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Private Insurance Data Requirements in New York

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New York requires organizations that provide covered health services to children to report enrollee demographic and health information to the Commissioner.1

Health maintenance organizations must report the termination of a health care provider to an appropriate disciplinary agency2 and must supply subscribers with information contained in the member handbook. Enrollees and prospective enrollees may also obtain, upon request, certain information about an HMO’s management structure, finances, and policies.3

 

Footnotes

  • 1. NY PUB HEALTH § 2511
  • 2. NY PUB HEALTH § 4405-b
  • 3. NY PUB HEALTH § 4408

 

Private Insurance Data Requirements in New York

Subtopic Statute/Regulation Description
Health plan required reporting Child Health Insurance Plan – N.Y. Pub. Health Law § 2511 Organizations approved by the Commissioner to provide covered health services to children must submit reports and information to the Commissioner...
Reporting of Physician Disciplinary Actions by Health Maintenance Organizations – N.Y. Pub. Health Law § 4405-b A health maintenance organization must make a report to the appropriate professional disciplinary agency within 30 days of the occurrence of any of...
Required and Prohibited Practices for Utilization Review Agents – N.Y. Ins. Law § 4905 Every utilization review agent must have procedures to assure that patient-specific information obtained during the utilization review process is...
Privacy notices required to be given to consumers (Cross reference to Privacy & Confidentiality) Requirements for Disclosure of Information by a Health Maintenance Organization – N.Y. Pub. Health Law § 4408 Upon request, each prospective subscriber to a health maintenance organization must be supplied with all written information that may be incorporated...
Click on the individual state law in the table above to see our summary of the individual law.


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by Dr. Radut.