Provider Notice Issued 02/08/2021
Date: February 8, 2021
To: Enrolled Pharmacy Providers
Re: COVID-19 Vaccine Administration Billing forthe Illinois Medicaid Pharmacy Benefits Manager System and the Federal HRSACOVID-19 Reimbursement Program for the Uninsured
This notice informs providers of theability to bill COVID-19 vaccination administration fees through the IllinoisPharmacy Benefits Management System (PBMS) for Illinois Medicaid fee-for-serviceand the appropriate PBMs for individual HealthChoice Illinois managed care plans.
Illinois Medicaid fee-for-serviceparticipants and individual HealthChoice Illinois managed care plan participantsshall not be turned down for COVID vaccination services when vaccinationsare available to be administered at the pharmacy location. Servicesare to be provided at no cost to the participant.
Regardless of income, citizenship, orimmigration status, the HealthResources and Services Administration (HRSA) COVID-19Claims Reimbursement to Health Care Providers and Facilities for Testing,Treatment, and Vaccine Administration for the Uninsured program reimburses providers at Medicare rates forproviding COVID-19 vaccine administration, treatment, testing, andtesting-related services to uninsured patients. For reimbursement, providersshould submit claims to the HRSA COVID-19 Claims Reimbursement Portal. The date of service mustbe on or after February 4, 2020. Uninsured individuals should not be chargedfor these services.
Questions regarding this notice may be directed to theBureau of Professional and Ancillary Services at 877-782-5565 forfee-for-service claims, or to the individualHealthChoice Illinois managed care plan.
Kelly Cunningham, Administrator
Division of Medical Programs