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In response to reports that some providers have been charging patients for vaccines, the Department of Health and Human Services' Office of the Inspector General is reiterating that any COVID-19 vaccine should be administered free of charge to recipients.
Among the terms of the program are that providers:
- must administer the vaccine with no out-of-pocket cost to the recipient.
- may not deny anyone vaccination based on the vaccine recipient's coverage status or network status.
- may not charge an office visit or other fee if COVID-19 vaccination is the sole medical service provided.
- must not require additional medical services to receive vaccination.
- may not seek any reimbursement, including through balance billing from the vaccine recipient.
- may seek appropriate reimbursement from a program or plan that covers vaccine administration fees for the recipient, such as Medicare or Medicaid or the recipient's private insurance.
"OIG is aware of complaints by patients about charges by providers when getting their COVID-19 vaccines," the agency wrote. "Providers that charge impermissible fees must refund them and ensure that individuals are not charged fees for the COVID-19 vaccine or vaccine administration in the future."
WHAT'S THE IMPACT?
Throughout the pandemic the OIG has also investigated a steady stream of allegations of COVID-19-related fraud and abuse. Fraudsters are using telemarketing, text messages, social media platforms and door-to-door visits to perpetrate scams to steal money and personal information, the group said.
Possible suspicious activity related to the vaccines includes:
- requests for payment to get a vaccine, including deposits or fees.
- requests for payment or offers of money to enhance ranking for vaccine eligibility (i.e., getting a better spot in line or on a wait list).
- offers to sell or ship doses of vaccine for payment.
- offers to purchase vaccine record cards containing personally identifiable information.
- offers of money to participate in a vaccine survey.
The OIG continues to update its COVID-19 Fraud Alert to warn the public about emerging fraud schemes.
"The public and private sectors must work together to ensure that vaccine distribution is conducted with integrity and in accordance with applicable rules," OIG said.
THE LARGER TREND
Nationally, vaccination efforts are trending in the right direction. As of April 15, the seven-day average number of COVID-19 vaccinations administered daily reached 3.3 million, a 10.3% increase from the previous week's average, according to new data from the Centers for Disease Control and Prevention.
That translates to about 198.3 million total vaccine doses administered. Overall, almost 126 million Americans (37.9% of the U.S population) have received at least one dose, while roughly 78.5 million (23.6%) have received both doses.
Disappointingly, the seven-day case average is on the rise, hitting 69,577 last week, an 8.1% increase from the week prior. But the average is still down more than 72% since the pandemic's seven-day average peak of 249,861 recorded on January 11.
Analyzing specimens collected through March 27, the CDC attributes 44.1% of U.S. COVID-19 cases to the U.K. variant B.1.1.7, while the Brazil variant accounted for about 1.4% of all cases, and the South African variant comprised 0.7% of all cases.
The current seven-day hospitalization average is 5,507, up 4.5% from the previous week, but is a 66.7% decrease from the peak seven-day average of 16,521 logged on January 9. Deaths showed a similar pattern, increasing 10.8% week over week to hit 712, which is still a 79.4% decrease from the January 13 peak of 3,457 deaths.