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NY A01456
Bill
Status
1/9/2025
Primary Sponsor
Pamela Hunter
Click for details
AI Summary
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Requires health insurers, Article 43 corporations, and HMOs to notify insureds and enrollees on their websites about whether they use artificial intelligence-based algorithms in the utilization review process
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Mandates insurers submit AI algorithms and training data sets used in utilization review to the Department of Financial Services for certification that they minimize bias based on race, color, religion, ancestry, age, sex, gender, national origin, or disability
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Requires clinical peer reviewers to open and document review of individual clinical records before issuing an adverse determination when AI algorithms are initially used in utilization review
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Establishes penalties for violations including license suspension/revocation, fines up to $5,000 per violation or $10,000 per willful violation, with aggregate annual caps of $500,000 for insurers and $100,000 for clinical peer reviewers
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Takes effect 60 days after becoming law, with immediate authority to promulgate necessary rules and regulations
Legislative Description
Provides for notice requirements where an insurer authorized to write accident and health insurance in this state, a corporation organized pursuant to article forty-three of this chapter, or a health maintenance organization certified pursuant to article forty-four of the public health law uses artificial intelligence-based algorithms in the utilization review process.
Last Action
referred to insurance
1/7/2026