SENATE BILL 121
52nd legislature - STATE OF NEW MEXICO - first session, 2015
INTRODUCED BY
Bill B. O’Neill and Terry H. McMillan
FOR THE LEGISLATIVE HEALTH AND HUMAN SERVICES COMMITTEE
AN ACT
RELATING TO PUBLIC HEALTH; ENACTING THE VACCINE PURCHASING ACT; ESTABLISHING A UNIVERSAL VACCINE PURCHASING PROGRAM; CREATING THE VACCINE PURCHASING FUND; REQUIRING REPORTING OF THE NUMBER OF INSURED CHILDREN; AUTHORIZING ASSESSMENTS TO BE LEVIED ON HEALTH INSURERS FOR COSTS OF VACCINES FOR INSURED CHILDREN; PROVIDING FOR PENALTIES FOR FAILURE TO REPORT NUMBER OF INSURED CHILDREN; MAKING AN APPROPRIATION; DECLARING AN EMERGENCY.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF NEW MEXICO:
SECTION 1. [NEW MATERIAL] SHORT TITLE.--This act may be cited as the "Vaccine Purchasing Act".
SECTION 2. [NEW MATERIAL] DEFINITIONS.--As used in the Vaccine Purchasing Act:
A. "advisory committee on immunization practices" means the group of medical and public health experts that develops recommendations on how to use vaccines to control diseases in the United States, established under Section 222 of the federal Public Health Service Act;
B. "department" means the department of health;
C. "fund" means the vaccine purchasing fund;
D. "health insurer" means any entity subject to regulation by the office of superintendent of insurance that:
(1) provides or is authorized to provide health insurance or health benefit plans;
(2) administers health insurance or health benefit coverage; or
(3) otherwise provides a plan of health insurance or health benefits;
E. "insured child" means a child under the age of nineteen who is eligible to receive benefits from a health insurer;
F. "office of superintendent" means the office of superintendent of insurance;
G. "policy" means any contract of health insurance between a health insurer and the insured, including all clauses, riders, endorsements and parts thereof; and
H. "vaccines for children program" means the federally funded program that provides vaccines at no cost to eligible children pursuant to Section 1928 of the federal Social Security Act.
SECTION 3. [NEW MATERIAL] UNIVERSAL VACCINE PURCHASING PROGRAM.--The department shall establish and administer a statewide universal vaccine purchasing program to:
A. expand access to childhood immunizations recommended by the advisory committee on immunization practices;
B. maintain and improve immunization rates;
C. facilitate the acquisition by health care providers of vaccines for childhood immunizations recommended by the advisory committee on immunization practices; and
D. leverage public and private funding and resources for the purchase, storage and distribution of vaccines for childhood immunizations recommended by the advisory committee on immunization practices.
SECTION 4. [NEW MATERIAL] VACCINE PURCHASING FUND.--
A. The "vaccine purchasing fund" is created in the state treasury. The fund consists of assessments paid by health insurers pursuant to the Vaccine Purchasing Act and appropriations and transfers made to the fund. Money in the fund shall be expended only for the purposes specified in the Vaccine Purchasing Act, by warrant issued by the secretary of finance and administration pursuant to vouchers approved by the secretary of health.
B. Money from the fund may be appropriated to the department to be expended only as authorized in Section 5 of the Vaccine Purchasing Act.
C. The fund shall be audited in the same manner as other state funds are audited, and all records of payments made from the fund shall be open to the public.
D. Any balance remaining in the fund shall not revert or be transferred to any other fund at the end of a fiscal year, and that balance shall be taken into consideration in the determination of the department's succeeding fiscal year's budget.
E. Money in the fund shall be invested by the state investment officer in accordance with the limitations in Article 12, Section 7 of the constitution of New Mexico. Income from investment of the fund shall be credited to the fund.
SECTION 5. [NEW MATERIAL] AUTHORIZED USES OF THE VACCINE PURCHASING FUND.--
A. The fund shall be used for the purchase, storage and distribution of vaccines, as recommended by the advisory committee on immunization practices, for insured children who are not eligible for the vaccines for children program.
B. The fund shall not be used for:
(1) the purchase, storage and distribution of vaccines for children who are eligible for the vaccines for children program; or
(2) administrative expenses associated with the statewide universal vaccine purchasing program.
SECTION 6. [NEW MATERIAL] REPORTING--ASSESSMENTS.--
A. The office of superintendent shall require each health insurer to annually reimburse the state for the cost of vaccines for childhood immunizations for each insured child according to each health insurer's policy obligations and in accordance with state and federal laws.
B. No later than July 1, 2015 and on May 1 of each year thereafter, each health insurer shall:
(1) report the number of children it insures who will be under the age of nineteen as of the following December 31 to the department and to the office of superintendent; and
(2) exclude from such report children who are:
(a) enrolled in medicaid or in any medical assistance program administered by the department or the human services department; and
(b) American Indian or Alaska Natives.
C. No later than August 1, 2015 and June 1 of each year thereafter, the department shall determine the amount to be expended by the department in the current calendar year to purchase, store and distribute vaccines recommended by the advisory committee on immunization practices to all insured children in the state and report the amount to the office of superintendent.
D. No later than September 1, 2015 and July 1 of each year thereafter, the office of superintendent shall determine the amount each health insurer must pay into the fund determined by a fraction, the denominator of which is the total number of insured children reported by all health insurers pursuant to Subsection B of this section and the numerator of which is the number of insured children reported by such health insurers pursuant to Subsection B of this section multiplied by the amount reported to be expended by the department pursuant to Subsection C of this section.
E. No later than October 1, 2015 and August 1 of each year thereafter, the office of superintendent shall submit a statement to each health insurer that includes the proposed assessment for such insurer for the current calendar year.
F. Each health insurer shall pay the assessment to the office of superintendent not later than November 1, 2015 and September 1 of each year thereafter for deposit into the vaccine purchasing fund.
G. The payment of an assessment pursuant to the Vaccine Purchasing Act shall be deemed payment for clinical services and activities to promote health care quality for the purpose of calculating a health insurer's medical loss ratio.
SECTION 7. [NEW MATERIAL] APPEAL--PENALTIES.--
A. A health insurer aggrieved by an assessment levied under Section 6 of the Vaccine Purchasing Act may appeal as provided in Section 59A-4-20 NMSA 1978.
B. A health insurer that fails to file the report required under Subsection B of Section 6 of the Vaccine Purchasing Act shall pay a late filing fee of five hundred dollars ($500) per day for each day from the date the report was due.
C. The office of superintendent may require a health insurer subject to the Vaccine Purchasing Act to produce records that were used to prepare the report required under Subsection B of Section 6 of the Vaccine Purchasing Act. If the office of superintendent determines that there is other than a good faith discrepancy between the number of insured children reported and the number of insured children that should have been reported, the health insurer shall pay a civil penalty of five hundred dollars ($500) for each report filed for which the office of superintendent determines there is such a discrepancy.
D. The department and the office of superintendent shall cooperate to verify the accuracy of health insurer reports required under Subsection B of Section 6 of the Vaccine Purchasing Act.
E. Failure of a health insurer to make timely payment of an assessment levied under Section 6 of the Vaccine Purchasing Act shall subject the health insurer to a civil penalty of five hundred dollars ($500) for each day from the date the payment is due.
SECTION 8. [NEW MATERIAL] POWERS AND AUTHORITY.--The department and the office of superintendent shall promulgate and enforce such rules as may be necessary to carry out the provisions of the Vaccine Purchasing Act.
SECTION 9. [NEW MATERIAL] APPLICABILITY.--The provisions of the Vaccine Purchasing Act:
A. do not apply to an entity that only issues policies, certificates or subscriber contracts within New Mexico that are limited to a specific disease; hospital confinement; indemnity; accident-only; credit; dental; vision; medicare supplement; long-term care; disability income insurance; student health benefits-only coverage issued as a supplement to liability insurance; workers' compensation or similar insurance; automobile medical payment insurance; nonrenewable short-term coverage issued for a period of twelve months or less; medicaid; or any medical assistance program administered by the department or the human services department; and
B. apply to policies, plans, contracts and certificates delivered or issued for delivery or renewed, extended or amended in this state on or after January 1, 2015.
SECTION 10. EMERGENCY.--It is necessary for the public peace, health and safety that this act take effect immediately.
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