COVID-19-Related Coverage and Payment

HRSA COVID-19 Coverage Assistance Fund (CAF)

On May 3, 2021, HHS, through the Health Resources and Services Administration (HRSA), announced a new program covering the cost of administering COVID-19 vaccines to patients enrolled in health plans that either do not cover vaccination fees or cover them with patient cost-sharing. This new program is called the HRSA COVID-19 Coverage Assistance Fund (CAF).

“After securing enough COVID-19 vaccines for all adults, the Biden-Harris Administration is elevating work to boost access to them,” said HHS Secretary Becerra. “We listened to our healthcare providers on the frontlines of the pandemic. On top of increasing reimbursement rates tied to administering the shots, we are closing the final payment gap that resulted as vaccines were administered to underinsured individuals. No healthcare provider should hesitate to deliver these critical vaccines to patients over reimbursement cost concerns.”

See the press release on this announcement here.

Learn more about CAF here. Also, see the CAF Fact Sheet and Frequently Asked Questions about the program.


Increased Medicare Payment for Administering Monoclonal Antibodies

CMS has increased Medicare payment for administering monoclonal antibodies to treat beneficiaries with COVID-19, continuing coverage under the Medicare Part B COVID-19 Vaccine Benefit. This means more providers and suppliers are readily able to administer these treatments. Beneficiaries are not responsible for any cost sharing, regardless of where the service is furnished – including in a physician’s office, other healthcare facility or at home.

The national average payment rate has increased from $310 to $450 for most health care providers. In support of providers’ efforts to prevent the spread of COVID-19, CMS will also establish a higher national payment rate of $750 for at-home monoclonal antibodies treatment.

See updated toolkits for providers, states, and insurers to help the health care system swiftly administer monoclonal antibody treatment with these new Medicare payment rates, here.

In addition, CMS is updating coding resources for providers. More information can be found here

For more information, visit www.cms.gov/covidvax.


New Funding for Rural Clinics and Hospitals

On May 4, HHS and HRSA announced new funding thanks to the American Rescue Plan to combat COVID-19 across the country. Rural clinics and hospitals will receive nearly $1 billion dollars to strengthen COVID-19 response efforts and increase vaccinations in rural communities, and approximately $250 million will be awarded to develop and support a community-based workforce who will serve as trusted voices sharing information about vaccines, work to increase COVID-19 vaccine confidence, and address any barriers to vaccination for individuals living in vulnerable and medically underserved communities.

The HHS press release on rural clinics and hospitals funding can be found here

The HHS press release on community-based workforce funding can be found here