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SB 107

Insurance: health insurers; coverage for immunization agents and certain laboratory tests administered and ordered by a pharmacist; require. Amends 1956 PA 218 (MCL 500.100 - 500.8302) by adding sec. 3406ss.

2025-2026 Regular Session Introduced by Sylvia Santana

Michigan insurers must cover pharmacist-provided immunizations, pharmacist-ordered tests, and pharmacist-dispensed drugs in-network starting Jan 1, 2026.

referred to Committee on Health Policy
#healthoccupations:pharmacists #health:immunizations #insurance:healthinsurers
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Bill Summary · SB 107

Summary — SB 107 (Michigan): Insurance coverage for pharmacist‑administered immunizations and pharmacist‑ordered tests

Bill number: SB 107
Adds: MCL 500.3406ss (adds section 3406ss to 1956 PA 218, Michigan Insurance Code)
Sponsor: Senator Sylvia Santana
Introduced: February 26, 2025 (referred to Senate Health Policy)
Key status notes: Reported favorably (Health Policy) 3/19/2025; passed the Senate 3/20/2025.
Effective / operative date in text: Coverage requirement begins January 1, 2026.
Legislative analyst / fiscal note: Senate Fiscal Agency reports no fiscal impact on state or local government.

Purpose / intent

Require health insurers that already cover immunization agents to also cover certain immunizations, pharmacist‑ordered laboratory tests, and pharmacist‑dispensed drugs when those services are provided in a pharmacy by a pharmacist authorized under Michigan’s Public Health Code. The aim is to align insurance coverage with expanded pharmacist scope of practice (codified in 2023) and increase affordable access to vaccines and point‑of‑care tests — particularly for populations underserved by traditional physician settings.

Key provisions

  • Adds MCL 500.3406ss to the Insurance Code. Beginning January 1, 2026, an insurer that delivers, issues for delivery, or renews in Michigan a health insurance policy that provides coverage for immunization agents must also cover all of the following when provided at a pharmacy within the insurer’s network:
    • A “qualified immunizing agent” listed on the CDC Immunization Schedules that is administered by a pharmacist under Public Health Code section 333.17724.
    • A “qualified laboratory test” ordered by a pharmacist under Public Health Code section 333.17724a.
    • A drug dispensed by a pharmacist as provided under Public Health Code section 333.17724a.
  • Coverage may be subject to the policy’s utilization management, prior authorization, or precertification requirements.
  • Insurers may apply standard cost‑sharing (deductible, co‑insurance, co‑pay) consistent with the policy.

Who is affected

  • Health insurers issuing or renewing health insurance policies in Michigan that already cover immunizations — they must extend coverage to the pharmacist‑provided/ordered services described above.
  • Pharmacists and pharmacies operating under sections 333.17724 and 333.17724a of the Public Health Code (pharmacist authority includes administering CDC‑recommended vaccines to individuals age 3+ and ordering certain FDA‑waived respiratory/COVID/influenza screening tests).
  • Patients/consumers who obtain vaccines, point‑of‑care respiratory tests, or associated drugs from in‑network pharmacies; broadened insurance coverage can reduce out‑of‑pocket costs and improve access, especially for rural or underserved populations.

Limits / conditions

  • Coverage is limited to services administered/ordered by pharmacists under the cited Public Health Code sections and provided at pharmacies within the insurer’s network.
  • The bill does not prohibit insurers from applying existing utilization management, prior authorization, or cost‑sharing rules.

Fiscal / policy notes

  • Senate Fiscal Agency: no fiscal impact on state or local government.
  • Bill is a reintroduction of Senate Bill 993 (2023–24 session). Supporters cite PA 97 (2023) which expanded pharmacist immunization authority; this bill aligns insurance coverage with that expanded practice.

If you want, I can: (1) extract the exact statutory text added, (2) compare this bill to the 2023 provisions (PA 97) and MCL 333.17724 / 333.17724a, or (3) draft a one‑page explainer for patients or insurers.

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

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