On November 18, Ohio Academy of Family Physicians (OAFP) Past President Sarah Sams, MD, joined Senator Sherrod Brown for a virtual press conference about the Helping Adults Protect Immunity Act. Supported by the American Academy of Family Physicians (AAFP), the Helping Adults Protect Immunity Act (HAPI) would create parity in vaccine coverage between traditional Medicaid and Medicaid expansion programs.
Individuals enrolled in Medicaid under the expansion pathway made possible by the Affordable Care Act (ACA) are able to receive vaccines recommended by the Advisory Committee on Immunization Practices (ACIP) for $0 out of pocket cost. In contrast, individuals enrolled in traditional Medicaid may face varying out-of-pocket costs, which can act as a barrier to vaccine access.
The AAFP supports the HAPI Act because it addresses an important challenge of reducing illness, hospitalizations, and deaths associated with infectious diseases. Immunizations are often touted as a 21st century public health success, yet 42,000 adults die each year from vaccine preventable diseases.
Dr. Sams spoke specifically to the importance of the patient’s medicine home. The HAPI Act would help reduce the need to get vaccinated in settings outside the patient’s medical home. The National Vaccine Advisory Committee recommends that immunizations be provided as part of coordinated health care and within a medical home setting. Family physicians understand their patients’ medical histories and risk factors and are effective at educating individuals when new immunizations are recommended. This proposal is particularly important in addressing the unique needs of adults with chronic conditions.
So glad to see Sarah and Senator Brown working on this together. Medicaid rules have long been an impediment to best practices for vaccines. Medicare rules have impediments too. Office-based physicians should be able to get reimbursement for vaccines covered under Medicare Part D without having to enroll in another bureaucatic system. Even the large hospital system I worked for wasn’t willing to get involved in the separate system for billing Medicare Park D from the office. It would be another big step in the right direction for physicians to be able to bill for Shingrrix in the office.