NY A03947

Requires health insurance companies authorized in New York to establish and maintain three application programming interfaces (APIs) starting January 1, 2026: Patient Access API, Provider Directory API, and Payer-to-Payer Exchange API

Patient Access API must provide secure access to patient membership, coverages, claims, clinical data, and prescription drug formulary information with required user authentication

Payer-to-Payer Exchange API enables secure transfer of patient health data when patients switch between insurance companies to ensure continuity of care

Authorizes the department to require two additional APIs (Provider Access API and Prior Authorization Support API) if and when federal rules are finalized by the Centers for Medicare and Medicaid Services

API standards must align with federal CMS final rules and comply with federal effective dates, including any enforcement delays or suspensions