Vaccination Update
CMS Increases Medicare Reimbursement Rate for Administering COVID-19 Vaccines
The Centers for Medicare and Medicaid Services (CMS) announced this week that for COVID-19 vaccines administered on or after March 15, 2021, the national average payment rate for physicians, hospitals, pharmacies, and many other immunizers will be $40 to administer each dose. This represents an increase from approximately $28 to $40 for the administration of single-dose vaccines and an increase from approximately $45 to $80 for the administration of vaccines requiring two doses. The exact payment rate for administration of each dose of a COVID-19 vaccine will depend on the type of entity that furnishes the service and will be geographically adjusted based on where the service is furnished. The announcement also addresses coverage of vaccine administration by Medicare Advantage, Medicaid, and private insurance carriers.
LeadingAge NY is hopeful that the combination of increased reimbursement, more supply coming online, and easier-to-store vaccine product will allow our members who have appropriate staff – such as nursing homes, assisted living, home health, hospice, and Programs of All-Inclusive Care for the Elderly (PACE) – to more easily set up ongoing processes to continue vaccinating their own staff, residents, and patients, including those who are homebound. We also hope that these types of changes allow for easier access to ongoing vaccination, via mobile clinics or other community-based partners, for our affordable housing members.
The CMS announcement is available here. More information on Medicare payment for COVID-19 vaccine administration – including a list of billing codes, payment allowances, and effective dates – is here. There will be more information provided in upcoming updates to the Medicaid toolkit here. Finally, information on the COVID-19 Claims Reimbursement to Health Care Providers and Facilities for Testing, Treatment, and Vaccine Administration for the Uninsured Program is available here.
Newly Eligible Populations and NYC Vaccination Update
Last week, the State announced the following newly eligible populations for vaccination:
- Individuals age 60 and over;
- Public-facing workers and volunteers working in specified home-delivered meal programs, food banks, and food pantries;
- Public-facing building workers;
- Public-facing public employees;
- Public-facing essential workers; and
- Public-facing workers in not-for-profits.
This includes member staff serving in independent living and senior housing.
The New York City Department of Health and Mental Hygiene (NYC DOHMH) is pairing all city-based nursing homes with long term care (LTC) pharmacies to provide on-site clinics to vaccinate new patients and staff members. This will be the long-term solution for city LTC facilities. In the interim, NYC DOHMH will be sending community health care vaccinators via MedRite into 75 nursing homes, including several LeadingAge NY members, to provide second doses to individuals until pairing with an LTC pharmacy can occur.
Also of note to members is that NYC DOHMH has indicated that it will be working with NYC hospitals to vaccinate individuals being discharged to LTC facilities with the one-shot Johnson & Johnson vaccine. This will help alleviate the burden of LTC facilities finding vaccinations for these individuals.
Reporting Requirement Updated for Vaccine Tracker
On March 16th, the Department of Health (DOH) issued the following communication to providers participating in the State's COVID-19 vaccine program:
In order to promote efficient administration of COVID-19 vaccine doses, the State is modifying the reporting frequency requirements of the ‘NYS Vaccine Tracker.’
Effective immediately, providers in receipt of COVID-19 vaccine, irrespective as to whether such doses are via a direct State or federal allocation or a redistribution, will now be required to report to the vaccine tracker on Mondays and Thursdays by 10am. All providers with COVID-19 vaccine doses on hand or that depleted their allocation since their last report are required to fill out the vaccine tracker both days. This reporting will continue to be used for allocation determinations and is still required.
If you have any questions regarding this change or the vaccine tracker in general, please email:VaccineTracker@health.ny.gov.
Contact: Meg Everett, meverett@leadingageny.org, 518-929-9342