In 1989 –
1991, a measles epidemic in the United States
resulted in tens of thousands of cases of
measles and hundreds of deaths. Upon investigation,
CDC found that more than half of the children
who had measles had not been immunized, even
though many of them had seen a health care
provider.
In
partial response to that epidemic, Congress
passed the Omnibus Budget Reconciliation
Act (OBRA) on August 10, 1993, creating the
Vaccines for Children (VFC) Program. VFC
became operational October 1, 1994. Known
as section 1928 of the Social Security Act,
the Vaccines for Children program is an entitlement
program (a right granted by law) for eligible
children, age 18 and below.
VFC helps families of children who may not
otherwise have access to vaccines by providing
free vaccines to doctors who serve them.
VFC
is administered at the national level by
the CDC through the National Immunization
Program. CDC contracts with vaccine manufacturers
to buy vaccines at reduced rates.
States
and eligible projects enroll physicians who
serve eligible patients up to and including
age 18 years and who provide routine immunizations
with little to no out-of-pocket costs to
the parents.
If your child
meets one of the VFC eligibility criteria
listed above, the vaccine must always be
provided free of charge.
Free
of charge means just that. The vaccines have
already been paid for with federal tax dollars.
This means that no one can charge a fee for
the vaccine itself.
However,
each state immunization provider has been
granted (by law) the ability to charge what
is called an “administrative fee.”
An administrative fee is
similar to a patient’s co-pay, in that
it helps providers offset their costs of
doing business.
The
amount of the administrative fee differs
from state to state, based on a regional
scale determined by the Centers for Medicare
and Medicaid Services (CMS).
The
fee table was published in the Federal Register
on October 3, 1994 and remains unchanged.
These
regional administrative charges are maximum
fees that providers may ask patients
to pay. That means that if a state's administrative
fee is $15.00, a provider may charge a patient
any amount up to, but not exceeding that
$15.00 charge, for each vaccine administered.
There is no lower limit, so providers have
the option to charge what they feel is fair,
including no charge at all.
NOTE:
If a patient cannot afford to pay the administrative
fee being charged by the provider, the law
requires that the provider must still administer
the vaccine to the patient. Parents of children
enrolled in Medicaid programs should not
be charged an administrative fee. To be reimbursed
the provider should bill the state Medicaid
program.
National
Immunization Program
Website: www.cdc.gov/nip/
Provides information about vaccines, including
precautions and contraindications for immunization
and vaccine shortages.
National
Immunization Hotline
English 800-232-2522
Spanish 800-232-0233
TTY
(American Sign Language)
800-243-7889
