Latebreakers: CMS offers Part D vaccine details

June 4, 2007

CMS has offered detailed guidelines on how it will handle pharmacy reimbursement for vaccines under Medicare Part D.

CMS has offered detailed guidelines on how it will handle pharmacy reimbursement for vaccines under Medicare Part D. Beginning in January 2008, pharmacies will be able to receive compensation for vaccine ingredient cost, a dispensing fee, and a vaccine administration fee. According to CMS, the new policy recognizes the "intrinsic linkage that exists between the vaccine and its corresponding administration, since a beneficiary would never purchase a vaccine without the expectation that it would be administered." As the guidelines state, CMS believes that Part D vaccines, including their administration, should be billed on one claim whenever possible and that administration fees would be part of negotiations between pharmacies and prescription drug plans.

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