STATE OF NEW YORK
________________________________________________________________________
3839
2025-2026 Regular Sessions
IN ASSEMBLY
January 30, 2025
___________
Introduced by M. of A. DINOWITZ, GLICK, HEVESI, KELLES, DeSTEFANO, RAGA
-- Multi-Sponsored by -- M. of A. SIMON -- read once and referred to
the Committee 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:
1 Section 1. Clause (iii) of subparagraph (B) of paragraph 17 of
2 subsection (i) of section 3216 of the insurance law, as amended by chap-
3 ter 219 of the laws of 2011, is amended to read as follows:
4 (iii) necessary immunizations, as determined by the superintendent in
5 consultation with the commissioner of health, consisting of at least
6 adequate dosages of vaccine against diphtheria, pertussis, tetanus,
7 polio, measles, rubella, mumps, haemophilus influenzae type b and hepa-
8 titis b, which meet the standards approved by the United States public
9 health service for such biological products, including reimbursement to
10 the health care provider for the acquisition costs of the vaccine,
11 according to the current or most recently reported United States centers
12 for disease control and prevention private sector cost plus a minimum of
13 twenty-one percent for shipping, handling and storage costs, and the
14 total cost of administration of the vaccine, including the cost of
15 supplies, data entry, vaccine counseling, inventory management and
16 routine nursing activities based on the current year's medicare rates as
17 published by the United States centers for medicare and medicaid
18 services.
19 § 2. Clause (ii) of subparagraph (E) of paragraph 17 of subsection (i)
20 of section 3216 of the insurance law, as amended by chapter 219 of the
21 laws of 2011, is amended to read as follows:
22 (ii) immunizations that have in effect a recommendation from the advi-
23 sory committee on immunization practices of the centers for disease
24 control and prevention with respect to the individual involved, includ-
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[] is old law to be omitted.
LBD07727-01-5
A. 3839 2
1 ing reimbursement to the health care provider for the acquisition costs
2 of the vaccine, according to the current or most recently reported
3 United States centers for disease control and prevention private sector
4 cost plus a minimum of twenty-one percent for shipping, handling and
5 storage costs, and the total cost of administration of the vaccine,
6 including the cost of supplies, data entry, vaccine counseling, invento-
7 ry management and routine nursing activities based on the current year's
8 medicare rates as published by the United States centers for medicare
9 and medicaid services;
10 § 3. Clause (iii) of subparagraph (B) of paragraph 8 of subsection (l)
11 of section 3221 of the insurance law, as amended by chapter 219 of the
12 laws of 2011, is amended to read as follows:
13 (iii) necessary immunizations, as determined by the superintendent in
14 consultation with the commissioner of health, consisting of at least
15 adequate dosages of vaccine against diphtheria, pertussis, tetanus,
16 polio, measles, rubella, mumps, haemophilus influenzae type b and hepa-
17 titis b, which meet the standards approved by the United States public
18 health service for such biological products, including reimbursement to
19 the health care provider for the acquisition costs of the vaccine,
20 according to the current or most recently reported United States centers
21 for disease control and prevention private sector cost plus a minimum of
22 twenty-one percent for shipping, handling and storage costs, and the
23 total cost of administration of the vaccine, including the cost of
24 supplies, data entry, vaccine counseling, inventory management and
25 routine nursing activities based on the current year's medicare rates as
26 published by the United States centers for medicare and medicaid
27 services.
28 § 4. Clause (ii) of subparagraph (E) of paragraph 8 of subsection (l)
29 of section 3221 of the insurance law, as amended by chapter 219 of the
30 laws of 2011, is amended to read as follows:
31 (ii) immunizations that have in effect a recommendation from the advi-
32 sory committee on immunization practices of the centers for disease
33 control and prevention with respect to the individual involved, includ-
34 ing reimbursement to the health care provider for the acquisition costs
35 of the vaccine, according to the current or most recently reported
36 United States centers for disease control and prevention private sector
37 cost plus a minimum of twenty-one percent for shipping, handling and
38 storage costs, and the total cost of administration of the vaccine,
39 including the cost of supplies, data entry, vaccine counseling, invento-
40 ry management and routine nursing activities based on the current year's
41 medicare rates as published by the United States centers for medicare
42 and medicaid services;
43 § 5. Subparagraph (C) of paragraph 2 of subsection (j) of section 4303
44 of the insurance law, as amended by chapter 219 of the laws of 2011, is
45 amended to read as follows:
46 (C) necessary immunizations, as determined by the superintendent in
47 consultation with the commissioner of health, consisting of at least
48 adequate dosages of vaccine against diphtheria, pertussis, tetanus,
49 polio, measles, rubella, mumps, haemophilus influenzae type b and hepa-
50 titis b, which meet the standards approved by the United States public
51 health service for such biological products, including reimbursement to
52 the health care provider for the acquisition costs of the vaccine,
53 according to the current or most recently reported United States centers
54 for disease control and prevention private sector cost plus a minimum of
55 twenty-one percent for shipping, handling and storage costs, and the
56 total cost of administration of the vaccine, including the cost of
A. 3839 3
1 supplies, data entry, vaccine counseling, inventory management and
2 routine nursing activities based on the current year's medicare rates as
3 published by the United States centers for medicare and medicaid
4 services.
5 § 6. Subparagraph (B) of paragraph 3 of subsection (j) of section 4303
6 of the insurance law, as added by chapter 219 of the laws of 2011, is
7 amended to read as follows:
8 (B) immunizations that have in effect a recommendation from the advi-
9 sory committee on immunization practices of the centers for disease
10 control and prevention with respect to the individual involved, includ-
11 ing reimbursement to the health care provider for the acquisition costs
12 of the vaccine, according to the current or most recently reported
13 United States centers for disease control and prevention private sector
14 cost plus a minimum of twenty-one percent for shipping, handling and
15 storage costs, and the total cost of administration of the vaccine,
16 including the cost of supplies, data entry, vaccine counseling, invento-
17 ry management and routine nursing activities based on the current year's
18 medicare rates as published by the United States centers for medicare
19 and medicaid services;
20 § 7. This act shall take effect on the first of January after it shall
21 have become a law and shall apply to any contract entered into, deliv-
22 ered, amended or modified on or after the date it takes effect.
