Washington Universal Vaccine Purchase Program

This is an update provided jointly by the Washington State Department of Health, Washington State Medical Association, Washington Chapter of the American Academy of Pediatrics and the Washington Academy of Family Physicians. There is a vaccine-related bill on its way to the Governor's desk for signature that will preserve the state’s universal purchase of life-saving childhood vaccines.

House Bill 2551 – the result of a year-long effort by a private-public partnership among state legislators, physicians, health plans and public health officials – saves the state’s universal vaccine purchase program which allows the state to purchase vaccines at bulk discount rates for children covered by private health insurance. Without this legislation, the program would end on May 1, 2010 due to cessation of direct funding by the state.

What does the legislation do?

• Health plans and other payers will pay the cost of the vaccine their members receive. This will allow the state to continue purchasing vaccines at bulk discount rates for children covered by private health insurance.
• It creates a new entity – the Washington Vaccine Association – to manage payments from health plans and other payers to the state to buy the vaccines.

What does the legislation mean for your practice?

• The new funding means all routinely recommended vaccines for children under age 19 will continue to be available at no cost to physicians and other providers, preserving easy access to one of the most effective tools for keeping kids healthy.
• Physicians and other providers will be able to continue working with state and local public health as before, using the same processes for ordering and receiving vaccines and the same quality assurance activities.
• However, new funding and the new entity means all physicians’ offices will have to make some changes to their billing procedures to document vaccines administered under the program and to help direct the health plans’ and payers’ payments to the state.
• Health plans and other payers will also have to make changes to their claims processing procedures and systems to accommodate this program.
  • Physicians, other providers and health plans are working cooperatively to develop simple and consistent tracking/billing procedures.
  • The details are still being worked out and tested. There are a couple of methods being considered, and it may be possible for different options to be available.
  • We will continue to keep you informed of new details as they develop.

What does your practice need to do?
We will keep you informed of new developments as the tracking and billing procedures are tested. In the meantime, you may want to assign an operations or billing person in your practice to specifically monitor these developments and examine what changes your office might need to make. This person will be a key contact for the Washington Vaccine Association when it is formed.

What about vaccines that are privately purchased?
The legislation permits health plans and other payers to determine whether they will reimburse providers for privately purchased vaccines. Each health plan or other payer will decide its own policy. This program will have the best chance for success if you obtain your vaccines through the state’s universal vaccine purchase program.

Important H1N1 (Swine Flu) Vaccine Information
From Washington State Department of Health

Dear Provider:

This fall, the federal government is planning to provide H1N1 (swine flu) vaccine to states at no cost. Vaccination is strictly voluntary. Some vaccine supplies (needles, syringes, sharps containers, and alcohol swabs) will also be provided at no cost.

The Washington State Department of Health and local health partners invite interested licensed health care providers and facilities (including hospitals, clinics, pharmacists, and community vaccinators) to pre-register to receive this new vaccine.

Becoming an H1N1 vaccine provider is a two-step process. First, pre-register by completing the online application (www.doh.wa.gov/swineflu/h1n1reg.htm). Second, sign the H1N1 Provider Agreement with the final terms. We’ll send the agreement to you before vaccine is sent to your clinic site.

There is no cost to pre-register and no obligation to order vaccine. Local health agencies will make final decisions about which providers receive H1N1 vaccine in their communities.

Pre-registered providers will receive periodic e-mail updates. H1N1 information is also available on our Web site—www.doh.wa.gov/swineflu.

Contact your local health agency (www.doh.wa.gov/LHJMap/LHJMap.htm) for information about the H1N1 (swine flu) vaccine. For more information about the pre-registration form, contact Jan Hicks-Thomson (jan.hicks-thomson@doh.wa.gov) at 360-236-3578.

Thanks for all you do for public health.

Mary C. Selecky,

Secretary Washington State Department of Health