A1. Why did the Alaska legislature form the Alaska Vaccine Assessment Program (AVAP)?
A2. How does the program save money?
A3. How does AVAP work for payers and providers?
A vaccine assessment account (Vaccine Account) has been established, and funds are used for purchasing pediatric and adult vaccines. The Vaccine Account is funded through vaccine assessments from assessable entities called “payers,” which include health care insurers, health benefit plans, and third-party administrators, based on their proportionate share of the overall vaccine costs. The Immunization Program uses the funds to order vaccine at a discounted bulk rate and distribute it statewide at no cost to health care providers (e.g., doctors, hospitals, clinics, etc.). Health care providers vaccinate their patients, only billing payers for the administrative fee.
A4. Who oversees the program?
A5. Are insurance carriers the only entities paying the assessment?
A6. What does "assessable entity" mean?
A7. Must both the employer and the insurer, or third-party administrator (TPA) administering the plan, pay the assessment for a given covered life?
No. AVAP avoids counting any covered life twice by holding the entity that pays for the vaccine administration cost also responsible for paying the assessment.
A8. Must Employee Retirement Income Security Act (ERISA) plans pay the assessment?
A9. Are publicly funded health care benefit plans mandated to participate in AVAP?
A10. How are an entity's assessments determined?
A11. What is the current assessment rate?
A12. Are the childhood and adult vaccine-eligible populations combined to form a single assessment cost per payer?
A13. Are payments made by assessment payers accountable as medical expenses?
A14. Does the Patient Protection and Affordable Care Act (ACA) preempt any provisions of the AVAP?
A15. Where can I find more details about the AVAP assessment rate calculation?
A16. When are assessment payments due?
AVAP operates on a calendar year running from January 1 to December 31. Quarterly assessments are due 45 days after the close of each quarter, meaning reports and payments will typically be due on February 15, May 15, August 15, and November 15. Quarterly payments are based on the number of covered lives an entity reports for the three months in each preceding quarter.
A17. What if AVAP collects too little?
If AVAP’s estimates produce funds that are too low to meet the needed vaccine costs, AVAP may issue a supplemental assessment. AVAP’s reserve methodology has been designed so that no supplemental assessment should be needed, but that cannot be guaranteed in advance.
A18. What if AVAP collects too much?
A19. If I am a Payer, where do I go to complete the online assessment?
A20. Are there any tutorials on the use of this system?
A21. What if I have registered in the assessment system, but I need to change some of my information?
A22. If I make a mistake in my report, how can I correct it?
A23. I accidentally overpaid. Can I be reimbursed?
A24. How do I submit my payment?
A25. What if I submit a late report or payment?
A26. How do I create a password for the assessment system on www.akvaccine.org?
A27. What should I do if my company has created a password for the assessment system on www.akvaccine.org, but I no longer have it?
A28. Can payers opt out of the Alaska Vaccine Assessment Program?
A29. Is the assessment voluntary?
No. Alaska law mandates that all assessable entities (essentially any entity which pays for any health benefits for any Alaska resident), must pay assessments set by the program.
A30. Will participating payers save money starting in 2016?
C1. Must entities report only child covered lives, or should adult covered lives be included as well?
C2. What are “adult covered lives”?
C3. What are “child covered lives”?
“Child covered lives” are Alaska residents who are 0 through 18 years of age who are:
(a) Covered under an individual health insurance policy;
(b) Covered under a group health insurance policy;
(c) Protected, in part, by a group excess loss insurance policy; or
(d) Protected, in part, by an employee benefit plan of a self-insured entity or any government plan for any employer or government entity.
C4. Must an entity file reports even if it does not provide medical benefits and therefore has zero covered lives?
C5. If an entity files a Permanent Zero Covered Lives Report, but it later has covered lives, what should it do?
C6. If my company has filed an Annual Zero Covered Lives Report, when should we file our next report?
G1. Has AVAP changed anything for the federally funded Vaccines for Children Program (VFC) or state-sponsored medical plans?
G2. Do providers still need to screen for VFC eligibility?
P1. Does this program affect how providers receive vaccine?
P2. What are the benefits for my practice in receiving state-supplied vaccine through AVAP?
AVAP is able to buy vaccines at discounted rates off a bulk contract compared to market prices. Providers can then receive state-supplied vaccines for all covered patients and avoid the financial and administrative burdens of purchasing vaccines and maintaining separate vaccine storage and tracking systems.
P3. Can providers still purchase vaccines privately?
P4. Do providers need to pay for state-supplied vaccines for children and covered adults?
P5. How does this program affect patients?
P6. Are health care providers who care for uninsured adults required to participate in the assessment?
P7. Could providers get vaccine for uninsured adults, funded by surplus funds, even if they don't opt in?
P8. Will providers incur a higher assessment cost for adult vaccines than they are currently paying?
P9. How will providers be compensated for the administration of vaccines?
P10. Are pharmacists able to participate in the program?
P11. Should providers bill $0.00 or $0.01 for state-supplied vaccines?
P12. How do providers enroll to receive state-supplied vaccine?
P13. How can I get updated information on AVAP?
P14. What patient eligibility (VFC) Codes should be used?
P15. Will providers have a choice of which vaccine brands to use?
V1. Who sets vaccine policy?
V2. What vaccines are covered by the Alaska Immunization Program?
The DHSS commissioner will maintain a list of vaccines included in the program based on the department’s review of the ACIP recommendations and the clinical and cost-benefit analysis of potential vaccines. Here is the current vaccine formulary offered by the Alaska Immunization Program.
V3. Is the cost of seasonal flu vaccine included in the assessment rates?
V4. Does AVAP establish a vaccine mandate?
V5. What is VacTrAK?
V6. Does AVAP impact my taxes?
No. AVAP does not impact taxes as it is not funded by taxpayers. AVAP collects the costs of vaccines and program expenses from insurers, third-party administrators, and other payers who are already obligated to pay health care costs for their beneficiaries.
V7. How does AVAP know the amount of vaccine it needs to purchase?
V8. Does DHSS expect vaccine uptake rates to increase once AVAP goes into effect?