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SB278 INTRODUCED
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SB278
ARDGPS7-1
By Senator Singleton
RFD: Banking and Insurance
First Read: 10-Feb-26
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ARDGPS7-1 02/09/2026 JC (L)lg 2026-627
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First Read: 10-Feb-26
SYNOPSIS:
This bill would require both private health
benefit plans and Medicaid to pay for influenza
vaccinations that are administered by a licensed health
care provider.
This bill would also recognize that the required
vaccination coverage does not affect the right of
individuals, parents, or legal guardians to make the
decision concerning whether to accept or decline a
vaccination.
A BILL
TO BE ENTITLED
AN ACT
Relating to health insurance; to require health benefit
plans to pay or reimburse for influenza vaccinations that are
administered by a licensed health care provider; and to
require the Alabama Medicaid Agency to provide the same
coverage for beneficiaries.
BE IT ENACTED BY THE LEGISLATURE OF ALABAMA:
Section 1. (a) The Legislature finds that:
(1) Lack of insurance coverage may limit access to
influenza vaccines, especially in rural or underserved
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influenza vaccines, especially in rural or underserved
communities;
(2) At the same time, a decision to receive an
influenza vaccination is personal and should be made by an
individual in consultation with a licensed health care
provider;
(3) Parents or legal guardians are the primary
decision-makers concerning the medical care of their children;
and
(4) Access to influenza vaccines should be enhanced by
requiring consistent insurance and Medicaid coverage while
preserving parental choice and individual medical
decision-making.
(b) For the purposes of this section, the following
terms have the following meanings:
(1) ADMINISTRATION COSTS. Costs associated with the
delivery of an influenza vaccine, including counseling, health
care provider fees, and necessary supplies.
(2) COMMUNITY-BASED HEALTH CLINIC. A
federally-qualified health center, rural health clinic, county
or municipal health department, nonprofit clinic, or other
health care facility licensed pursuant to Article 2, Chapter
21 of Title 22, Code of Alabama 1975.
(3) COVERAGE. Payment or reimbursement under a health
benefit plan for a health care service.
(4) HEALTH BENEFIT PLAN. a. Any plan, policy, or
contract issued, delivered, or renewed in this state that
provides health coverage that includes payment for
hospitalization, physician care, treatment, surgery, therapy,
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hospitalization, physician care, treatment, surgery, therapy,
drugs, equipment, and any other medical expense, regardless of
the following:
1. Whether the plan, policy, or contract is provided by
a health care insurer, health maintenance organization
established under Chapter 21A of Title 27, Code of Alabama
1975, health care services plan established under Chapter 20
of Title 10A, Code of Alabama 1975, a nonprofit agricultural
organization that provides health benefits to its members
under Chapter 33 of Title 2, Code of Alabama 1975, or any
other entity that pays for, purchases, or reimburses for
health care services.
2. Whether the plan is for a group or an individual.
b. The term does not include accident-only, specified
disease, individual hospital indemnity, credit, dental-only,
Medicare supplement, long-term care, disability income, or
other limited benefit health insurance policies, or coverage
issued as supplemental to liability insurance, workers'
compensation, or automobile medical payment insurance.
(5) HOSPITAL. A hospital licensed pursuant to Article
2, Chapter 21 of Title 22, Code of Alabama 1975.
(6) LICENSED HEALTH CARE PROVIDER. A physician,
physician assistant, certified registered nurse practitioner,
or pharmacist who is licensed and certified pursuant to Title
34, Code of Alabama 1975, or an individual who administers
vaccinations under the standing order of any licensed
physician.
(7) SCHOOL-BASED HEALTH CLINIC. A health clinic located
at or affiliated with a public or private school which has the
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at or affiliated with a public or private school which has the
purpose of providing health care services to students and is
operated by or in partnership with a licensed health care
provider, hospital, or health care delivery system.
(c)(1) A health benefit plan shall provide coverage for
an influenza vaccine when administered by a licensed health
care provider.
(2) Coverage shall include the vaccine and
administration costs.
(3) Coverage may not be denied, limited, or restricted
based on the location where the vaccine is administered,
including, but not limited to, a physician's office, hospital
or hospital outpatient department, pharmacy, community-based
health clinic, or school-based health clinic.
(d) The coverage required by this section applies
solely to influenza vaccines, and nothing herein shall be
construed to:
(1) Apply to any other vaccine;
(2) Amend, expand, repeal, or otherwise affect existing
school immunization requirements or exemptions established
under Chapter 30 of Title 16, Code of Alabama 1975;
(3) Limit the right of an individual to accept or
decline an influenza vaccine; or
(4) Interfere with parental or legal guardian consent
requirements.
(e) The Department of Insurance of the State of Alabama
may adopt rules to implement this section.
Section 2. (a) The Alabama Medicaid Agency shall pay
for an influenza vaccination for any individual who is
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for an influenza vaccination for any individual who is
accepted for participation in Medicaid.
(b) Payment shall be made according to the coverage
terms provided in Section 1 without any additional requirement
that would discourage or restrict access, including, but not
limited to, cost-sharing, prior authorization, or a site of
service requirement.
(c) The Alabama Medicaid Agency may adopt rules to
implement this section.
Section 3. This act shall become effective on August 1,
2026.
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