Vaccine Prioritization and Reimbursement

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Vaccine Prioritization

The first wave of population to receive the vaccine will include healthcare personnel, essential workers who work within clinics and public health, adults with underlying medical conditions, and people 65 years of age and older. According to Arizona V-MAP Taskforce, vaccines may be administered via mobile locations to limit crowding and creating more clinic sites. Due to challenges in storage and handling, early vaccination should be focused on the critical population as much as possible. For the post-acute care facilities, the facilities will be responsible for storing, handling, and administering the vaccines.

Recommendations for prioritizing vaccination are as follows:

Healthcare providers

  • Inpatient healthcare providers

  • Outpatient healthcare providers

  • Long term care providers / nursing home health/care providers

  • Pharmacists & pharm techs

People at risk

  • People living in post-acute care facilities

  • People with underlying conditions and comorbidities

  • People 65 or older

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Reimbursement 

Vaccine reimbursement could potentially be deployed under emergency use authorization by the end of 2020, pending positive safety and immune data reviewed by the FDA to ensure efficacy and quality of the vaccines. The Coronavirus Aid, Relief, and Economic Security (CARES) Act requires Medicare to pay for the vaccine without copays or deductibles for their beneficiaries. Furthermore, Arizona Governor Ducey signed an executive order that made vaccination available to all Arizonans without copays. Health care providers are covered under the Families First Coronavirus Response Act (FFCRA) and Paycheck Protection Program and Health Care Enhancement Act (PPPHCEA). Once the vaccine is released to market, the Center for Medicare Services (CMS) will provide the HPCP codes necessary for reimbursement.

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Prepared in collaboration with graduate students from Keck Graduate Institute (Claremont, CA): Kaljit Atwal, Paola Montes, Joseph Nguyen, Alice Wen