New York Assembly Bill A03947 Latest Draft

   
  STATE OF NEW YORK ________________________________________________________________________ 3947 2025-2026 Regular Sessions  IN ASSEMBLY January 30, 2025 ___________ Introduced by M. of A. PAULIN -- read once and referred to the Committee on Insurance AN ACT to amend the insurance law, in relation to requiring API to facilitate patient and provider access to health information for enrollees and contract providers The People of the State of New York, represented in Senate and Assem- bly, do enact as follows: 1 Section 1. The insurance law is amended by adding a new section 112 to 2 read as follows: 3 § 112. Information for enrollees and contracted providers. (a) 4 Commencing January first, two thousand twenty-six, to facilitate patient 5 and provider access to health information, any health care insurance 6 company authorized in this state to write health insurance shall estab- 7 lish and maintain the following application programming interfaces (API) 8 for the benefit of enrollees and contracted providers, as applicable: 9 (1) Patient access API; 10 (2) Provider directory API; and 11 (3) Payer-to-payer exchange API. 12 (b) In addition to the API described in subsection (a) of this 13 section, the department may require any health care insurance companies 14 authorized to write health insurance to establish and maintain the 15 following API, if and when final rules are published by the federal 16 government: 17 (1) Provider access API; and 18 (2) Prior authorization support API. 19 (c) The API described in subsection (b) of this section shall be in 20 accordance with standards published in a final rule issued by the feder- 21 al Centers for Medicare and Medicaid Services and published in the 22 Federal Register, and shall align with federal effective dates, includ- 23 ing enforcement delays and suspensions, issued by the federal Centers 24 for Medicare and Medicaid Services. EXPLANATION--Matter in italics (underscored) is new; matter in brackets [ ] is old law to be omitted. LBD06912-01-5 
 A. 3947 2 1 (d) For purposes of this section: 2 (1) "Application Programming Interface" or "API" means a set of rules 3 or protocols that allows different software applications to communicate 4 with each other, exchanging data and functionality, and acts as a stand- 5 ardized way for programs to interact and share information with one 6 another. 7 (2) "Patient access API" means a secure and public-facing API to make 8 patient membership, coverages, claims, clinical and prescription drug 9 formulary information available. This API requires authentication for 10 any user. 11 (3) "Provider directory API" means a secure and public facing API to 12 make provider information available. 13 (4) "Payer-to-Payer exchange API" means a secure and public facing API 14 to exchange patient data when a patient moves between payers to ensure 15 continued access to their health data and support continuity of care 16 between payers. 17 § 2. This act shall take effect immediately.