S T A T E O F N E W Y O R K
________________________________________________________________________
7794
2013-2014 Regular Sessions
I N A S S E M B L Y
June 4, 2013
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Introduced by M. of A. GLICK, McDONALD, JAFFEE, PEOPLES-STOKES, ROSA,
BRONSON, COLTON, COOK, DINOWITZ, GABRYSZAK, GALEF, GUNTHER, HOOPER,
JACOBS, MAGNARELLI, MAISEL, MOSLEY, RAIA, SCARBOROUGH, SKOUFIS, TITUS,
GOTTFRIED -- Multi-Sponsored by -- M. of A. ABBATE, ARROYO, BARRON,
BRENNAN, DUPREY, GIBSON, McLAUGHLIN, MOYA, ROBINSON, SEPULVEDA, SOLAG-
ES, SWEENEY, TITONE, WEISENBERG -- read once and referred to the
Committee on Insurance
AN ACT to amend the insurance law, in relation to requiring insurance
coverage for immunizations administered by a pharmacist
THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
BLY, DO ENACT AS FOLLOWS:
Section 1. Subsection (i) of section 3216 of the insurance law is
amended by adding a new paragraph 17-a to read as follows:
(17-A) EVERY POLICY DELIVERED OR ISSUED FOR DELIVERY IN THIS STATE
THAT PROVIDES MEDICAL, MAJOR MEDICAL, OR SIMILAR COMPREHENSIVE-TYPE
COVERAGE AND PROVIDES COVERAGE FOR IMMUNIZING AGENTS SHALL PROVIDE
COVERAGE FOR IMMUNIZATIONS AND THEIR ADMINISTRATION WHEN SUCH IMMUNIZA-
TIONS ARE ADMINISTERED BY A PHARMACIST AUTHORIZED TO ADMINISTER SUCH
IMMUNIZATIONS UNDER SECTION SIXTY-EIGHT HUNDRED ONE OF THE EDUCATION
LAW. NOTHING IN THIS PARAGRAPH SHALL BE CONSTRUED TO PREVENT A POLICY
FROM REQUIRING SERVICES THROUGH AN IN-NETWORK PROVIDER. NOTHING IN THIS
PARAGRAPH SHALL BE CONSTRUED TO AUTHORIZE A POLICY TO REQUIRE THE
INSURED TO RECEIVE IMMUNIZATIONS BY A PHARMACIST. SUCH COVERAGE MAY BE
SUBJECT TO COPAYMENTS, COINSURANCE OR DEDUCTIBLES, PROVIDED THAT THE
COPAYMENTS, COINSURANCE OR DEDUCTIBLES ARE AT LEAST AS FAVORABLE TO AN
INSURED AS THE COPAYMENTS, COINSURANCE OR DEDUCTIBLES THAT APPLY TO
COVERAGE FOR IMMUNIZATIONS AND THEIR ADMINISTRATION WHEN SUCH IMMUNIZA-
TIONS ARE ADMINISTERED IN A PHYSICIAN'S OFFICE.
S 2. Subsection (l) of section 3221 of the insurance law is amended by
adding a new paragraph 8-a to read as follows:
EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD11165-02-3
A. 7794 2
(8-A) EVERY GROUP OR BLANKET POLICY DELIVERED OR ISSUED FOR DELIVERY
IN THIS STATE THAT PROVIDES MEDICAL, MAJOR MEDICAL, OR SIMILAR COMPRE-
HENSIVE-TYPE COVERAGE AND PROVIDES COVERAGE FOR IMMUNIZING AGENTS SHALL
PROVIDE COVERAGE FOR IMMUNIZATIONS AND THEIR ADMINISTRATION WHEN SUCH
IMMUNIZATIONS ARE ADMINISTERED BY A PHARMACIST AUTHORIZED TO ADMINISTER
SUCH IMMUNIZATIONS UNDER SECTION SIXTY-EIGHT HUNDRED ONE OF THE EDUCA-
TION LAW. NOTHING IN THIS PARAGRAPH SHALL BE CONSTRUED TO PREVENT A
POLICY FROM REQUIRING SERVICES THROUGH AN IN-NETWORK PROVIDER. NOTHING
IN THIS PARAGRAPH SHALL BE CONSTRUED TO AUTHORIZE A POLICY TO REQUIRE
THE INSURED TO RECEIVE IMMUNIZATIONS BY A PHARMACIST. SUCH COVERAGE MAY
BE SUBJECT TO COPAYMENTS, COINSURANCE OR DEDUCTIBLES, PROVIDED THAT THE
COPAYMENTS, COINSURANCE OR DEDUCTIBLES ARE AT LEAST AS FAVORABLE TO AN
INSURED AS THE COPAYMENTS, COINSURANCE OR DEDUCTIBLES THAT APPLY TO
COVERAGE FOR IMMUNIZATIONS AND THEIR ADMINISTRATION WHEN SUCH IMMUNIZA-
TIONS ARE ADMINISTERED IN A PHYSICIAN'S OFFICE.
S 3. Section 4303 of the insurance law is amended by adding a new
subsection (k-1) to read as follows:
(K-1) EVERY POLICY ISSUED BY A MEDICAL EXPENSE INDEMNITY CORPORATION,
A HOSPITAL SERVICE CORPORATION OR A HEALTH SERVICE CORPORATION FOR
DELIVERY IN THIS STATE THAT PROVIDES MEDICAL, MAJOR MEDICAL, OR SIMILAR
COMPREHENSIVE-TYPE COVERAGE FOR IMMUNIZING AGENTS SHALL PROVIDE COVERAGE
FOR IMMUNIZATIONS AND THEIR ADMINISTRATION WHEN SUCH IMMUNIZATIONS ARE
ADMINISTERED BY A PHARMACIST AUTHORIZED TO ADMINISTER SUCH IMMUNIZATIONS
UNDER SECTION SIXTY-EIGHT HUNDRED ONE OF THE EDUCATION LAW. NOTHING IN
THIS SUBSECTION SHALL BE CONSTRUED TO PREVENT A POLICY FROM REQUIRING
SERVICES THROUGH AN IN-NETWORK PROVIDER. NOTHING IN THIS SUBSECTION
SHALL BE CONSTRUED TO AUTHORIZE A POLICY TO REQUIRE THE INSURED TO
RECEIVE IMMUNIZATIONS BY A PHARMACIST. SUCH COVERAGE MAY BE SUBJECT TO
COPAYMENTS, COINSURANCE OR DEDUCTIBLES, PROVIDED THAT THE COPAYMENTS,
COINSURANCE OR DEDUCTIBLES ARE AT LEAST AS FAVORABLE TO AN INSURED AS
THE COPAYMENTS, COINSURANCE OR DEDUCTIBLES THAT APPLY TO COVERAGE FOR
IMMUNIZATIONS AND THEIR ADMINISTRATION WHEN SUCH IMMUNIZATIONS ARE
ADMINISTERED IN A PHYSICIAN'S OFFICE.
S 4. This act shall take effect on the sixtieth day after it shall
have become a law.