2023 New York Laws › ISC - Insurance › Article 3 - Administrative and Procedural Provisions › 320 - Records to Be Made Available by Organizations Subject to the Provisions of This Chapter.

§  320.  Records  to be made available by organizations subject to the
provisions of this chapter. (a) Every insurer shall, upon request of the
state department of social  services  or  of  a  local  social  services
district  for any records, or any information contained in such records,
pertaining to the coverage  of  any  individual  for  such  individual's
medical  costs  under any individual or group policy or other obligation
made by such organizations, or the medical benefits paid  by  or  claims
made  to  such organizations pursuant to such policy or other obligation
in accordance with the limitations of subsection (c)  hereof,  make  the
requested  records  or information available upon a certification by the
department of social services or the social services district that  such
individual is an applicant for or recipient of medical assistance, or is
a  person who is legally responsible for such an applicant or recipient,
pursuant to the social services law.
(b) The superintendent and the commissioner of the state department of
social services shall enter into a cooperative agreement  setting  forth
mutually  agreeable procedures for requesting and furnishing appropriate
information,  not  inconsistent  with  any   law   pertaining   to   the
confidentiality  and  privacy of records, which procedures shall include
financial arrangements as may be necessary  to  reimburse  insurers  for
necessary  costs  incurred  in furnishing requested information, and the
time and manner such procedures are to become effective. Such procedures
may be added to a new cooperative agreement which  shall  supersede  the
agreement  currently  in  existence  between  the superintendent and the
commissioner of social services.
(c) The department of social  services  or  a  local  social  services
district  shall  request  only  that  information necessary to determine
whether any insurance benefits have been or should have been claimed and
paid with respect to items of medical care and services  received  by  a
particular  individual  for  which  medical  assistance  coverage  would
otherwise be available.
(d) Not later than the  date  upon  which  the  procedures  agreed  to
pursuant  to  subsection (b) hereof become effective, the superintendent
shall establish guidelines to assure that  information  relating  to  an
individual  certified  to  be  an  applicant for or recipient of medical
assistance, furnished to any insurer, is used only for  the  purpose  of
identifying  the  records  or information requested in such manner so as
not to violate the confidentiality provisions  of  the  social  services
law.
(e)   (1)   Every   insurer  shall,  upon  request  of  an  authorized
representative  of  the  state  office  of  temporary   and   disability
assistance, or a social services district child support enforcement unit
established  pursuant  to  section  one  hundred  eleven-c of the social
services law, enter into an agreement with the state office of temporary
and disability assistance or a social services district to  develop  and
operate  a  data  match  system,  using  automated data exchanges to the
maximum extent feasible, in  which  each  such  insurer,  pension  fund,
retirement  system or other organization shall provide for each calendar
quarter the name,  record  address,  social  security  number  or  other
taxpayer  identification  number,  and other identifying information for
each individual who maintains a  demand  deposit  account,  checking  or
negotiable  withdrawal  order  account,  savings  account,  time deposit
account, or money-market mutual fund account at such institution and who
owes past-due support, as identified by the state  office  of  temporary
and  disability  assistance  or a social services district child support
enforcement unit by name and social security number  or  other  taxpayer
identification  number.  Nothing  herein  shall  be  deemed to limit the

authority of a local social services district  support  collection  unit
pursuant to section one hundred eleven-h of the social services law.
(2)  No  insurer which discloses information pursuant to paragraph one
of this subsection, or discloses  any  financial  record  to  the  state
office  of  temporary  and  disability  assistance  or a social services
district child support enforcement unit for the purpose of  enforcing  a
child  support  obligation of such person, shall be liable under any law
to any person for such disclosure, or for any other action taken in good
faith to comply with paragraph one of this subsection.
(f) "Insurer", as used in this section, means:
(1) (i) an insurer required to be licensed to do an insurance business
in this state under this chapter, including  a  corporation  subject  to
article forty-three or forty-seven of this chapter;
(ii)  a pension fund, retirement system or other organization required
by law to make reports to, or which is subject to  examination  by,  the
superintendent;
(iii)  a health maintenance organization subject to article forty-four
of the public health law; or
(iv) a self-funded plan or any  other  insurer  with  respect  to  any
medical claim or benefit of a resident of this State; and
(2)  any  person  or  other  entity  acting on behalf of an insurer as
described in paragraph one  of  this  subsection  with  respect  to  any
medical claim or benefit of a resident of this State.