New York A 1456: Relates to the use of artificial intelligence for utilization review

Bill Text

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A01456 Summary:

BILL NOA01456 

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SAME ASNo Same As

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SPONSORHunter

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COSPNSR

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MLTSPNSR

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Add §338, Ins L

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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.

Go to top A01456 Actions:

BILL NOA01456 

&nbsp

01/09/2025referred to insurance

01/07/2026referred to insurance

Go to topA01456 Committee&nbspVotes:

Go to topA01456 Floor&nbspVotes:

There are no Assembly votes for this bill in this legislative session.

Go to topA01456 Text:

 STATE OF NEW YORK
 ________________________________________________________________________

 1456

 2025-2026 Regular Sessions

 IN ASSEMBLY

 January 9, 2025
 ___________

 Introduced by M. of A. HUNTER -- read once and referred to the Committee
 on Insurance

 AN ACT to amend the insurance law, in relation to the use of artificial
 intelligence for utilization review

 The People of the State of New York, represented in Senate and Assem-
 bly, do enact as follows:

 1 Section 1. The insurance law is amended by adding a new section 338 to
 2 read as follows:
 3 § 338. Notification regarding the use of artificial intelligence for
 4 utilization review. (a) As used in this section, the following terms
 5 shall have the following meanings:
 6 (1) "Adverse determination" shall have the same meaning as such term
 7 is defined in section four thousand nine hundred of the public health
 8 law.
 9 (2) "Artificial intelligence-based algorithm" means any artificial
 10 system that performs tasks under varying and unpredictable circumstances
 11 without significant human oversight or that can learn from experience
 12 and improve performance when exposed to data sets.
 13 (3) "Clinical peer reviewer" shall have the same meaning as such term
 14 is defined in section four thousand nine hundred of the public health
 15 law.
 16 (4) "Utilization review" shall have the same meaning as such term is
 17 defined in section forty-nine hundred of the public health law.
 18 (b) The superintendent shall require all insurers authorized to write
 19 accident and health insurance in this state, corporations organized
 20 pursuant to article forty-three of this chapter, and a health mainte-
 21 nance organization certified pursuant to article forty-four of the
 22 public health law to notify insureds and enrollees about the use or lack
 23 of use of artificial intelligence-based algorithms in the utilization
 24 review process on the accessible Internet website of such insurer
 25 authorized to write accident and health insurance in this state, corpo-

 EXPLANATION--Matter in italics (underscored) is new; matter in brackets
 [ ] is old law to be omitted.
 LBD01878-01-5

 A. 1456 2

 1 ration organized pursuant to article forty-three of this chapter, or
 2 health maintenance organization certified pursuant to article forty-four
 3 of the public health law.
 4 (c) Every insurer authorized to write accident and health insurance in
 5 this state, corporation organized pursuant to article forty-three of
 6 this chapter, and health maintenance organization certified pursuant to
 7 article forty-four of the public health law shall submit the artificial
 8 intelligence-based algorithms and training data sets that are being used
 9 or will be used in the utilization review process to the department. The
 10 department shall implement a process that allows the department to
 11 certify that these artificial intelligence-based algorithms and training
 12 data sets have minimized the risk of bias based on the covered person's
 13 race, color, religious creed, ancestry, age, sex, gender, national
 14 origin, handicap or disability and adhere to evidence-based clinical
 15 guidelines.
 16 (d) A clinical peer reviewer who participates in a utilization review
 17 process for an insurer authorized to write accident and health insurance
 18 in this state, a corporation organized pursuant to article forty-three
 19 of this chapter, and a health maintenance organization certified pursu-
 20 ant to article forty-four of th