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On May 3, the Health Resources and Services Administration announced a new program — the COVID-19 Coverage Assistance Fund (CAF) — that reimburses providers for vaccinations administered to patients enrolled in health plans that either do not cover vaccination fees or cover them with patient cost-sharing.
Claims for vaccinations administered to qualifying patients — including co-payments, deductibles, and co-insurance — submitted to the CAF will be reimbursed at the national Medicare rate, based on the time of service. Before submitting a claim to the CAF, the provider must submit a claim for vaccination administration to the individual’s health plan for payment and have the claim partially paid or denied.
To participate in the program, providers must register and attest they will meet certain conditions such as billing the patient’s primary insurance, verifying that no other payer will reimburse for the administration fee, accepting reimbursement as payment in full, not balance billing the patient, and agreeing to program terms and conditions.