Reports Outline Vaccines Study Results from Center for Disease Control and Prevention (Medicaid provider reimbursement policy for adult immunizations)

By a News Reporter-Staff News Editor at Vaccine Weekly -- Researchers detail new data in Immunization. According to news reporting from Atlanta, Georgia, by NewsRx journalists, research stated, "State Medicaid programs establish provider reimbursement policy for adult immunizations based on: costs, private insurance payments, and percentage of Medicare payments for equivalent services. Each program determines provider eligibility, payment amount, and permissible settings for administration."

The news correspondents obtained a quote from the research from Center for Disease Control and Prevention, "Total reimbursement consists of different combinations of Current Procedural Terminology codes: vaccine, vaccine administration, and visit. Determine how Medicaid programs in the 50 states and the District of Columbia approach provider reimbursement for adult immunizations. Observational analysis using document review and a survey. Medicaid administrators in 50 states and the District of Columbia. Whether fee-for-service programs reimburse providers for: vaccines; their administration; and/or office visits when provided to adult enrollees. We assessed whether adult vaccination services are reimbursed when administered by a wide range of providers in a wide range of settings. Medicaid programs use one of 4 payment methods for adults: (1) a vaccine and an administration code; (2) a vaccine and visit code; (3) a vaccine code; and (4) a vaccine, visit, and administration code. Limitations: Study results do not reflect any changes related to implementation of national health reform. Nine of fifty one programs did not respond to the survey or declined to participate, limiting the information available to researchers. Medicaid reimbursernent policy for adult vaccines impacts provider participation and enrollee access and uptake."

According to the news reporters, the research concluded: "While programs have generally increased reimbursement levels since 2003, each program could assess whether current policies reflect the most effective approach to encourage providers to increase vaccination services."

For more information on this research see: Medicaid provider reimbursement policy for adult immunizations. Vaccine, 2015;33(43):5801-5808. Vaccine can be contacted at: Elsevier Sci Ltd, The Boulevard, Langford Lane, Kidlington, Oxford OX5 1GB, Oxon, England. (Elsevier - www.elsevier.com; Vaccine - www.journals.elsevier.com/vaccine/)

Our news journalists report that additional information may be obtained by contacting A.M. Stewart, Center Dis Control & Prevent, Natl Center Immunizat & Resp Dis, Atlanta, GA, United States. Additional authors for this research include M.C. Lindley and M.A. Cox (see also Immunization).

Keywords for this news article include: Atlanta, Georgia, Vaccines, Vaccination, Immunization, Legal Issues, United States, Biological Products, North and Central America

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