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Billing Third Party Payers for Vaccines: State and Local Health Department Perspectives

Quintanilla, Carlos; Duncan, Lorraine; Luther, Lydia

Journal of Public Health Management and Practice: September-October 2009 - Volume 15 - Issue 5 - p E1–E5
doi: 10.1097/PHH.0b013e3181a23dd5
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The cost of adequately immunizing a child has risen steadily with recommendations of new, more expensive vaccines. The Vaccines for Children (VFC) program, a federal entitlement, has continued to fund all recommended vaccines for eligible children. The one other federal vaccine-funding source, Section 317 of the Public Health Service Act, has not kept pace with rising vaccine costs. For local health departments to immunize children not eligible for VFC, but whose families are underinsured or otherwise unable to pay for vaccines, state immunization programs have often relied on Section 317 funds. Recognizing this funding challenge and having learned that children covered by health insurance were being immunized in public clinics with publicly supplied vaccines, the Oregon Immunization Program (OIP) launched a project to expand billing of health plans by local health departments for vaccines administered to covered persons. This has resulted in significant savings of Section 317 funds, allowing the Oregon program to provide more vaccines for high-need persons.

This article describes a projected launched by the Oregon Immunization Program to expand billing of health plans by local health departments for vaccines administered to covered persons.

Carlos Quintanilla, MA, is a public health advisor with the National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, and is assigned to the Oregon Immunization Program, Portland.

Lorraine Duncan, BS, is Manager of the Oregon Immunization Program, Office of Family Health, Division of Public Health, Department of Human Services, Portland.

Lydia Luther, BS, is Provider Services Manager for the Oregon Immunization Program, Office of Family Health, Division of Public Health, Department of Human Services, Portland.

Corresponding Author: Carlos Quintanilla, MA, Centers for Disease Control and Prevention, 1600 Clifton Rd, Atlanta, GA 30333 (carlos.quintanilla@state.or.us); 800 NE Oregon St, Ste 370, Portland, OR 97232.

The project described in this article was supported in part by a grant from the National Center for Immunization and Respiratory Diseases at the Centers for Disease Control and Prevention (grant 2H23IP022550-06).

© 2009 Lippincott Williams & Wilkins, Inc.