S T A T E O F N E W Y O R K
________________________________________________________________________
1709
2013-2014 Regular Sessions
I N S E N A T E
(PREFILED)
January 9, 2013
___________
Introduced by Sen. GRISANTI -- read twice and ordered printed, and when
printed to be committed to the Committee on Insurance
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-b
to read as follows:
S 1123-B. 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
AND IS LOCATED IN AN EIGHT, TWELVE OR FIVE COUNTY REGION OF THE WORK-
EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD04290-01-3
S. 1709 2
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, 2015 and shall expire Janu-
ary 1, 2018 when upon such date the provisions of this act shall be
deemed repealed.