Bill requires health plans to fully reimburse cost of vaccinations
Sacramento- AB 2064 (V. Manuel Perez) will require health plans and insurers to fully reimburse physicians for the costs to acquire and administer recommended vaccines that are already required to be covered. The bill will also prohibit health plans and insurers from charging co-payments, deductibles or other out-of-pocket expenses that deter parents from immunizing their children and prohibit health plans and insurers from including the cost of immunizations in a policy's dollar limit.
Pediatric immunizations have proven to be one of most successful, safe and cost-effective public health interventions of the 20th and this century. Worldwide, millions of childhood deaths are prevented by vaccinations every year. Vaccine-preventable disease levels are at or near record lows.
“AB 2064 is an example of good public policy that will help to keep our children healthier,” said James T. Hay, M.D., President of CMA.
Due to increasing numbers of approved and recommended life-saving vaccines, as well as increasing prices, pediatric vaccine purchase costs have increased dramatically in recent years and could triple by the year 2020. Physicians typically face higher vaccine prices than large public purchasers and usually lose money when they provide immunizations due to chronic under-reimbursement by private health plans.
“If we’re going to ask more people to get immunized and to become educated about the benefits of vaccines, then it only follows suit that those immunizations need to be fully reimbursed by health plans and insurers,” said Dr. Hay. “Pediatricians and family physicians are integral to providing basic preventive medicine to children in California, and while many have willingly continued to offer vaccines at a real cost to themselves, they can no longer subsidize this service. This is a critical safety net for vulnerable children that ought not to be jeopardized.”
The purchase of vaccines is the single most expensive part of a pediatric or family practice. When providers are not adequately reimbursed to cover the direct and indirect costs of providing immunizations, the viability of their practice is threatened, which jeopardizes access.