A1. Why did the Alaska legislature form the Alaska Vaccine Assessment Program (AVAP)?
The Alaska Legislature formed AVAP to preserve universal-select access to state-supplied vaccines for children and to provide select state-supplied vaccines for covered adults.AVAP enables the Alaska Immunization Program to purchase vaccines and distribute them at no financial cost to health care providers.
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?
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?
Yes. Publicly funded health care benefit plans (e.g., Medicare, the Veterans Administration, and TRICARE) are included in the bill’s definition of “health care insurer.” In 2016, they are not participating in AVAP. Medicare is exempt from mandatory participation until federal approval is obtained. DHSS is working with federal officials and others to obtain the necessary approvals.
Medicaid (adults ≤ 19 years) is not participating in AVAP during 2016; however DHSS is covering the participation cost for Medicaid.
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?
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?
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”?
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?
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?
No. Providers do not need to pay for state-supplied vaccines. Providers can receive state-supplied vaccines at no out of pocket cost for all children vaccines and select vaccines for adults covered by participating payers. The assessment for this vaccine is paid by the assessable entities that provide health care coverage for these patients.
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?
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?
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?