Assembly Bill A8122A

                            
                    S T A T E   O F   N E W   Y O R K
________________________________________________________________________

                                 8122--A

                       2011-2012 Regular Sessions

                          I N  A S S E M B L Y

                              June 2, 2011
                               ___________

Introduced  by M. of A. HEASTIE -- read once and referred to the Commit-
  tee on Insurance -- recommitted  to  the  Committee  on  Insurance  in
  accordance  with Assembly Rule 3, sec. 2 -- committee discharged, bill
  amended, ordered reprinted as amended and recommitted to said  commit-
  tee

AN  ACT to amend the insurance law, in relation to establishing a demon-
  stration program to prevent influenza; and providing for the repeal of
  such provisions upon expiration thereof

  THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
BLY, DO ENACT AS FOLLOWS:

  Section 1. The insurance law is amended by adding a new section 1123-a
to read as follows:
  S 1123-A. HEALTH INSURANCE DEMONSTRATION PROGRAM TO PREVENT INFLUENZA.
(A)  PURPOSE  OF  THE  DEMONSTRATION PROGRAM. THE LEGISLATURE RECOGNIZES
THAT HUNDREDS OF THOUSANDS OF NEW YORK CITIZENS GET THE FLU EVERY  YEAR.
MOST  CALL OUT OF WORK FOR DAYS TO NURSE THE ILLNESS, WHILE MANY OTHERS,
LACKING PROPER IMMUNIZATION, SUCCUMB TO THE FLU  EVERY  YEAR,  INCLUDING
THE  ELDERLY,  CHRONICALLY  ILL AND CHILDREN. THE FLU IS ONE OF THE MOST
PREVENTABLE DISEASES IN BOTH SEVERITY AND OVERALL ILLNESS THROUGH VACCI-
NATION. THE DEMONSTRATION PROGRAM IS  INTENDED  TO  TEST  MECHANISMS  TO
ASSIST  INSURERS  EXPAND  BEYOND  PREDETERMINED  SETTINGS  AND PROVIDERS
CURRENTLY ELIGIBLE AS  PARTICIPATING  PROVIDERS  BY  INSURERS  PROVIDING
INFLUENZA VACCINATION FOR INFLUENZA.
  (B) DEFINITIONS. AS USED IN THIS SECTION:
  (1)  "ELIGIBLE HEALTH CARE PROVIDER" MEANS A PERSON, CLINIC, AGENCY OR
PHARMACY THAT IS LICENSED OR CERTIFIED PURSUANT TO THE PUBLIC HEALTH LAW
OR EDUCATION LAW  AND  WHO  IS  LICENSED  TO  PRESCRIBE  AND  ADMINISTER
VACCINES  IN ACCORDANCE WITH STANDARDS AND REQUIREMENTS SET FORTH IN THE
EDUCATION LAW OR ANY OTHER APPLICABLE LAW OR RULE.
  (2) "ELIGIBLE INSURER" MEANS ANY INSURER  PROVIDING  HEALTH  INSURANCE
COVERAGE  PURSUANT  TO ARTICLE FORTY-THREE OR THIRTY-TWO OF THIS CHAPTER

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD10841-02-2
              

A. 8122--A                          2

AND IS LOCATED IN AN EIGHT, TWELVE OR FIVE COUNTY REGION  OF  THE  WORK-
FORCE  RETRAINING  PROGRAM  AS  DEFINED PURSUANT TO SECTION TWENTY-EIGHT
HUNDRED SEVEN-G OF THE PUBLIC HEALTH LAW.
  (3)  "REGION"  MEANS AN EIGHT, TWELVE OR FIVE COUNTY REGION AS DEFINED
FOR THE WORKFORCE RETRAINING PROGRAM PURSUANT  TO  SECTION  TWENTY-EIGHT
HUNDRED SEVEN-G OF THE PUBLIC HEALTH LAW.
  (C)  DEMONSTRATION PROGRAM TO PREVENT INFLUENZA. (1) BOTH INSURERS AND
HEALTH CARE PROVIDERS SHALL BE SUBJECT TO THE PROVISIONS OF THIS CHAPTER
AND ANY REGULATIONS PROMULGATED THEREUNDER.
  (2) SUBJECT TO PARAGRAPH THREE OF THIS SUBSECTION, THE  SUPERINTENDENT
MAY  ISSUE  AN  APPROVAL  TO  AN ELIGIBLE HEALTH CARE PROVIDER PROVIDING
VACCINATIONS IF:
  (A) THE ELIGIBLE HEALTH CARE PROVIDER DEMONSTRATES THAT  IT  SATISFIES
ALL  FINANCIAL,  OPERATIONAL  AND OTHER REQUIREMENTS OF THIS CHAPTER AND
REGULATIONS PROMULGATED THEREUNDER, OTHER THAN ANY REQUIREMENTS EXPRESS-
LY WAIVED BY THIS SECTION, AND SHALL OPERATE THE  DEMONSTRATION  PROGRAM
IN ACCORDANCE WITH THE REQUIREMENTS OF THIS SECTION;
  (B)  THE  SUPERINTENDENT  DETERMINES  THAT  THE  DEMONSTRATION PROGRAM
FURTHERS THE PUBLIC POLICY GOALS OF THIS SECTION;
  (C) THE HEALTH CARE PROVIDER INTENDS TO ADMINISTER  INFLUENZA  VACCINE
IN THE REGION;
  (D) THE NUMBER OF ELIGIBLE HEALTH CARE PROVIDERS DOES NOT EXCEED FIFTY
IN  THE  REGION  UNLESS  THE ELIGIBLE INSURER IN SUCH REGION CONSENTS TO
SUCH ADDITIONAL ELIGIBLE HEALTH CARE PROVIDERS.
  (3) ANY ELIGIBLE HEALTH CARE  PROVIDER  SEEKING  THE  SUPERINTENDENT'S
APPROVAL  UNDER  PARAGRAPH TWO OF THIS SUBSECTION SHALL SUBMIT A WRITTEN
REQUEST TO THE SUPERINTENDENT WITHIN THIRTY DAYS OF THE  EFFECTIVE  DATE
OF  THIS  SECTION.  THE SUPERINTENDENT SHALL MAKE A DETERMINATION ON ANY
REQUEST WITHIN NINETY DAYS OF RECEIPT OF ALL NECESSARY INFORMATION.
  (4) THE SUPERINTENDENT MAY REVOKE AN APPROVAL ISSUED  UNDER  PARAGRAPH
TWO  OF  THIS SUBSECTION IF: THE HEALTH CARE PROVIDER THAT RECEIVED SUCH
APPROVAL NO LONGER QUALIFIES AS AN ELIGIBLE HEALTH CARE PROVIDER  OR  IS
OTHERWISE OPERATING IN A MANNER INCONSISTENT WITH THE PROVISIONS OF THIS
CHAPTER  OR  REGULATIONS PROMULGATED THEREUNDER. ELIGIBLE INSURERS SHALL
SUBMIT PERIODIC REPORTS TO THE SUPERINTENDENT SUFFICIENT TO  ENABLE  THE
SUPERINTENDENT  TO  EVALUATE  THE  EFFECTIVENESS  OF  THE  DEMONSTRATION
PROGRAM. SUCH  REPORTS  SHALL  IDENTIFY  WHETHER  TRIVALENT  INACTIVATED
VACCINE  OR  LIVE ATTENUATED INFLUENZA VACCINE WAS UTILIZED. IN ADDITION
SUCH REPORT SHALL INCLUDE WHETHER SUCH VACCINE WAS ADMINISTERED  OUTSIDE
A  PHYSICIAN'S OFFICE, BARRIERS TO MAKING THE INFLUENZA VACCINATION MORE
AVAILABLE AND ANY STRATEGIES FOR REMOVING SUCH BARRIERS.
  S 2. This act shall take effect January 1, 2013 and shall expire Janu-
ary 1, 2016 when upon such date the provisions  of  this  act  shall  be
deemed repealed.