BACKGROUND:
Medicare reimburses the cost of administering influenza and pneumococcal vaccine to Medicare beneficiaries, and for the cost of the vaccine itself. In 2003 the Massachusetts Department of Public Health (MDPH) collected $160,000 in Medicare B reimbursement for the cost of state-supplied influenza and pneumococcal vaccine administered to Medicare beneficiaries. For the 2001-2002 and 2002-2003 influenza seasons, 40 boards of health(BOH) in Massachusetts submitted roster bills to Medicare for the cost of administering state-supplied vaccine and sent copies of the roster bills to MDPH. MDPH used the information from the roster bills to seek reimbursement for the cost of the vaccine. During calendar year 2003, MDPH, in collaboration with the University of Massachusetts Medical School and National Heritage Insurance Company embarked on a state-wide effort to provide enrollment and roster billing training to BOH’s billing Medicare B for vaccine administration reimbursement for the first time. The education effort proved to be a success with an additional 60 BOH’s attending the training sessions. As a result, MDPH expects to receive rosters from an estimated 100 BOH’s in Massachusetts for the 2003-04 influenza season.

OBJECTIVE:
To educate and provide assistance to Massachusetts BOH’s regarding the revenue maximization opportunities that city/town is entitled to as well as providing revenue to support state purchase of vaccines for adults.

METHOD:
Training seminars were provided to BOH’s over a three-month period. Six regional training sessions were conducted across the state. Communication via e-mail, phone, and fax provided BOH’s with information, as well as question and answer documents.

RESULT:
MDPH has collected $160,000 in reimbursement for state-supplied vaccines and expects to expand utilization of Medicare roster billing to additional BOH’s and to long-term care facilities in the state.

CONCLUSION:
Medicare reimbursement is an effective means of enhancing revenue at the local and state level departments of health.

LEARNING OBJECTIVES:
The importance of Medicare reimbursement for BOH’s and Public Health.