What's happening
This bill requires insurance plans to fully reimburse health care providers for the cost and administration of vaccines, including associated expenses.
Why it matters
Ensures health care providers are fully reimbursed for both the cost of vaccines and the added expenses involved in storing, handling, and administering them. this could make it financially feasible for more providers to offer vaccines, especially in smaller practices or underserved areas.
Ties reimbursement rates to up-to-date federal benchmarks (CDC private sector cost plus 21% for logistics, and Medicare rates for administration). , which may prevent underpayment and reflect actual market costs, possibly improving provider participation in vaccination programs.
Covers all recommended immunizations, including both those specifically listed (like measles, polio, hepatitis B) and any with a CDC Advisory Committee recommendation. , so it adapts automatically as new vaccines become standard, supporting broader public health goals.
Explicitly reimburses for all associated administrative activities (supplies, data entry, counseling, inventory management, nursing). , recognizing the true scope and labor of vaccine delivery, which may encourage thorough record-keeping and improved patient education.
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Who cares
Headline styles
Cover Vaccine Provider Costs
Plain English, a few words. Used as the page title.
Sponsors
21 Co-sponsors
History
- Referred to insurance
- Referred to insurance
Full text
3 pagesUnderlined is new[Struck] is removedOfficial text on nysenate.gov ↗
STATE OF NEW YORK
4061
2017-2018 Regular Sessions
IN ASSEMBLY
February 1, 2017
Introduced by M. of A. GOTTFRIED, DINOWITZ, GALEF, GRAF, GUNTHER, PAULIN, ROSENTHAL, TITONE, AUBRY, BENEDETTO, BRONSON, COLTON, JAFFEE, McDONALD, MONTESANO, MOSLEY, RIVERA, SKOUFIS, HOOPER, OTIS, SEPULVEDA, QUART -- Multi-Sponsored by -- M. of A. CARROLL, COOK, FAHY, McDO- NOUGH, RAIA, RICHARDSON -- read once and referred to the Committee on Insurance
AN ACT to amend the insurance law, in relation to insurance reimbursement for vaccination
The People of the State of New York, represented in Senate and Assembly, 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 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 hepatitis 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:
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD02607-01-7
A. 4061 2
(ii) immunizations that have in effect a recommendation from the advisory committee on immunization practices of the centers for disease control and prevention with respect to the individual involved, 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;
§ 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 hepatitis 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 advisory committee on immunization practices of the centers for disease control and prevention with respect to the individual involved, 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;
§ 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 hepatitis 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
A. 4061 3
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.
§ 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 advisory committee on immunization practices of the centers for disease control and prevention with respect to the individual involved, 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;
§ 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, delivered, amended or modified on or after the date it takes effect.
Reflowed for reading: line numbers and page breaks removed. Cite the official text.
Summaries, headlines and scores are AI-generated from the official bill text. How we score bills. Source: NYS Open Legislation.