CMS News: Vaccine Counseling Under Medicaid & Children’s Health Insurance Program

View in browser | Distributed by Center for Medicaid and CHIP Services (CMCS) Today, the Biden-Harris Administration, through the Centers for Medicare & Medicaid Services, is now requiring states to cover certain Medicaid COVID-19 vaccine counseling visits in which healthcare providers talk to families about the importance of kids’ vaccination. CMS will now consider COVID-19 vaccine counseling visits for children and youth under age 21 as part of the Medicaid Early and Periodic Screening, Diagnostic and Treatment (EPSDT) benefit to be COVID-19 vaccine administration. For these services, state expenditures can be federally matched at 100% through the last day of the first quarter that begins one year after the end of the COVID-19 public health emergency, under the American Rescue Plan Act of 2021 (ARP).  This action not only underscores the importance of vaccination education, but is also a critical step in increasing COVID-19 vaccine rates by increasing families’ access to information from providers as they make decisions concerning vaccinations for their children. As a reminder, states have the option to cover and reimburse for counseling visits about COVID-19 vaccine administration, during which a COVID-19 vaccine is not injected, for all Medicaid and Children’s Health Insurance Program (CHIP) populations.  State expenditures on such visits are matched at the state’s applicable federal match rate.  Additionally, moving forward, Medicaid will require that states reimburse for and cover stand-alone vaccine counseling visits as part of vaccine administration required for all pediatric vaccines under EPSDT, regardless of federal matching rate.   After the 100% federal match rate for COVID-19 vaccine administration (including pediatric COVID-19 vaccine counseling) that is available under the ARP expires, the federal government will match state Medicaid expenditures on COVID-19 vaccine administration at the state’s applicable federal match rate. CMS will be providing more information to states on the next CMCS COVID-19 All-State Call and Webinar, which will take place on December 9th from 3:00-4:00pm EST.  An invitation will be shared with states in advance of the call.  Following that presentation, more information will be posted on Medicaid.gov.  Learn more here: https://www.cms.gov/newsroom/press-releases/biden-harris-administration-makes-100-federal-medicaid-matching-funds-available-state-expenditures

 

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