Legislative Analysis
Phone: (517) 373-8080
COVERAGE FOR IMMINUZATION AGENTS, TESTS, OR
http://www.house.mi.gov/hfa
DRUGS ADMINISTERED BY PHARMACIST
Analysis available at
Senate Bill 993 (S-1) as passed by the Senate http://www.legislature.mi.gov
Sponsor: Sen. Sylvia A. Santana
House Committee: [Placed on second reading]
Senate Committee: Health Policy
Complete to 12-17-24
SUMMARY:
Senate Bill 993 would amend the Insurance Code to require an insurer that delivers, issues for
delivery, or renews a health insurance policy in Michigan that provides coverage for
immunization agents to provide coverage for all of the following:
• A qualified immunizing agent listed on the Immunization Schedules of the Centers for
Disease Control and Prevention (CDC) that is administered by a pharmacist under the
Public Health Code at a pharmacy in the insurer’s network.
• A qualified laboratory test ordered by a pharmacist as provided under the Public Health
Code at a pharmacy in the insurer’s network.
• A drug dispensed by a pharmacist as provided under the Public Health Code at a
pharmacy in the insurer’s network.
The above provisions would apply beginning January 1, 2026. The required coverage would
be subject to a health insurance policy’s utilization management, prior authorization, or
precertification requirements. An insurer could subject the required coverage to applicable
cost-sharing, including deductible, co-insurance, or co-pay provisions of the insurer’s health
insurance policy.
Proposed MCL 500.3406kk
FISCAL IMPACT:
Senate Bill 993 would not have a direct fiscal impact on any units of state or local government.
However, section 150 of the Insurance Code provides for recourse and penalties in the event
of a violation of the code. Under the provisions of that section, violators have the opportunity
for an administrative hearing before the director of the Department of Insurance and Financial
Services, who may levy a civil fine of $1,000 for each violation, or $5,000 if the individual
knew or reasonably should have known that they were violating the Insurance Code. Civil fine
payments under the Insurance Code are capped at $50,000, and any revenue collected must be
deposited to the state’s general fund. To the extent that violations of the new provisions within
the bill occur, additional general fund revenue may be realized and enforcement costs incurred.
Legislative Analyst: Rick Yuille
Fiscal Analyst: Una Jakupovic
■ This analysis was prepared by nonpartisan House Fiscal Agency staff for use by House members in their
deliberations and does not constitute an official statement of legislative intent.
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Statutes affected:
Substitute (S-1): 500.100, 500.8302
Senate Introduced Bill: 500.100, 500.8302
As Passed by the Senate: 500.100, 500.8302