STATE OF NEW YORK
________________________________________________________________________
5126
2023-2024 Regular Sessions
IN ASSEMBLY
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:
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-
25 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
1 of the vaccine, according to the current or most recently reported
2 United States centers for disease control and prevention private sector
3 cost plus a minimum of twenty-one percent for shipping, handling and
4 storage costs, and the total cost of administration of the vaccine,
5 including the cost of supplies, data entry, vaccine counseling, invento-
6 ry management and routine nursing activities based on the current year's
7 medicare rates as published by the United States centers for medicare
8 and medicaid services;
9 § 3. Clause (iii) of subparagraph (B) of paragraph 8 of subsection (l)
10 of section 3221 of the insurance law, as amended by chapter 219 of the
11 laws of 2011, is amended to read as follows:
12 (iii) necessary immunizations, as determined by the superintendent in
13 consultation with the commissioner of health, consisting of at least
14 adequate dosages of vaccine against diphtheria, pertussis, tetanus,
15 polio, measles, rubella, mumps, haemophilus influenzae type b and hepa-
16 titis b, which meet the standards approved by the United States public
17 health service for such biological products, including reimbursement to
18 the health care provider for the acquisition costs of the vaccine,
19 according to the current or most recently reported United States centers
20 for disease control and prevention private sector cost plus a minimum of
21 twenty-one percent for shipping, handling and storage costs, and the
22 total cost of administration of the vaccine, including the cost of
23 supplies, data entry, vaccine counseling, inventory management and
24 routine nursing activities based on the current year's medicare rates as
25 published by the United States centers for medicare and medicaid
26 services.
27 § 4. Clause (ii) of subparagraph (E) of paragraph 8 of subdivision (l)
28 of section 3221 of the insurance law, as amended by chapter 219 of the
29 laws of 2011, is amended to read as follows:
30 (ii) immunizations that have in effect a recommendation from the advi-
31 sory committee on immunization practices of the centers for disease
32 control and prevention with respect to the individual involved, includ-
33 ing reimbursement to the health care provider for the acquisition costs
34 of the vaccine, according to the current or most recently reported
35 United States centers for disease control and prevention private sector
36 cost plus a minimum of twenty-one percent for shipping, handling and
37 storage costs, and the total cost of administration of the vaccine,
38 including the cost of supplies, data entry, vaccine counseling, invento-
39 ry management and routine nursing activities based on the current year's
40 medicare rates as published by the United States centers for medicare
41 and medicaid services;
42 § 5. Subparagraph (C) of paragraph 2 of subsection (j) of section 4303
43 of the insurance law, as amended by chapter 219 of the laws of 2011, is
44 amended to read as follows:
45 (C) necessary immunizations, as determined by the superintendent in
46 consultation with the commissioner of health, consisting of at least
47 adequate dosages of vaccine against diphtheria, pertussis, tetanus,
48 polio, measles, rubella, mumps, haemophilus influenzae type b and hepa-
49 titis b, which meet the standards approved by the United States public
50 health service for such biological products, including reimbursement to
51 the health care provider for the acquisition costs of the vaccine,
52 according to the current or most recently reported United States centers
53 for disease control and prevention private sector cost plus a minimum of
54 twenty-one percent for shipping, handling and storage costs, and the
55 total cost of administration of the vaccine, including the cost of
56 supplies, data entry, vaccine counseling, inventory management and
A. 5126 3
1 routine nursing activities based on the current year's medicare rates as
2 published by the United States centers for medicare and medicaid
3 services.
4 § 6. Subparagraph (B) of paragraph 3 of subsection (j) of section 4303
5 of the insurance law, as added by chapter 219 of the laws of 2011, is
6 amended to read as follows:
7 (B) immunizations that have in effect a recommendation from the advi-
8 sory committee on immunization practices of the centers for disease
9 control and prevention with respect to the individual involved, includ-
10 ing reimbursement to the health care provider for the acquisition costs
11 of the vaccine, according to the current or most recently reported
12 United States centers for disease control and prevention private sector
13 cost plus a minimum of twenty-one percent for shipping, handling and
14 storage costs, and the total cost of administration of the vaccine,
15 including the cost of supplies, data entry, vaccine counseling, invento-
16 ry management and routine nursing activities based on the current year's
17 medicare rates as published by the United States centers for medicare
18 and medicaid services;
19 § 7. This act shall take effect on the first of January after it shall
20 have become a law and shall apply to any contract entered into, deliv-
21 ered, amended or modified on or after the date it takes effect.
