Be Aware: Some Providers Are Getting Shortchanged on COVID-19 Vaccine Reimbursements

First the urgent care industry saw itself cut out of the distribution chain for COVID-19 testing supplies. Next, it saw vaccines go preferentially to go health systems, public health organizations, and chain drugstores and big box stores. Now, as it continues to come back from those oversights, there are reports that UnitedHealth Group is undercutting the reimbursement rate set by the Centers for Medicare and Medicaid Services for immunizing patients against SARS-CoV-2. They’re not legally obligated to follow the CMS guidelines for reimbursement, of course, but refusing to do so leaves providers in the position of having to choose between losing money every time they administer the vaccine or trying to charge patients for a potentially lifesaving vaccine that they can get elsewhere for free. As reported by Modern Healthcare, the American Academy of Pediatrics is receiving complaints from its members that UHG is paying only around half the rate put forth by CMS. They’re also reimbursing operators less than what they pay for COVID-19 tests at a time when the pandemic is resurging across the country. While UHG has said it will increase what they pay providers for testing, there are no plans to revisit previous reimbursements that were below what other insurers have paid.