Bill > A07981

This bill requires contracts between insurers, health care plans, and hospitals to include provisions for electronically sharing medical records during utilization review processes. Specifically, the bill mandates that hospitals provide electronic medical records to insurers, health care plans, or their utilization review agents when requested for individual claim care review and adjudication. The bill sets important limitations on how these records can be used: they must be used exclusively for patient care review, cannot be used for auditing or detecting billing patterns, and must include complete medical record information. The legislation also emphasizes patient privacy, requiring health care plans to prioritize data protection and implement robust security protocols. Additionally, the bill recommends that health care plans seek Health Information Trust Alliance (HITRUST) certification to ensure high standards of data security and privacy. The new requirements will apply to contracts issued, renewed, or modified 90 days after the bill becomes law, affecting various types of health insurance entities including health maintenance organizations, insurers, and municipal health benefit plans.

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https://www.nysenate.gov/legislation/bills/2025/A7981