STATE OF NEW YORK ________________________________________________________________________ 227 2021-2022 Regular Sessions IN ASSEMBLY (Prefiled) January 6, 2021 ___________ Introduced by M. of A. GOTTFRIED, DINOWITZ, GALEF, GUNTHER, PAULIN, L. ROSENTHAL, AUBRY, BENEDETTO, BRONSON, COLTON, MONTESANO, J. RIVERA, OTIS, QUART, SAYEGH, DeSTEFANO -- Multi-Sponsored by -- M. of A. CARROLL, COOK, FAHY, JONES, McDONOUGH, RICHARDSON -- 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: EXPLANATION--Matter in italics (underscored) is new; matter in brackets [] is old law to be omitted. LBD00101-01-1A. 227 2 1 (ii) immunizations that have in effect a recommendation from the advi- 2 sory committee on immunization practices of the centers for disease 3 control and prevention with respect to the individual involved, includ- 4 ing reimbursement to the health care provider for the acquisition costs 5 of the vaccine, according to the current or most recently reported 6 United States centers for disease control and prevention private sector 7 cost plus a minimum of twenty-one percent for shipping, handling and 8 storage costs, and the total cost of administration of the vaccine, 9 including the cost of supplies, data entry, vaccine counseling, invento- 10 ry management and routine nursing activities based on the current year's 11 medicare rates as published by the United States centers for medicare 12 and medicaid services; 13 § 3. Clause (iii) of subparagraph (B) of paragraph 8 of subsection (l) 14 of section 3221 of the insurance law, as amended by chapter 219 of the 15 laws of 2011, is amended to read as follows: 16 (iii) necessary immunizations, as determined by the superintendent in 17 consultation with the commissioner of health, consisting of at least 18 adequate dosages of vaccine against diphtheria, pertussis, tetanus, 19 polio, measles, rubella, mumps, haemophilus influenzae type b and hepa- 20 titis b, which meet the standards approved by the United States public 21 health service for such biological products, including reimbursement to 22 the health care provider for the acquisition costs of the vaccine, 23 according to the current or most recently reported United States centers 24 for disease control and prevention private sector cost plus a minimum of 25 twenty-one percent for shipping, handling and storage costs, and the 26 total cost of administration of the vaccine, including the cost of 27 supplies, data entry, vaccine counseling, inventory management and 28 routine nursing activities based on the current year's medicare rates as 29 published by the United States centers for medicare and medicaid 30 services. 31 § 4. Clause (ii) of subparagraph (E) of paragraph 8 of subdivision (l) 32 of section 3221 of the insurance law, as amended by chapter 219 of the 33 laws of 2011, is amended to read as follows: 34 (ii) immunizations that have in effect a recommendation from the advi- 35 sory committee on immunization practices of the centers for disease 36 control and prevention with respect to the individual involved, includ- 37 ing reimbursement to the health care provider for the acquisition costs 38 of the vaccine, according to the current or most recently reported 39 United States centers for disease control and prevention private sector 40 cost plus a minimum of twenty-one percent for shipping, handling and 41 storage costs, and the total cost of administration of the vaccine, 42 including the cost of supplies, data entry, vaccine counseling, invento- 43 ry management and routine nursing activities based on the current year's 44 medicare rates as published by the United States centers for medicare 45 and medicaid services; 46 § 5. Subparagraph (C) of paragraph 2 of subsection (j) of section 4303 47 of the insurance law, as amended by chapter 219 of the laws of 2011, is 48 amended to read as follows: 49 (C) necessary immunizations, as determined by the superintendent in 50 consultation with the commissioner of health, consisting of at least 51 adequate dosages of vaccine against diphtheria, pertussis, tetanus, 52 polio, measles, rubella, mumps, haemophilus influenzae type b and hepa- 53 titis b, which meet the standards approved by the United States public 54 health service for such biological products, including reimbursement to 55 the health care provider for the acquisition costs of the vaccine, 56 according to the current or most recently reported United States centersA. 227 3 1 for disease control and prevention private sector cost plus a minimum of 2 twenty-one percent for shipping, handling and storage costs, and the 3 total cost of administration of the vaccine, including the cost of 4 supplies, data entry, vaccine counseling, inventory management and 5 routine nursing activities based on the current year's medicare rates as 6 published by the United States centers for medicare and medicaid 7 services. 8 § 6. Subparagraph (B) of paragraph 3 of subsection (j) of section 4303 9 of the insurance law, as added by chapter 219 of the laws of 2011, is 10 amended to read as follows: 11 (B) immunizations that have in effect a recommendation from the advi- 12 sory committee on immunization practices of the centers for disease 13 control and prevention with respect to the individual involved, includ- 14 ing reimbursement to the health care provider for the acquisition costs 15 of the vaccine, according to the current or most recently reported 16 United States centers for disease control and prevention private sector 17 cost plus a minimum of twenty-one percent for shipping, handling and 18 storage costs, and the total cost of administration of the vaccine, 19 including the cost of supplies, data entry, vaccine counseling, invento- 20 ry management and routine nursing activities based on the current year's 21 medicare rates as published by the United States centers for medicare 22 and medicaid services; 23 § 7. This act shall take effect on the first of January after it shall 24 have become a law and shall apply to any contract entered into, deliv- 25 ered, amended or modified on or after the date it takes effect.