The Coronavirus Aid, Relief, and Economic Security (CARES) Act suspended the payment adjustment percentage of 2% applied to all Medicare Fee-For-Service (FFS) claims from May 1 through December 31.  The Consolidated Appropriations Act, 2021, signed into law on December 27, extends the suspension period to March 31, 2021.

Pennsylvania Secretary of Health Dr. Rachel Levine today signed an order directing that a percentage of all vaccine distributions to hospitals, health systems, federally qualified health centers (FQHCs) and pharmacies be designated for health care personnel within Phase 1A, including those health care personnel working in Emergency Medical Services, that are not affiliated with a hospital or health system. This order goes into effect January 6, 2021.

“Getting Pennsylvanians immunized with a safe and effective COVID-19 vaccine is an essential step in reducing the number of virus-related cases, hospitalizations and deaths, including all those who continue to take care of us,” Dr. Levine said. “There are nearly one million health care personnel across the commonwealth who work directly or indirectly with patients and are eligible for vaccine initially. The department will continue to follow and update our COVID-19 interim vaccination plan to address how and when all Pennsylvanians can receive their vaccine.”

Health care personnel are defined by the Advisory Committee on Immunization Practices as paid and unpaid persons serving in health care settings who have the potential for direct or indirect exposure to patients or infectious materials. This may include, but is not limited to, emergency medical service personnel, nurses, nursing assistants, physicians, technicians, therapists, phlebotomists, pharmacists, students and trainees, direct support professionals, clinical personnel in school settings or correctional facilities, contractual staff not employed by the health care facility, and persons (e.g., clerical, dietary, environmental services, laundry, security, maintenance, engineering and facilities management, administrative, billing, and volunteer personnel) not directly involved in patient care but potentially exposed to infectious agents that can be transmitted among from health care personnel and patients.

Interested health care personnel not affiliated with a hospital or health system should take the following steps to ensure they can receive the vaccine:

• Review the COVID-19 interim vaccination plan, including Phase 1A sub-prioritization guidance;
• Talk with their employer to identify which type of enrolled COVID-19 vaccine provider is most appropriate;
• Find a participating location if their employer does not assign one;
• Be patient with providers;
• Schedule full vaccine regimen; and
• Provide necessary documentation when being vaccinated.

This order requires providers to designate at least 10 percent of each vaccine shipment received for vaccination of Phase 1A non-hospital affiliated health care personnel.

The Pfizer-BioNTech COVID-19 vaccine and Moderna COVID-19 vaccine will be distributed as outlined in Pennsylvania’s COVID-19 Interim Vaccination Plan.There are three phases to vaccinate residents across the commonwealth. The first phase is broken out into three parts starting with 1A for all health care personnel and those working and living in long-term care facilities.

“The vaccination process will take time. We need Pennsylvanians, including health care personnel to be patient as we continue to get the vaccine into the hands of the right people at the right time so we can protect against COVID-19,” Dr. Levine said. “We appreciate the work of our health systems, hospitals, FQHCs and pharmacies for their partnership on this effort to ensure all health care personnel can receive the vaccine. We are hopeful as we move forward, additional vaccines trials will be completed and receive an Emergency Use Authorization, enhancing the number of vaccines we receive.”

You can find more information regarding the COVID-19 vaccine, guidance and fact sheets for health care personnel and enrolled providers related to this order and the COVID-19 Interim Vaccination Plan at the Department of Health’s website here.

As the number of people and communities affected by the COVID-19 pandemic grows, so do the scams associated with it. Scammers use public health emergencies as opportunities for new fraud schemes, and because older adults and people with disabilities are at greater risk for serious illness from COVID-19, they may target these populations.

It’s important to remember that although the Centers for Disease Control and Prevention (CDC) and other public health officials may contact you if they believe you may have been exposed to the virus, they will not need to ask you for insurance or financial information.

Scammers rapidly alter their tactics and adapt their schemes to the changing landscape, and we anticipate that they will leverage the COVID-19 vaccine to prey on unsuspecting people. Be vigilant and protect yourself from potential fraud concerning COVID-19 vaccines and treatments.

Here are things you need to know about the COVID-19 vaccine:

• You likely will not need to pay anything out-of-pocket to get the vaccine during this public health emergency.
• You cannot pay to put your name on a list to get the vaccine.
• You cannot pay to get early access to the vaccine.
• You will not be solicited door to door to receive the vaccine.
• No one from Medicare or the Health Department with contact you.
• No one from a vaccine distribution site or health care payer, like a private insurance company, will call you asking for your Medicare number, Social Security number, or your credit card or bank account information to sign you up to get the vaccine.

The Senior Medicare Patrol (SMP) recommends that Medicare beneficiaries:

• Contact your own doctor if you are experiencing potential symptoms of COVID-19.
• Do not give out your Medicare number, Social Security number, or personal information in response to unsolicited calls, texts, emails, home visits, or booths at health fairs and other public venues.  If your personal information is compromised, it may be used in other fraud schemes as well.
• Be suspicious of anyone going door-to-door to offer free coronavirus or COVID-19 testing, supplies, treatments, or vaccines.
• Beware of providers offering other products, treatments, or medicines to prevent the virus. Check with your health care provider before paying for or receiving any COVID-19-related treatment.
• If you get a call, text, email — or even someone knocking on your door — claiming they can get you early access to the vaccine, STOP. That’s a scam.
• Carefully review your Medicare Summary Notice (MSN) or Explanation of Benefits (EOB), looking for errors or claims for products or services that weren’t received.
• Follow the instructions of your state or local government for other actions you should be taking in response to COVID-19.
• Contact your local SMP for help. SMPs empower and assist Medicare beneficiaries, their families, and caregivers to prevent, detect, and report health care fraud, errors, and abuse.

The Senior Medicare Patrol (SMP) is ready to provide you with the information you need to PROTECT yourself from Medicare fraud, errors, and abuse; DETECT potential fraud, errors, and abuse; and REPORT your concerns. SMPs help educate and empower Medicare beneficiaries in the fight against health care fraud. Your SMP can help you with your questions, concerns, or complaints about potential fraud and abuse issues. It also provides information and educational presentations. To locate your local Senior Medicare Patrol, call 1-877-808-2468 or visit www.smpresource.org.

More Information

• SMP COVID-19 Fraud Page
• SMP Consumer Fraud Alert: COVID-19
• SMP Consumer Fraud Alerts Page