S T A T E O F N E W Y O R K
________________________________________________________________________
5126
2023-2024 Regular Sessions
I N A S S E M B L Y
March 2, 2023
___________
Introduced by M. of A. DINOWITZ -- read once and referred to the Commit-
tee on Insurance
AN ACT to amend the insurance law, in relation to insurance reimburse-
ment for vaccination
THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
BLY, DO ENACT AS FOLLOWS:
Section 1. Clause (iii) of subparagraph (B) of paragraph 17 of
subsection (i) of section 3216 of the insurance law, as amended by chap-
ter 219 of the laws of 2011, is amended to read as follows:
(iii) necessary immunizations, as determined by the superintendent in
consultation with the commissioner of health, consisting of at least
adequate dosages of vaccine against diphtheria, pertussis, tetanus,
polio, measles, rubella, mumps, haemophilus influenzae type b and hepa-
titis b, which meet the standards approved by the United States public
health service for such biological products, INCLUDING REIMBURSEMENT TO
THE HEALTH CARE PROVIDER FOR THE ACQUISITION COSTS OF THE VACCINE,
ACCORDING TO THE CURRENT OR MOST RECENTLY REPORTED UNITED STATES CENTERS
FOR DISEASE CONTROL AND PREVENTION PRIVATE SECTOR COST PLUS A MINIMUM OF
TWENTY-ONE PERCENT FOR SHIPPING, HANDLING AND STORAGE COSTS, AND THE
TOTAL COST OF ADMINISTRATION OF THE VACCINE, INCLUDING THE COST OF
SUPPLIES, DATA ENTRY, VACCINE COUNSELING, INVENTORY MANAGEMENT AND
ROUTINE NURSING ACTIVITIES BASED ON THE CURRENT YEAR'S MEDICARE RATES AS
PUBLISHED BY THE UNITED STATES CENTERS FOR MEDICARE AND MEDICAID
SERVICES.
§ 2. Clause (ii) of subparagraph (E) of paragraph 17 of subsection (i)
of section 3216 of the insurance law, as amended by chapter 219 of the
laws of 2011, is amended to read as follows:
(ii) immunizations that have in effect a recommendation from the advi-
sory committee on immunization practices of the centers for disease
control and prevention with respect to the individual involved, INCLUD-
ING REIMBURSEMENT TO THE HEALTH CARE PROVIDER FOR THE ACQUISITION COSTS
EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD07666-01-3
A. 5126 2
OF THE VACCINE, ACCORDING TO THE CURRENT OR MOST RECENTLY REPORTED
UNITED STATES CENTERS FOR DISEASE CONTROL AND PREVENTION PRIVATE SECTOR
COST PLUS A MINIMUM OF TWENTY-ONE PERCENT FOR SHIPPING, HANDLING AND
STORAGE COSTS, AND THE TOTAL COST OF ADMINISTRATION OF THE VACCINE,
INCLUDING THE COST OF SUPPLIES, DATA ENTRY, VACCINE COUNSELING, INVENTO-
RY MANAGEMENT AND ROUTINE NURSING ACTIVITIES BASED ON THE CURRENT YEAR'S
MEDICARE RATES AS PUBLISHED BY THE UNITED STATES CENTERS FOR MEDICARE
AND MEDICAID SERVICES;
§ 3. Clause (iii) of subparagraph (B) of paragraph 8 of subsection (l)
of section 3221 of the insurance law, as amended by chapter 219 of the
laws of 2011, is amended to read as follows:
(iii) necessary immunizations, as determined by the superintendent in
consultation with the commissioner of health, consisting of at least
adequate dosages of vaccine against diphtheria, pertussis, tetanus,
polio, measles, rubella, mumps, haemophilus influenzae type b and hepa-
titis b, which meet the standards approved by the United States public
health service for such biological products, INCLUDING REIMBURSEMENT TO
THE HEALTH CARE PROVIDER FOR THE ACQUISITION COSTS OF THE VACCINE,
ACCORDING TO THE CURRENT OR MOST RECENTLY REPORTED UNITED STATES CENTERS
FOR DISEASE CONTROL AND PREVENTION PRIVATE SECTOR COST PLUS A MINIMUM OF
TWENTY-ONE PERCENT FOR SHIPPING, HANDLING AND STORAGE COSTS, AND THE
TOTAL COST OF ADMINISTRATION OF THE VACCINE, INCLUDING THE COST OF
SUPPLIES, DATA ENTRY, VACCINE COUNSELING, INVENTORY MANAGEMENT AND
ROUTINE NURSING ACTIVITIES BASED ON THE CURRENT YEAR'S MEDICARE RATES AS
PUBLISHED BY THE UNITED STATES CENTERS FOR MEDICARE AND MEDICAID
SERVICES.
§ 4. Clause (ii) of subparagraph (E) of paragraph 8 of subdivision (l)
of section 3221 of the insurance law, as amended by chapter 219 of the
laws of 2011, is amended to read as follows:
(ii) immunizations that have in effect a recommendation from the advi-
sory committee on immunization practices of the centers for disease
control and prevention with respect to the individual involved, INCLUD-
ING REIMBURSEMENT TO THE HEALTH CARE PROVIDER FOR THE ACQUISITION COSTS
OF THE VACCINE, ACCORDING TO THE CURRENT OR MOST RECENTLY REPORTED
UNITED STATES CENTERS FOR DISEASE CONTROL AND PREVENTION PRIVATE SECTOR
COST PLUS A MINIMUM OF TWENTY-ONE PERCENT FOR SHIPPING, HANDLING AND
STORAGE COSTS, AND THE TOTAL COST OF ADMINISTRATION OF THE VACCINE,
INCLUDING THE COST OF SUPPLIES, DATA ENTRY, VACCINE COUNSELING, INVENTO-
RY MANAGEMENT AND ROUTINE NURSING ACTIVITIES BASED ON THE CURRENT YEAR'S
MEDICARE RATES AS PUBLISHED BY THE UNITED STATES CENTERS FOR MEDICARE
AND MEDICAID SERVICES;
§ 5. Subparagraph (C) of paragraph 2 of subsection (j) of section 4303
of the insurance law, as amended by chapter 219 of the laws of 2011, is
amended to read as follows:
(C) necessary immunizations, as determined by the superintendent in
consultation with the commissioner of health, consisting of at least
adequate dosages of vaccine against diphtheria, pertussis, tetanus,
polio, measles, rubella, mumps, haemophilus influenzae type b and hepa-
titis b, which meet the standards approved by the United States public
health service for such biological products, INCLUDING REIMBURSEMENT TO
THE HEALTH CARE PROVIDER FOR THE ACQUISITION COSTS OF THE VACCINE,
ACCORDING TO THE CURRENT OR MOST RECENTLY REPORTED UNITED STATES CENTERS
FOR DISEASE CONTROL AND PREVENTION PRIVATE SECTOR COST PLUS A MINIMUM OF
TWENTY-ONE PERCENT FOR SHIPPING, HANDLING AND STORAGE COSTS, AND THE
TOTAL COST OF ADMINISTRATION OF THE VACCINE, INCLUDING THE COST OF
SUPPLIES, DATA ENTRY, VACCINE COUNSELING, INVENTORY MANAGEMENT AND
A. 5126 3
ROUTINE NURSING ACTIVITIES BASED ON THE CURRENT YEAR'S MEDICARE RATES AS
PUBLISHED BY THE UNITED STATES CENTERS FOR MEDICARE AND MEDICAID
SERVICES.
§ 6. Subparagraph (B) of paragraph 3 of subsection (j) of section 4303
of the insurance law, as added by chapter 219 of the laws of 2011, is
amended to read as follows:
(B) immunizations that have in effect a recommendation from the advi-
sory committee on immunization practices of the centers for disease
control and prevention with respect to the individual involved, INCLUD-
ING REIMBURSEMENT TO THE HEALTH CARE PROVIDER FOR THE ACQUISITION COSTS
OF THE VACCINE, ACCORDING TO THE CURRENT OR MOST RECENTLY REPORTED
UNITED STATES CENTERS FOR DISEASE CONTROL AND PREVENTION PRIVATE SECTOR
COST PLUS A MINIMUM OF TWENTY-ONE PERCENT FOR SHIPPING, HANDLING AND
STORAGE COSTS, AND THE TOTAL COST OF ADMINISTRATION OF THE VACCINE,
INCLUDING THE COST OF SUPPLIES, DATA ENTRY, VACCINE COUNSELING, INVENTO-
RY MANAGEMENT AND ROUTINE NURSING ACTIVITIES BASED ON THE CURRENT YEAR'S
MEDICARE RATES AS PUBLISHED BY THE UNITED STATES CENTERS FOR MEDICARE
AND MEDICAID SERVICES;
§ 7. This act shall take effect on the first of January after it shall
have become a law and shall apply to any contract entered into, deliv-
ered, amended or modified on or after the date it takes effect.