We have been able to work with the State Department of Insurance to get a revision in their immunization coverage requirement. The current web update clearly indicates that immunization coverage starts on the date the ACIP makes the recommendation and posts it on its website. Previously, the Department of Insurance used publication in MMWR as an option to trigger insurance coverage. The former approach led to parents sometimes requesting new vaccines which were not yet published in MMWR, which often has a several month’s delay from ACIP recommendation, and pediatricians being unable to get paid based on the insurer’s legal ability to delay payment until publication in MMWR.

With the new clarification, once ACIP makes its recommendation and posts it, usually right away, all insurers must pay for all costs associated with the immunization. You can check out the new statement at http://www.ins.state.ny.us/health/ih_hreqimmun.htm