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.
STATE OF NEW YORK
________________________________________________________________________
11623
IN ASSEMBLY
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:
1 Section 1. Section 4903 of the public health law is amended by adding
2 a new subdivision 10 to read as follows:
3 10. The commissioner, in conjunction with the superintendent of finan-
4 cial services, shall develop standards for prior authorization requests
5 to be utilized by all health care plans for the purpose of submitting a
6 request for a utilization review determination for coverage of health
7 care services under this chapter. The department and the department of
8 financial services, in development of the standards, shall require an
9 electronic prior authorization program and shall take into consideration
10 existing electronic prior authorization standards.
11 § 2. Section 4903 of the insurance law is amended by adding a new
12 subsection (j) to read as follows:
13 (j) The superintendent, in conjunction with the commissioner of
14 health, shall develop standards for prior authorization requests to be
15 utilized by all health care plans for the purpose of submitting a
16 request for a utilization review determination for coverage of health
17 care services under this chapter. The department and the department of
18 health, in development of the standards, shall require an electronic
19 prior authorization program and shall take into consideration existing
20 electronic prior authorization standards.
21 § 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
