Bill > S08203

This bill requires that contracts between insurers, health care plans, and hospitals include provisions mandating the electronic sharing of medical records for utilization review purposes. Specifically, hospitals participating in health care plan networks must provide electronic medical records to insurers or their utilization review agents (organizations that review the medical necessity of healthcare services). The bill sets important limitations on how these records can be used: they must be used exclusively for individual claim review and patient care, cannot be used for auditing or detecting billing patterns, and must include complete medical information. Health care plans are required to prioritize data protection, with a recommendation to seek HITRUST (Health Information Trust Alliance) certification to ensure data security and privacy compliance. The bill defines "health care plan" broadly, including health maintenance organizations, insurers, and various types of health benefit plans. The electronic record-sharing requirement will apply to new, renewed, or modified contracts starting 90 days after the bill becomes law, aiming to streamline healthcare record access while protecting patient privacy and limiting potential misuse of medical information.

Business and Industry

https://www.nysenate.gov/legislation/bills/2025/S8203