Senate Bill S9992

                             
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   9992
 
                             I N  S E N A T E
 
                              April 21, 2026
                                ___________
 
 Introduced  by  Sen.  MAYER  -- read twice and ordered printed, and when
   printed to be committed to the Committee on Insurance
 
 AN ACT to amend the insurance law,  in  relation  to  requiring  API  to
   facilitate  patient  and  provider  access  to  health information for
   enrollees and contract providers
 
   THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section 1. The insurance law is amended by adding a new section 112 to
 read as follows:
   §  112.  INFORMATION  FOR  ENROLLEES  AND  CONTRACTED  PROVIDERS.  (A)
 COMMENCING JANUARY  FIRST,  TWO  THOUSAND  TWENTY-SEVEN,  TO  FACILITATE
 PATIENT  AND  PROVIDER  ACCESS  TO  HEALTH  INFORMATION, ANY HEALTH CARE
 INSURANCE COMPANY AUTHORIZED IN THIS STATE  TO  WRITE  HEALTH  INSURANCE
 SHALL  ESTABLISH  AND  MAINTAIN  THE  FOLLOWING  APPLICATION PROGRAMMING
 INTERFACES (API) FOR THE BENEFIT OF ENROLLEES AND CONTRACTED  PROVIDERS,
 AS APPLICABLE:
   (1) PATIENT ACCESS API;
   (2) PROVIDER DIRECTORY API; AND
   (3) PAYER-TO-PAYER EXCHANGE API.
   (B)  IN  ADDITION  TO  THE  API  DESCRIBED  IN  SUBSECTION (A) OF THIS
 SECTION, THE DEPARTMENT MAY REQUIRE ANY HEALTH CARE INSURANCE  COMPANIES
 AUTHORIZED  TO  WRITE  HEALTH  INSURANCE  TO  ESTABLISH AND MAINTAIN THE
 FOLLOWING API, IF AND WHEN FINAL RULES  ARE  PUBLISHED  BY  THE  FEDERAL
 GOVERNMENT:
   (1) PROVIDER ACCESS API; AND
   (2) PRIOR AUTHORIZATION SUPPORT API.
   (C)  THE  API  DESCRIBED IN SUBSECTION (B) OF THIS SECTION SHALL BE IN
 ACCORDANCE WITH STANDARDS PUBLISHED IN A FINAL RULE ISSUED BY THE FEDER-
 AL CENTERS FOR MEDICARE AND  MEDICAID  SERVICES  AND  PUBLISHED  IN  THE
 FEDERAL  REGISTER, AND SHALL ALIGN WITH FEDERAL EFFECTIVE DATES, INCLUD-
 ING ENFORCEMENT DELAYS AND SUSPENSIONS, ISSUED BY  THE  FEDERAL  CENTERS
 FOR MEDICARE AND MEDICAID SERVICES.
   (D) FOR PURPOSES OF THIS SECTION:
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD06912-02-6
              

 S. 9992                             2
 
   (1)  "APPLICATION PROGRAMMING INTERFACE" OR "API" MEANS A SET OF RULES
 OR PROTOCOLS THAT ALLOWS DIFFERENT SOFTWARE APPLICATIONS TO  COMMUNICATE
 WITH EACH OTHER, EXCHANGING DATA AND FUNCTIONALITY, AND ACTS AS A STAND-
 ARDIZED  WAY  FOR  PROGRAMS  TO  INTERACT AND SHARE INFORMATION WITH ONE
 ANOTHER.
   (2)  "PATIENT ACCESS API" MEANS A SECURE AND PUBLIC-FACING API TO MAKE
 PATIENT MEMBERSHIP, COVERAGES, CLAIMS, CLINICAL  AND  PRESCRIPTION  DRUG
 FORMULARY  INFORMATION  AVAILABLE.  THIS API REQUIRES AUTHENTICATION FOR
 ANY USER.
   (3) "PROVIDER DIRECTORY API" MEANS A SECURE AND PUBLIC FACING  API  TO
 MAKE PROVIDER INFORMATION AVAILABLE.
   (4) "PAYER-TO-PAYER EXCHANGE API" MEANS A SECURE AND PUBLIC FACING API
 TO  EXCHANGE  PATIENT DATA WHEN A PATIENT MOVES BETWEEN PAYERS TO ENSURE
 CONTINUED ACCESS TO THEIR HEALTH DATA AND  SUPPORT  CONTINUITY  OF  CARE
 BETWEEN PAYERS.
   § 2. This act shall take effect immediately.