Bill Text: NY A10403 | 2021-2022 | General Assembly | Introduced
Bill Title: Requires certain medical records to be made available when requested by utilization review agents.
Spectrum: Partisan Bill (Democrat 1-0)
Status: (Introduced - Dead) 2022-05-13 - referred to health [A10403 Detail]
Download: New_York-2021-A10403-Introduced.html
STATE OF NEW YORK ________________________________________________________________________ 10403 IN ASSEMBLY May 13, 2022 ___________ Introduced by COMMITTEE ON RULES -- (at request of M. of A. Lunsford) -- read once and referred to the Committee on Health AN ACT to amend the public health law, the mental hygiene law and the insurance law, in relation to utilization review agents access to electronic medical records The People of the State of New York, represented in Senate and Assem- bly, do enact as follows: 1 Section 1. Section 2803 of the public health law is amended by adding 2 a new subdivision 14 to read as follows: 3 14. The commissioner shall require every general hospital and every 4 clinic licensed pursuant to this article to adopt a process by which 5 access to electronic medical records are provided to utilization review 6 agents for purposes of article forty-nine of this chapter and article 7 forty-nine of the insurance law. Nothing contained herein shall prohibit 8 a health care plan from entering into an agreement with a health care 9 provider for the transmission of electronic medical records pursuant to 10 this subdivision. 11 § 2. Paragraph (g) of subdivision 1 of section 4902 of the public 12 health law, as added by chapter 705 of the laws of 1996, is amended to 13 read as follows: 14 (g) Establishment of appropriate policies and procedures to ensure 15 that all applicable state and federal laws to protect the confidentiali- 16 ty of individual medical records, including electronic medical records, 17 are followed; 18 § 3. Subdivision 7 of section 4905 of the public health law, as 19 amended by section 6 of subpart C of part AA of chapter 57 of the laws 20 of 2022, is amended to read as follows: 21 7. When making prospective, concurrent and retrospective determi- 22 nations, utilization review agents shall collect only such information 23 as is necessary to make such determination and shall not routinely 24 require health care providers to numerically code diagnoses or proce- 25 dures to be considered for certification or routinely request copies of 26 medical records of all patients reviewed. During prospective or concur- 27 rent review, copies of medical records shall only be required when EXPLANATION--Matter in italics (underscored) is new; matter in brackets [] is old law to be omitted. LBD14809-02-2A. 10403 2 1 necessary to verify that the health care services subject to such review 2 are medically necessary. In such cases, only the necessary or relevant 3 sections of the medical record shall be required. A utilization review 4 agent may request copies of partial or complete medical records retros- 5 pectively. Medical records requested by utilization review agents for 6 purposes of this subdivision shall be made available electronically by 7 health care providers pursuant to subdivision fourteen of section twen- 8 ty-eight hundred three of this chapter and subdivision (f) of section 9 31.04 of the mental hygiene law. 10 § 4. Section 31.04 of the mental hygiene law is amended by adding a 11 new subdivision (f) to read as follows: 12 (f) The commissioner, in consultation with the commissioner of health 13 shall require every clinic licensed pursuant to this article to adopt a 14 process by which access to electronic medical records are provided to 15 utilization review agents for purposes of article forty-nine of the 16 public health law and article forty-nine of the insurance law. Nothing 17 contained herein shall prohibit a health care plan from entering into an 18 agreement with a clinic licensed pursuant to this article for the trans- 19 mission of electronic medical records pursuant to this subdivision. 20 § 5. Paragraph 7 of subsection (a) of section 4902 of the insurance 21 law, as added by chapter 705 of the laws of 1996, is amended to read as 22 follows: 23 (7) Establishment of appropriate policies and procedures to ensure 24 that all applicable state and federal laws to protect the confidentiali- 25 ty of individual medical records, including electronic medical records, 26 are followed; 27 § 6. Subsection (g) of section 4905 of the insurance law, as amended 28 by section 5 of subpart C of part AA of chapter 57 of the laws of 2022, 29 is amended to read as follows: 30 (g) When making prospective, concurrent and retrospective determi- 31 nations, utilization review agents shall collect only such information 32 as is necessary to make such determination and shall not routinely 33 require health care providers to numerically code diagnoses or proce- 34 dures to be considered for certification or routinely request copies of 35 medical records of all patients reviewed. During prospective or concur- 36 rent review, copies of medical records shall only be required when 37 necessary to verify that the health care services subject to such review 38 are medically necessary. In such cases, only the necessary or relevant 39 sections of the medical record shall be required. A utilization review 40 agent may request copies of partial or complete medical records retros- 41 pectively. Medical records requested by utilization review agents for 42 purposes of this subsection shall be made available electronically by 43 health care providers pursuant to subdivision fourteen of section twen- 44 ty-eight hundred three of the public health law and subdivision (f) of 45 section 31.04 of the mental hygiene law. 46 § 7. This act shall take effect immediately.
