Covid-19 Vaccine

The US Department of Health and Human Services (HHS) announced a new program that will cover the costs of administering COVID-19 vaccines to patients enrolled in health plans that either do not cover vaccination fees or cover them with patient cost-sharing. Since providers cannot bill patients for COVID-19 vaccination fees, this new program–the COVID-19 Coverage Assistance Fund–will help ensure that providers on the front lines vaccinating underinsured patients are fairly reimbursed.

“After securing enough COVID-19 vaccines for all adults, the Biden-Harris Administration is elevating work to boost access to them,” said HHS Secretary Xavier Becerra. “We listened to our health care providers on the frontlines of the pandemic. On top of increasing reimbursement rates tied to administering the shots, we are closing the final payment gap that resulted as vaccines were administered to underinsured individuals. No health care provider should hesitate to deliver these critical vaccines to patients over reimbursement cost concerns.”

The COVID-19 Coverage Assistance Fund is focusing on instances where individuals have insurance, but vaccines are either not covered or are covered with patient cost-sharing. To address these gaps, the fund will be compensating providers for eligible claims, at national Medicare rates which increased in March to reflect newer information on the true costs associated with administering the vaccines. CAF also builds on the HHS Health Resources and Services Administration’s COVID-19 Uninsured Program, which has been reimbursing providers for vaccine administration fees associated with uninsured individuals.

The availability of COVID-19 vaccines have fundamentally changed and strengthened our battle against this pandemic. While the COVID-19 vaccines themselves are free to all adults in the US, providers incur other costs – from training to storage to staffing – when administering them.

Typically, providers would bill either insurance plans or patients for these expenses, but due to the COVID-19 pandemic and the urgency around getting Americans vaccinated, the Centers for Disease Control and Prevention (CDC) issued guidance in February, that requires all providers to administer the COVID-19 vaccines regardless of the recipient’s ability to pay COVID-19 vaccine administration fees or coverage status and with no out-of-pocket cost to the recipient.

The COVID-19 Coverage Assistance Fund will accept eligible claims from providers dated on or after December 14, 2020. Claims must be submitted electronically and are subject to available funding.

For more information, click here.

HRSA will also be hosting two provider webinars this week to go over the new program. Presenters will provide an overview and cover information such as: enrolling as a provider participant, submitting patient information, submitting claims and receiving payment via direct deposit

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