Vaccine Reimbursement Program for Public Providers

On behalf of the Department of Public Health, UMass Medical School's Commonwealth Medicine division is working with both traditional and Medicare Advantage health plans to provide reimbursement for the administration of seasonal flu vaccine in public settings.

The goal of this initiative is to increase access to the seasonal influenza vaccine in public clinics while providing financial support to public providers. 

 

How Does It Work? 

For a 10% fee, the Center for Health Care Financing (CHCF) will bill the contracted health plans for the: 

• Administration of the influenza vaccine to individuals ages 6 months and older 
• Cost of privately purchased vaccine administered to individuals ages 19 and older 
• Administration of the pneumococcal vaccine to Medicare Advantage members  

CHCF will then distribute payments from the private health plans to public providers. For more information and to view the program's training guide please click on the "2012 Training Guide" document located to the right under Additional Resources.

 

Program Growth 

 

PROGRAM SEASON	# OF PUBLIC HEALTH PROVIDERS	# OF CLAIMS SUBMITTED	AMOUNT OF PAID CLAIMS
2009 H1N1 Pandemic	43	44,428	$320,000
2010-2011 Flu Season	110	45,676	$440,000
2011-2012 Flu Season	166	53,572	$800,000

 

 

 

              

How Can Providers Participate?

In order to participate public providers must submit two signed originals of the contract to CHCF, located to the left under Documents and Forms. For cities and towns to receive payment, they must also submit a University of Massachusetts Substitute W-9 Form (Form UMW-9) to Commonwealth Medicine. Please feel free to contact us with any questions regarding the contracting process.

 

Contracted Health Plans

• Blue Cross Blue Shield of Massachusetts 
• BMC HealthNet  
• Fallon 
• Harvard Pilgrim 
• Health New England  
• MassHealth*
• Neighborhood Health Plan 
• Tufts 
• Unicare  

*If you are eligible and choose to complete MassHealth's application process. For more information please view the MassHealth presentation under Additional Resources

 

Contact Us:

Holly Oldham

Brittany Tibbetts

Andrew Wagner

Email: vaccine.reimbursement@umassmed.edu
Phone: (800) 890-2986