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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…
In one paragraph
New York's A 1456 would add Insurance Law § 338 requiring accident and health insurers, Article 43 corporations and Article 44 HMOs to tell insureds on their public websites about their use or lack of use of AI-based algorithms in utilization review, to submit those algorithms and training data to the Department for certification that bias risk is minimized, and to have clinical peer reviewers document review of individual records before an adverse determination. Fines would be up to $5,000 per violation or $10,000 per willful violation. Referred to Insurance January 7, 2026; it has not passed either chamber.
Plain-English summary, written with AI assistance. The official text controls.
What it means for business
None yet: the bill is pending. If enacted, health insurers and HMOs using AI in utilization review would have to disclose it, submit algorithms for bias certification and face fines of up to $5,000 per violation ($10,000 if willful).
Key provisions
- Covered entities must notify insureds and enrollees on a public website about the "use or lack of use" of AI-based algorithms in utilization review
- They must submit the algorithms and training data sets to the Department, which must create a process to certify that bias risk is minimized and evidence-based clinical guidelines are followed
- A clinical peer reviewer at an entity that uses AI-based algorithms must open and document review of individual clinical records before an adverse determination
- Penalties at the Superintendent's discretion: license suspension or revocation, and fines up to $5,000 per violation or $10,000 per willful violation, capped at $500,000 per entity (and $100,000 per reviewer) per year
- Superintendent must make implementing rules; would take effect on the 60th day after becoming law
Latest legislative action
Jan 7, 2026. referred to insurance
Sponsors (showing 5 of 7)
| Name | Role |
|---|---|
| BYRNE | Primary |
| Jeffrion Aubry | Primary |
| Pamela J. Hunter D | Primary |
| SANTABARBARA | Primary |
| ZEBROWSKI O | Primary |
Topics and industries
Related topics
Affected industries
This page is general information, not legal advice. Summaries are AI-assisted and may contain errors; read the statute for the controlling text and talk to a lawyer about your situation. Full disclaimer · Report an error