WeVote
Log In

Bill

Bill

S 4067

Codifies the disparate impact standard in the human rights law

2025 Regular Session Introduced by Jamaal Bailey and 26 co-sponsors

NJ insurers must reimburse vaccine providers at CDC cost-per-dose in effect on the service date, boosting provider finances and vaccine access.

SUBSTITUTED BY A4040A
0
WeVote Research Nonpartisan
Bill Summary · S 4067

Summary — S4067 (Introduced Jan 30, 2025; Substituted by A4040A)

Purpose

S4067 requires health insurance carriers doing business in New Jersey to reimburse health care providers for vaccines at a rate that is at least equal to the Centers for Disease Control and Prevention (CDC) cost‑per‑dose rate listed on the CDC vaccine price list. The intent is to ensure providers are not paid less than the CDC contract price for vaccines they administer.

Note: The bill heading provided in some records ("Codifies the disparate impact standard in the human rights law") does not match the bill text included here. The operative text of S4067 (print A) concerns vaccine reimbursement.

Key provisions

  • Reimbursement minimum: A carrier must reimburse a health care provider who administers a vaccine at a rate no less than the CDC cost‑per‑dose rate for that vaccine as shown on the CDC vaccine price list.
  • Rate timing: The CDC cost‑per‑dose rate used is the rate in effect on the date the vaccine was provided.
  • Definition of carriers: Applies to health insurance carriers, including insurance companies, health, hospital, and medical service corporations, and health maintenance organizations (as typically defined under New Jersey law).
  • Effective date and applicability: The act takes effect on the first day of the 13th month following enactment and applies to contracts entered into or renewed after that date.

Who is affected

  • Health care providers who purchase and administer vaccines (physicians, clinics, pharmacies, community health centers): will be guaranteed a minimum reimbursement aligned with CDC cost-per-dose.
  • Health insurance carriers (commercial insurers, HMOs, health service corporations): required to set vaccine reimbursement no lower than the CDC price list rate.
  • Patients/plan members: potential indirect effects on access to vaccination and on insurance premiums, depending on carrier cost impacts.
  • State health programs and contract administrators to the extent they fall within the statutory definition of “carrier.”

Potential impacts

  • Providers: Reduces the risk that providers are reimbursed below acquisition cost for vaccines, which may improve financial sustainability of offering vaccinations.
  • Carriers: May increase vaccine-related payment obligations; carriers might adjust negotiated reimbursement schedules, formularies, or contracts with networks.
  • Public health: Could improve provider willingness to stock and administer vaccines, potentially improving vaccine access and uptake.
  • Administrative: Carriers and providers must reference and track CDC price list rates effective on service dates; contract revisions may be necessary after the effective date.

Legislative status & sponsors

  • Introduced in the Senate (1/30/2025); referred to Senate Commerce, then to Investigations and Government Operations; print number 4067A created (2/24/2025).
  • Advanced to third reading (6/4/2025).
  • Substituted by A4040A (6/11/2025) — legislative substitute means the Assembly bill A4040A replaces S4067 in further consideration.
  • Primary sponsor: Sen. Brian Kavanagh. Multiple cosponsors listed from both chambers.

Related legislation

  • A4040 (companion / substitute) — the Assembly version that supplanted S4067 for further action.

If you want, I can:
- Compare A4040A's text to this bill and summarize differences, or
- Produce a short briefing on likely budgetary effects for carriers and providers.

Compiled from official sources — confirm details with the bill’s official record.

Sign in to ask a question.