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?
A8. Must Employee Retirement Income Security Act (ERISA) plans pay the assessment?
A9. Are publicly funded health care benefit plans mandated to particfipate in the program?
A10. How are an entity's assessments determined?
A11. What is the 2017 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. What is the three-year phase-in period?
A17. 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.
A18. What if AVAP collects too little?
A19. What if AVAP collects too much?
A20. If I am a Payer, where do I go to complete the online assessment?
A21. Are there any tutorials on the use of this system?
A22. What if I have registered in the assessment system, but I need to change some of my information?
A23. If I make a mistake in my report, how can I correct it?
A24. I accidentally overpaid. Can I be reimbursed?
Yes. Please e-mail Help@AKvaccine.org explaining the mistake and the amount you need for reimbursement. The AVAP Council will then determine the best way to correct the mistake.
A25. How do I submit my payment?
A26. What if I submit a late report or payment?
A27. How do I create a password for the assessment system on www.akvaccine.org?
A28. 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?
A29. Can payers opt out of the Alaska Vaccine Assessment Program?
A30. Is opt out advisable?
No. Vaccines recommended by medical experts have long been recognized as the second most effective public health initiative next to clean drinking water. Overall, studies have shown that direct savings in health care costs from proper vaccination exceed $10 for every $1 spent. Perhaps even more substantial are the indirect costs for caregivers and those who die, become disabled, or experience other effects of vaccine-preventable illnesses.
AVAP is an important initiative by the State of Alaska to capture more of the benefits of recommended vaccines by making it easier for providers to participate in vaccination programs for their patients while also lowering the costs for payers. AVAP builds upon the proven track record of programs in other states, which have resulted in consistently lower vaccine costs, generally saving between 20-25% on vaccine costs for health benefit plans.
Plans that undermine this initiative for their own beneficiaries also diminish “herd effect” of protecting the small number of individuals for whom vaccinations are not medically advisable. Hence they expose themselves to liability risks on multiple fronts.
A31. Can individual health plans or clients opt out on their own?
A32. Have the opt out procedures been established as contemplated by statute [AS.18.09.220(e)]?
A33. Is the assessment voluntary?
A34. 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”?
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?
C7. Must Payers who opt out still report their covered lives using the AVAP online self-reporting assessment system?
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?
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?
No. State funds are not sufficient to cover adults who are uninsured or not covered by an assessed payer. Providers who don’t opt in for uninsured can receive state-supplied vaccine only for covered adults with participating payers or Medicaid, but will need to use privately purchased vaccine for uninsured adults and adults with non-participating payers (e.g., TRICARE, Medicare). A list of non-participating payers is posted here.
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?
P16. Why is PCV13 not on the adult state-supplied formulary?
V1. Who sets vaccine policy?
V2. What vaccines are covered 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?
VacTrAK is Alaska’s Immunization Information System (IIS). This web-based system provides a confidential, population-based, computerized system to maintain immunization information for Alaskans of all ages. Effective December 29, 2013, health care providers are required to report all administered immunizations to VacTrAK within 14 days of vaccine administration (7 AAC 27.650). This reporting requirement is applicable for any vaccine administered, including state supplied and privately purchased vaccine.
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?