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A09149

Provides for notice requirements where an insurer authorized to write accident and health insurance in this state, a corporation organized pursuant t… Verified

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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.

AI Summary

Requires insurers using AI in utilization reviews to notify insureds and submit algorithms for bias review.

Business Impact

If you use AI for utilization reviews in NY, you must notify insureds and submit algorithms or face fines up to $10,000/violation.

State
New York
Bill Number
A09149
Status
Introduced
Risk Level
High
Category
Sector-Specific
Effective Date
Apr 8, 2024
Last Action
Feb 8, 2024
Last Verified
Apr 21, 2026
Data Updated
Apr 21, 2026
What do these statuses mean?
Introduced — Filed in the legislature; not yet heard in committee
In Committee — Assigned to and being reviewed by a legislative committee
Passed — Approved by one or both chambers; awaiting further action
Signed / Enacted — Signed into law by the governor; may or may not be in effect yet
Dead / Vetoed — Vetoed, failed to pass, or session expired without action
Unknown — Status data not yet available or awaiting classification

Affected Industries

Insurance Healthcare

Topics

What This Means

This bill mandates that insurers in New York using AI algorithms for utilization reviews must notify insureds and submit their AI systems for bias evaluation. It aims to ensure transparency and reduce bias in AI-driven decisions affecting health insurance claims. Non-compliance can lead to significant fines or license suspension, making it crucial for insurers to align with these new requirements.

Key Provisions

Latest Legislative Action

referred to insurance

Bill Sponsors

Name Role District
Sponsor HD-128

Compliance Checklist

Notify insureds about AI use in utilization reviews
Who: Insurers, corporations, and health maintenance organizations
Deadline: Before using AI in reviews
Penalty: Fines up to $10,000 per violation
Submit AI algorithms and training data for certification
Who: Insurers, corporations, and health maintenance organizations
Deadline: Before using AI in reviews
Penalty: Fines up to $10,000 per violation

Related & Companion Bills

New York A01456 — Provides for notice requirements where an insurer authorize…

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