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OPA COVID-19 Vaccines and Therapeutics: June 21, 2022 Update


New COVID-19 Vaccine Formulations Approved for Individuals Ages 6 Months to 5 Years
The Centers for Disease Control and Prevention's (CDC) Director Rochelle P. Walensky, M.D., M.P.H., endorsed the Advisory Committee on Immunization Practice’s (ACIP) recommendation that all children 6 months through 5 years of age should receive a COVID-19 vaccine. Moderna's two-dose primary COVID-19 vaccine series was approved for individuals ages 6 months to 5 years. Pfizer BioNTech's three-dose primary COVID-19 vaccine series was also approved for individuals ages 6 months to 4 years. Pharmacists can now vaccinate children ages 3 and above. If your site does not plan to provide the vaccine to younger age groups, please refer patients to the nearest location that administers pediatric vaccinations.

New CMS Requires State Medicaid Programs to Enroll and Reimburse Pharmacists for COVID-19 Vaccine Services
The Centers for Medicare & Medicaid Services (CMS) clarified that state Medicaid programs must enroll and reimburse providers, including pharmacists, to provide vaccine services. This includes vaccine administration and counseling. See this letter from C.M.S. clarifying the vaccine counseling codes. C.M.S. also released stand-alone Healthcare Common Procedure Coding System codes for vaccine counseling provided to beneficiaries eligible for early and periodic screening, diagnostic, and treatment provisions required under the American Rescue Plan. OPA is grateful for the collaboration from the Ohio Department of Medicaid and Ohio's Medicaid Managed Care Organizations for continuing to reimburse pharmacists for COVID-19 vaccine administration services.

Additional Resources for COVID-19 Pediatric Vaccinations 
Here are additional resources for vaccine providers. Your site may choose not to administer vaccines to pediatric patients. However, these resources may help inform a patient/guardian/caregiver’s decision to get a vaccine.

Reminder: ODH Shares Interim Provider Guidance for COVID-19 Vaccine for Children Younger than 5 Years
ODH prepared a guide titled Interim Provider Guidance for COVID-19 Vaccines for Children Younger than 5 Years to provide preliminary guidance on the ordering, storage, handling, and administration of COVID-19 pediatric vaccine formulations. This guidance document will be updated following federal regulatory action and clinical considerations that the CDC will publish.

Reminder: The following incentives end on Thursday, June 30, 2022.

Reminder: Medicaid Patients Eligible for $100 Incentive for First COVID-19 Vaccine and All Booster Doses 
ODH and Ohio’s Medicaid Managed Care Organizations (MCOs) announced continued and additional incentives for Medicaid and MyCare patients to receive their COVID-19 vaccine series and booster shots. Here is additional information:

  1. Medicaid and MyCare patients ages five and older are eligible to receive a $100 gift card for their first COVID-19 vaccine. See this first dose incentive flyer for additional information.
  2. Medicaid patients ages 12 and older are eligible to receive a $100 gift card for their first and second booster COVID-19 vaccines. See this booster dose incentive flyer for additional information. Note: MyCare patients are not included in this incentive.
  3. Both incentives extend to June 30, 2022.
  4. Each MCO has different requirements for patients to claim their gift cards, and the flyers provide additional information.

Reminder: $100 COVID-19 Vaccine Administration Fee 
ODM and Ohio’s MCOs announced that the administration fee for COVID-19 vaccines is $100 for all COVID-19 shots, including first, second, and booster doses for Medicaid members, has been extended to June 30, 2022. See further details on the Provider and Pharmacy Resources webpage. The MCO leadership encourages pharmacies to assist Medicaid patients with accessing first, second, and booster shots through phone calls, walk-in appointments, and other personalized outreach.

    OPA is working diligently to facilitate communication between state decision-makers and member pharmacists. OPA has created multiple COVID-19 resources, including a COVID-19 Vaccine Information Webpage, COVID-19 Testing Hub, and COVID-19 Resources Webpage, on the OPA website under the Resources drop-down box. Please contact Myriam Shaw Ojeda, Director of Pharmacy Extension and Public Health Initiatives, for further questions at [email protected].

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