120.870 Mandating Health Insurers to Provide a Real-Time Online Tool for Coverage and Payment Policies, Integrated into Electronic Health Records (EHRs)
The Medical Society of the State of New York (MSSNY) shall advocate for legislation or regulations requiring all health insurers in New York State to provide a real-time online tool for physicians and patients to determine coverage and payment policies for medical procedures, treatments, and services at the time of suggested procedures.
The online payment policy tool must include detailed, accurate, and up-to-date information regarding covered services, co-pays, deductibles, and payment policies for specific procedures, and that this tool be binding on the insurers for the purposes of determining payment for claims.
The online payment policy tool must be a uniform interface that works across all insurers and physicians, ensuring consistent and streamlined access to coverage information for physicians and patients. A similar resolution be brought to the AMA to encourage this real-time online tool to be fully integrated into the common Electronic Health Records (EHRs) platforms. (HOD 2025-253)
