§ 320. Records to be made available by organizations subject to the\nprovisions of this chapter.
(a)Every insurer shall, upon request of the\nstate department of social services or of a local social services\ndistrict for any records, or any information contained in such records,\npertaining to the coverage of any individual for such individual's\nmedical costs under any individual or group policy or other obligation\nmade by such organizations, or the medical benefits paid by or claims\nmade to such organizations pursuant to such policy or other obligation\nin accordance with the limitations of subsection (c) hereof, make the\nrequested records or information available upon a certification by the\ndepartment of social services or the social services district that such\nindividual is an
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§ 320. Records to be made available by organizations subject to the\nprovisions of this chapter. (a) Every insurer shall, upon request of the\nstate department of social services or of a local social services\ndistrict for any records, or any information contained in such records,\npertaining to the coverage of any individual for such individual's\nmedical costs under any individual or group policy or other obligation\nmade by such organizations, or the medical benefits paid by or claims\nmade to such organizations pursuant to such policy or other obligation\nin accordance with the limitations of subsection (c) hereof, make the\nrequested records or information available upon a certification by the\ndepartment of social services or the social services district that such\nindividual is an applicant for or recipient of medical assistance, or is\na person who is legally responsible for such an applicant or recipient,\npursuant to the social services law.\n (b) The superintendent and the commissioner of the state department of\nsocial services shall enter into a cooperative agreement setting forth\nmutually agreeable procedures for requesting and furnishing appropriate\ninformation, not inconsistent with any law pertaining to the\nconfidentiality and privacy of records, which procedures shall include\nfinancial arrangements as may be necessary to reimburse insurers for\nnecessary costs incurred in furnishing requested information, and the\ntime and manner such procedures are to become effective. Such procedures\nmay be added to a new cooperative agreement which shall supersede the\nagreement currently in existence between the superintendent and the\ncommissioner of social services.\n (c) The department of social services or a local social services\ndistrict shall request only that information necessary to determine\nwhether any insurance benefits have been or should have been claimed and\npaid with respect to items of medical care and services received by a\nparticular individual for which medical assistance coverage would\notherwise be available.\n (d) Not later than the date upon which the procedures agreed to\npursuant to subsection (b) hereof become effective, the superintendent\nshall establish guidelines to assure that information relating to an\nindividual certified to be an applicant for or recipient of medical\nassistance, furnished to any insurer, is used only for the purpose of\nidentifying the records or information requested in such manner so as\nnot to violate the confidentiality provisions of the social services\nlaw.\n (e) (1) Every insurer shall, upon request of an authorized\nrepresentative of the state office of temporary and disability\nassistance, or a social services district child support enforcement unit\nestablished pursuant to section one hundred eleven-c of the social\nservices law, enter into an agreement with the state office of temporary\nand disability assistance or a social services district to develop and\noperate a data match system, using automated data exchanges to the\nmaximum extent feasible, in which each such insurer, pension fund,\nretirement system or other organization shall provide for each calendar\nquarter the name, record address, social security number or other\ntaxpayer identification number, and other identifying information for\neach individual who maintains a demand deposit account, checking or\nnegotiable withdrawal order account, savings account, time deposit\naccount, or money-market mutual fund account at such institution and who\nowes past-due support, as identified by the state office of temporary\nand disability assistance or a social services district child support\nenforcement unit by name and social security number or other taxpayer\nidentification number. Nothing herein shall be deemed to limit the\nauthority of a local social services district support collection unit\npursuant to section one hundred eleven-h of the social services law.\n (2) No insurer which discloses information pursuant to paragraph one\nof this subsection, or discloses any financial record to the state\noffice of temporary and disability assistance or a social services\ndistrict child support enforcement unit for the purpose of enforcing a\nchild support obligation of such person, shall be liable under any law\nto any person for such disclosure, or for any other action taken in good\nfaith to comply with paragraph one of this subsection.\n (f) "Insurer", as used in this section, means:\n (1) (i) an insurer required to be licensed to do an insurance business\nin this state under this chapter, including a corporation subject to\narticle forty-three or forty-seven of this chapter;\n (ii) a pension fund, retirement system or other organization required\nby law to make reports to, or which is subject to examination by, the\nsuperintendent;\n (iii) a health maintenance organization subject to article forty-four\nof the public health law; or\n (iv) a self-funded plan or any other insurer with respect to any\nmedical claim or benefit of a resident of this State; and\n (2) any person or other entity acting on behalf of an insurer as\ndescribed in paragraph one of this subsection with respect to any\nmedical claim or benefit of a resident of this State.\n