A 3839: Requires insurance reimbursement for the total direct and indirect practice expenses associated with vaccinations.

  
  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.