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Assembly Bill A11623

2025-2026 Legislative Session

Requires standards for an electronic prior authorization program for the utilization review of health care services

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Current Bill Status - In Assembly Committee

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2025-A11623 (ACTIVE) - Details

Current Committee:
Assembly Health
Law Section:
Public Health Law
Laws Affected:
Amd §4903, Pub Health L; amd §4903, Ins L

2025-A11623 (ACTIVE) - Summary

Requires the commissioner of health and the superintendent of insurance to develop standards for an electronic prior authorization program for the utilization review of health care services.

2025-A11623 (ACTIVE) - Bill Text download pdf 

                             
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   11623
 
                           I N  A S S E M B L Y
 
                               July 29, 2026
                                ___________
 
 Introduced  by  COMMITTEE  ON RULES -- (at request of M. of A. Yeger) --
   read once and referred to the Committee on Health
 
 AN ACT to amend the public health law and the insurance law, in relation
   to an electronic  prior  authorization  program  for  the  utilization
   review of health care services
 
   THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section 1. Section 4903 of the public health law is amended by  adding
 a new subdivision 10 to read as follows:
   10. THE COMMISSIONER, IN CONJUNCTION WITH THE SUPERINTENDENT OF FINAN-
 CIAL  SERVICES, SHALL DEVELOP STANDARDS FOR PRIOR AUTHORIZATION REQUESTS
 TO BE UTILIZED BY ALL HEALTH CARE PLANS FOR THE PURPOSE OF SUBMITTING  A
 REQUEST  FOR  A  UTILIZATION REVIEW DETERMINATION FOR COVERAGE OF HEALTH
 CARE SERVICES UNDER THIS CHAPTER. THE DEPARTMENT AND THE  DEPARTMENT  OF
 FINANCIAL  SERVICES,  IN  DEVELOPMENT OF THE STANDARDS, SHALL REQUIRE AN
 ELECTRONIC PRIOR AUTHORIZATION PROGRAM AND SHALL TAKE INTO CONSIDERATION
 EXISTING ELECTRONIC PRIOR AUTHORIZATION STANDARDS.
   § 2. Section 4903 of the insurance law is  amended  by  adding  a  new
 subsection (j) to read as follows:
   (J)  THE  SUPERINTENDENT,  IN  CONJUNCTION  WITH  THE  COMMISSIONER OF
 HEALTH, SHALL DEVELOP STANDARDS FOR PRIOR AUTHORIZATION REQUESTS  TO  BE
 UTILIZED  BY  ALL  HEALTH  CARE  PLANS  FOR  THE PURPOSE OF SUBMITTING A
 REQUEST FOR A UTILIZATION REVIEW DETERMINATION FOR  COVERAGE  OF  HEALTH
 CARE  SERVICES  UNDER THIS CHAPTER. THE DEPARTMENT AND THE DEPARTMENT OF
 HEALTH, IN DEVELOPMENT OF THE STANDARDS,  SHALL  REQUIRE  AN  ELECTRONIC
 PRIOR  AUTHORIZATION  PROGRAM AND SHALL TAKE INTO CONSIDERATION EXISTING
 ELECTRONIC PRIOR AUTHORIZATION STANDARDS.
   § 3. This act shall take effect immediately.
 
 

  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD15968-01-6

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