Health Savings Account (HSA) eligibility. This regulatory update emphasizes cost protection while maintaining insurer oversight to align care with established clinical standards.