The Centers for Medicare & Medicaid Services will allow Medicare-enrolled immunizers to directly bill and receive direct reimbursements from the program for vaccinating Medicare residents in skilled nursing facilities.
Current federal regulations require SNFs to bill for vaccine administration, even if they rely on an outside vendor to perform the service. The agency explained in an Medicare Learning Network article it would “exercise enforcement discretion” in regards to current regulations.
CMS, which announced the move Friday, said it’s part of an effort to more efficiently administer COVID-19 vaccines to SNF residents.
The move indicates that pharmacies will “likely be playing a significant role in not only providing the vaccine but also the vaccinators,” noted Robert Accetta, president/owner of Rivercare Consulting, LLC.
“Pharmacy providers should be pleased. Facility providers, like SNFs and ALFs, will be given the opportunity to decide who their vaccine provider would be,” he told McKnight’s Long-Term Care News on Friday. “Pharmacies will be paid one fee for all the service, record keeping, reporting, and also [for] providing the pharmacist immunizer.”
LTC pharmacies included
The federal government on Friday announced an agreement with CVS and Walgreens to administer a COVID-19 vaccine to long-term care facilities free of charge.
The American Society of Consultant Pharmacists said both moves show the U.S. government’s “preferential treatment to large corporations rather than working to ensure the best public health outcomes for our seniors.”
“Friday’s announcement illustrates the administration’s prioritization of ease over effectiveness when combating the COVID-19 public health pandemic,” explained ASCP Chief Executive Chad Worz.
“The options [the Department of Health and Human Services] has laid out for SNFs and assisted living facilities do not go far enough to prioritize effective distribution of vaccinations to residents living in long-term care settings,” Worz told McKnight’s on Monday.
“Only now is CMS willing to allow Medicare-enrolled immunizers, including pharmacies and pharmacists, to bill directly and receive direct reimbursement from the Medicare program for vaccinating Medicare SNF residents,” he added.
Sign-ups for facilities to opt-in to the optional program started Monday. Long-term care providers are still free to use their existing pharmacy partners. Worz said the group was glad to see that option. Providers, however, must make their selection known during the registration process
“We are disappointed that CMS’ guidance from Friday appears to be aimed at benefiting chain retail pharmacies with little experience serving vulnerable residents in SNFs and ALFs,” he added. “We remain positive that our work with the [Centers for Disease Control and Prevention] and [Operation Warp Speed] will continue to create opportunities for better health outcomes for our nations seniors and better relationships for our dedicated senior care pharmacies and pharmacists.”
Stakeholders stress that providers may continue with their currently contracted pharmacist(s) to administer any COVID-19 vaccines. That way, personnel and processes may be more familiar to residents and facility staff alike, and medication management may be overseen by specialists in the care of the elderly.
