N.Y. Insurance Law § 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.