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?
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 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?
A17. What if AVAP collects too little?
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?
Yes. 2016 rates are favorable even when viewed against similar programs in other states that are more mature and, therefore, already had paid all of their startup costs. For most payers, savings for 2016 are anticipated to run in the 20% range and to get even better in subsequent years. DHSS is committed to financial transparency in this program and so anticipates publishing a retrospective financial analysis after each program year to evaluate actual cost savings of AVAP when measured against CDC’s annual survey of private purchase vaccine costs. Other states with universal vaccine purchase programs similar to AVAP typically have produced vaccine cost savings, on average, between 22% and 30%. Savings have been consistent year after year in those states.
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?
Yes. However, the entity may be eligible to file an Annual or Permanent Zero Covered Lives Report instead of the typical quarterly reports. Please note that if an entity has zero covered lives for one quarter only, then it should file a normal quarterly report with “0” values.
If, however, an entity does not administer medical benefits and therefore has zero covered lives, it should file one of two types of Zero Covered Lives Reports. For example, this type of report would be appropriate for entities such as those administering eye care or dental benefit only plans. If the entity has zero covered lives and will continue to have zero covered lives for the balance of the year, then it should file an Annual Zero Covered Lives Report during the first quarter of the calendar year. No other report will be due until the first quarter of the following calendar year. If the entity has zero covered lives and expects to never have covered lives, it should file a Permanent Zero Covered Lives Report to eliminate the need for further compliance follow up. A guide to Zero Covered Lives Reports is available here.
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?
P3. Can providers still purchase vaccines privately?
Yes. Nothing in the statute prohibits this. However, regulation 3 AAC 26.110 allows payers to reimburse providers at the state's cost for the vaccine, instead of the provider's private purchased priced. Reimbursement rates will be set by payers, providers will need to negotiate this privately with payers.
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?
Providers who currently receive state-supplied vaccine will enroll for the statewide program during their annual Vaccine Distribution Program re-enrollment period. New providers will need to initiate enrollment through the Alaska Immunization Program. Providers can order state-supplied vaccine as soon as they complete this enrollment.
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?