As COVID-19 vaccines continue rolling out across the country, CMS is taking action to protect the health and safety of our nation’s patients and providers and keeping you updated on the latest COVID-19 resources from HHS, CDC and CMS.
With information coming from many different sources, CMS has up-to-date resources and materials to help you share important and relevant information on the COVID-19 vaccine with the people that you serve. You can find these and more resources on the COVID-19 Partner Resources Page and the HHS COVID Education Campaign page. We look forward to partnering with you to encourage our beneficiaries to get vaccinated when they have the opportunity. For more information, visit the CMS COVID-19 Policies and Guidance page.
COVID-19 SNAPSHOT OF NEW COVID-19 VACCINE INFORMATION
CMS, CDC and HHS have released new guidance and resources related to the COVID-19 vaccine to serve our beneficiaries. This important information is highlighted below for our partners to share with providers and consumers.
No Out-of-Pocket Cost for COVID-19 Vaccine. CMS has recently become aware of instances where consumers are being charged to receive a COVID-19 vaccine. We encourage you to remind vaccine providers of the following information as the vaccine becomes more widely available help curb any consumer barriers to receiving a vaccine.
COVID-19 VACCINE PROVIDER REMINDER:
If you participate in the CDC COVID-19 Vaccination Program, you must:
- Administer the vaccine with no out-of-pocket cost to your patients for the vaccine or administration of the vaccine
- Vaccinate everyone, including the uninsured, regardless of coverage or network status
You also can’t:
- Balance bill for COVID-19 vaccinations
- Charge your patients for an office visit or other fee if COVID-19 vaccination is the only medical service given
- Require additional medical or other services during the visit as a condition for getting a COVID-19 vaccination
Report any potential violations of these requirements to the HHS Office of the Inspector General:
- Call 1-800-HHS-TIPS
- Submit an online complaint
Submit claims for administering COVID-19 vaccines to:
- Medicare, if your patient has Medicare Part B coverage or, for 2020 and 2021, Medicare Advantage (Part C)
- Private insurance company (PDF), including if your patient only has Medicare Part A coverage with supplemental coverage from a private insurer
- Your state’s Medicaid program for patients with Medicaid and Children’s Health Insurance Program (CHIP) coverage
- Health Resources & Services Administration (HRSA) COVID-19 Uninsured Program, including if your Medicare patient only has Part A coverage with no supplemental coverage
For more information on COVID-19 Vaccine Administration, visit the CMS COVID-19 Vaccine Provider page.
COVID-19 VACCINE CONSUMER REMINDER. In addition, we encourage you to share the information below with consumers to help address issues relating to consumers who may have received a charge or paid for COVID-19 vaccination.
If you paid to get a COVID-19 vaccine: When you get a COVID-19 vaccine, your provider can’t charge you for an office visit or other fee if the vaccine is the only medical service you get. If you get other medical services at the same time you get the COVID-19 vaccine, you may owe a copayment or deductible for those services.
If you paid a fee or got a bill for a COVID-19 vaccine, check this list to see if your provider should have charged you:
- Check the receipts and statements you get from your provider for any mistakes.
- Call your provider’s office to ask about any charges you think are incorrect. The person you speak to may help you better understand the services you got, or realize they made a billing error.
- If you have Original Medicare, review your “Medicare Summary Notice” for errors. Report anything suspicious to Medicare by calling 1-800-MEDICARE (1-800-633-4227).
- If you have other coverage like a Medicare Advantage Plan, review your “Explanation of Benefits.” Report anything suspicious to your insurer.
If you think your provider incorrectly charged you for the COVID-19 vaccine, ask them for a refund. If you think your provider charged you for an office visit or other fee, but the only service you got was a COVID-19 vaccine, report them to the Office of the Inspector General, U.S. Department of
Health and Human Services by calling 1-800-HHS-TIPS or visiting TIPS.HHS.GOV.
NEW COVID-19 VACCINE RESOURCES
CDC Guidance for Fully Vaccinated People: What you Need to Know.
- If you are fully vaccinated, you can start doing many things that you had stopped doing because of the pandemic.
- When choosing safer activities, consider how COVID-19 is spreading in your community, the number of people participating in the activity, and the location of the activity.
- Outdoor visits and activities are safer than indoor activities, and fully vaccinated people can participate in some indoor events safely, without much risk. Additional CDC guidance can be found here.
- If you haven’t been vaccinated yet, find a COVID-19 near you at Vaccines.gov.
NEW CMS COVID-19 Fraud Resources. CMS just launched new materials to help protect Medicare beneficiaries against COVID-19 vaccine fraud. Spread the word by sharing the resources, graphics and messaging within your communities:
- Use the social media messaging and downloadable graphics in the COVID-19 Fraud Campaign toolkit.
- Play the videos, Protect Yourself from Fraud and What Do You Say to Vaccine Scammers? in waiting areas, on webinars and at conferences.
- Share information in your newsletters – Learn to detect and prevent vaccine fraud at Medicare.gov/fraud
- Additional resources can be found on the COVID-19 Partner Resources Page.
Building COVID-19 Vaccine Confidence Webinar: Thursday, May 13th from 12:00-1:00 p.m. E.T. – hosted by the CMS Office of Minority Health.
Dr. LaShawn McIver, Director of CMS OMH, will share information and resources to help you address vaccine hesitancy in your community. Dr. McIver will be joined by Dr. Peter Marks, Director of the Center for Biologics Evaluation and Research (CBER) at FDA, who will give an overview of vaccines and their safety. This webinar will equip you to speak persuasively about the COVID-19 vaccine. Register here: https://register.gotowebinar.com/register/6555661473692736014
Please note: You will receive an email with login information from GoToWebinar upon registration. If you do not receive an email in a few days’ time, please contact CMSOMHTeam@ketchum.com.
For more information on CMS COVID-19 Partner Updates, please contact us: Partnership@cms.hhs.gov