Provider Notice issued 05/22/07

Vaccines For Children (VFC) Program

 Based on the recommendations made by the Advisory Committee on Immunization Practices (ACIP), we are pleased to announce that additional vaccines have been made available through the Vaccines For Children (VFC) Program (also known as VFC Plus).  Details of the ACIP recommendations can be found at: http://www.hfs.illinois.gov/assets/052407immunization.pdf.

A complete list of VFC Program covered vaccines is attached to this notice.  Those vaccines which were recently added to the VFC Program are identified with asterisks (*) and include Rotavirus, Measles, Mumps, Rubella and Varicella (MMRV) and Human Papillomavirus (HPV).

Healthcare providers receive childhood vaccines from either Illinois Department of Public Health (IDPH) or Chicago Department of Public Health (CDPH) (Chicago only) VFC Program for their VFC eligible children.  The VFC Program helps families of children who may not otherwise have access to vaccines by providing free vaccines to providers who serve them.

All Healthcare and Family Services (HFS) enrolled participants ages 19 and 20 years throughout the state are covered through an interagency agreement between HFS and IDPH.  ACIP recommended vaccines for all HFS eligible clients under age 21 should be ordered from the Illinois Vaccines for Children Program or the Chicago Vaccines for Children Program.

Providers enrolled in the VFC Program are reimbursed for the administration of vaccines through HFS.  Reimbursement for the vaccines is not available through HFS, as the provider receives the vaccines at no cost through the VFC Program.  Providers who do not routinely administer vaccinations, such as those in obstetrics and gynecology practices, and are, therefore, not enrolled with the VFC Program, may receive full reimbursement for Gardasil® vaccinations rendered to patients 9 through 20 years of age.  Additional information on the billing procedures for Gardasil®  will be forthcoming in a separate provider notice.

While there is no additional payment for administration of a vaccine to providers serving managed care enrollees or to centers or clinics billing an encounter rate, the detail regarding the specific vaccination defined by the Current Procedural Terminology (CPT) code must be reported on the encounter billing form so that an accurate immunization history is recorded by HFS and is available to the child’s “medical home” provider, parent/caretaker relative or guardian.

For general information about the VFC Program, becoming enrolled in the program or ordering vaccines covered under the program, contact 1-800-526-4372.  Providers located in Chicago should contact the Chicago VFC Program at 312-746-6358.

For information about recommended vaccines for children, view the Centers for Disease Control Web site at: http://www.cdc.gov/ or the Illinois Chapter, American Academy of Pediatrics Web site at: http://www.illinoisaap.org/immunizations.html.

Your participation in our health care program is beneficial to the health and well being of Illinois children.  We greatly appreciate your participation and partnership.

If you have questions regarding this notice, please contact the Bureau of Comprehensive Health Services at 1-877-782-5565.

Theresa Eagleson, Administrator
Division of Medical Programs

List of Vaccines Available through VFC Program

*   Vaccine was added to VFC Program effective 09/01/06
** Vaccine was added to VFC Program effective 01/01/07