Yes, Provider Relief Funding Can Be Used to Cover COVID-19 Vaccination Costs

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As long-term care facilities and other health care providers turn their attention and efforts to COVID-19 vaccination, many have inquired about the ability to use Provider Relief Funding (“Funding”) for vaccine-related costs. The U.S. Department of Health & Human Services (“HHS”) recently released updated Frequently Asked Questions (“FAQs”) on the topic.  In summary, Funding can be used to support vaccine-related expenses, such as distribution costs, preparatory costs (such as obtaining refrigerators, personnel costs, and transportation costs), and administration fees.  However, consistent with terms and conditions, Funding may only be used for vaccination costs that have not been reimbursed from other sources or that other sources are not obligated to reimburse.  For example, Medicare has determined payment rates for COVID-19 vaccine administration: for single-dose vaccines, the payment rate will be $28.39, and for vaccines requiring a series of two doses, the initial dose administration payment rate will be $16.94, and $28.39 for the administration of the final dose in the series.  Thus, a provider may not use Funding to cover these same costs for Medicare beneficiaries, but if Medicare reimbursement does not cover the full expense of administering vaccines, and no other source is obligated to reimburse the cost, Funding may be used to cover the remaining associated costs.

The new HHS FAQs specifically provide:

  • Can Provider Relief Fund payments be used to support COVID-19 vaccine distribution? Provider Relief Fund payments may be used to support expenses associated with the distribution of a COVID-19 vaccine licensed or approved by the Food and Drug Administration (FDA) that have not been reimbursed from other sources or that other sources are not obligated to reimburse. Funds may also be used ahead of an FDA-licensed or approved vaccine becoming available. This may include using funds to purchase additional refrigerators, personnel costs to provide vaccinations, and transportation costs not otherwise reimbursed.
  • Can Provider Relief Funds be used to cover the cost of vaccination, including doses and administration fees, for Medicare, Medicaid, or CHIP beneficiaries? In line with the Terms and Conditions, funds may not be used to reimburse expenses or losses that have been reimbursed from other sources or that other sources are obligated to reimburse, which include, but are not limited to, Medicare, Medicaid, and CHIP. If reimbursement does not cover the full expense of administering vaccines, Provider Relief Funds may be used to cover the remaining associated costs.

DISCLAIMER: Because of the generality of this update, the information provided herein may not be applicable in all situations and should not be acted upon without specific legal advice based on particular situations.

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