| 1. |
When did the New Jersey VFC program officially start? |
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New Jersey's VFC program became fully operational in January 1999.
There are over 2,000 physicians enrolled in the NJ VFC Program to date
and vaccines are being shipped to over 1,000 provider sites.
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| 2. |
What forms do I have to complete for enrollment? |
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All VFC forms can be accessed via the internet at http://njiis.nj.gov.
You will need to complete the following forms:
"Provider Enrollment" (IMM-25), "Provider Profile" (IMM-26),
"Additional Enrollment for Other Providers within the Practice" (IMM-26A),
and "Varicella Vaccine Storage Questionnaire" (IMM -33).
Please complete all forms and return them by fax to (609) 588-7575.
The "Provider Enrollment" IMM-25 lists all the requirements for participation in the VFC program
and is to be submitted at the time of enrollment and signed by a
physician (the lead or chief physician or equivalent may sign for all physicians in the practice).
This form is retained on file with the New Jersey Department of Health and Senior Services (NJ DHSS).
All enrolling health care providers must also complete the "Provider Profile" (IMM-26).
This profile which is retained by NJ DHSS, is used to determine the number of patients expected to receive
immunization services and the number of patients in the provider's practice that are eligible for
immunizations through the VFC program.
Vaccines will be shipped to the provider site location/address listed on the profile.
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| 3. |
How do I enroll in the VFC program if I have different office
locations? |
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Providers are to complete a "Provider Enrollment" (IMM-25) and a
"Provider Profile" (IMM-26) for each location where VFC vaccines will
be stored and administered and where the patient's medical record is
maintained.
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| 4. |
What if I have several physicians involved in the practice? |
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No, the practice can enroll. However, one lead physician should
sign provider profile as the responsible contact. Each provider
site must list all associated practice site contacts. Physicians,
nurse practitioners, and residents in a group practice who will
be administering state provided vaccines on the "Provider Profile
" (IMM-26), or if necessary on the supplemental "Additional
Enrollment for other Providers within the Practice."
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| 5. |
Do providers have to re-enroll in the VFC program annually? |
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Yes.The "VFC Provider Profile" (IMM-26), the "Varicella Questionnaire" (IMM-33)
and if necessary, the "Additional Providers Within the Practice" (IMM-26A)
by practice site must be completed annually. {These forms are federally mandated}.
All forms are located on the internet at www.njiis.nj.gov.
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| 6. |
Are current Medicaid and NJ FamilyCare
fee for service (FFS) providers required to enroll? |
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We strongly encourage these providers to enroll.
On April 1, 1999, the New Jersey Medicaid Program has terminated
fee for service coverage and reimbursement for vaccines available
from Vaccine For Children Program for all children under 19 years
of age. However, Medicaid fee for services practitioners are
eligible to receive an enhanced administration fee of $11.50 per
injection, through the Medicaid managed care HMO's.
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| 7. |
Will private physicians be required to
enroll in Medicaid in order to participate in the VFC program? |
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No, however administration fees or office visit fees under
fee-for-service Medicaid will not be paid by the Medicaid program
unless the child is Medicaid enrolled and the physician is a
Medicaid provider.
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| 8. |
Once providers enroll, do they have to see
children in their practice only because they are eligible for VFC? |
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No, a physician is not required to accept an uninsured child into
his/her practice merely because the child is eligible for
immunization through the VFC program.
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| 9. |
What children are eligible to receive
VFC-provided vaccines?
|
| |
The National VFC program was created to meet
the vaccination needs of children from birth through 18 years of age.
Children with Medicaid, Medicaid Managed Care, NJ FamilyCare Plans, Native American, Alaskan Native,
or who are uninsured are eligible to receive VFC-provided vaccines.
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| 10. |
What about children whose
insurance doesn't include vaccination as a
covered benefit? Can they receive VFC vaccine? |
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These children, who are considered to be underinsured by federal
rules, can only receive VFC vaccine at federally qualified
health centers. Recent implementation of New Jersey regulations
requires most health insurance companies or plans to cover
vaccine services (self insured plans and small employee group
exceptions as a covered benefit for children without first
meeting a deductible). If the parent of an underinsured child
chooses to stay in your practice for immunizations, you cannot
administer free government provided VFC vaccine.
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| 11. |
How do I order vaccines? |
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New providers can order vaccine after the mandatory forms, outlined in Question #2 have been submitted,
reviewed, and processed.
You will receive a Provider Identification Number (PIN) used by the VFC Program
to process vaccine orders.
Orders may be called, faxed, or e-mailed.
Telephone orders can call toll-free 1-800-589-7516.
To fax an order, complete the "Vaccine Order Form" (IMM-27) and send it to (609) 588-7575.
Emails should be directed to vfc@doh.state.nj.us.
Orders submitted by fax or e-mail will require confirmation of the order over the telephone.
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| 12. |
How will the vaccines be distributed to my office? |
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Upon receipt of all mandatory enrollment forms and after processing of the vaccine order
forms with the proper Provider Identification Number (PIN),
all vaccines will be shipped from a privately contracted warehouse
within 5 business days by an express courier service. Delivery days are Monday, Tuesday, and Wednesday.
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| 13. |
Will I be able to choose a specific manufacturer's vaccine? |
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Yes. NJ offers vaccine manufacturer choice for most vaccines.
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| 14. |
Will I be paid for administration
of VFC-available vaccines for my patients enrolled in the New Jersey
Care 2000 or NJ KidCare managed health care programs? |
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Fees for administration of VFC-available vaccines are determined by each
State-participating HMO. The State's HMO capitation fee for enrolled New
Jersey Family Care beneficiaries will include the enhanced administration
fee allowance of $11.50 per administered vaccine for services provided on
or after January 1, 1999.
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| 15. |
Do I have to use the vaccine information
statements (VIS)? |
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Yes. Under the National Vaccine Injury Compensation Act, all
private and public sector providers administering vaccines are
required to give the appropriate VIS forms to the parent/patient
each time before a vaccine is administered. Photocopying and
printing of these forms are permitted but they cannot be modified.
They may be accessed from the web at: www.immunize.org/vis.
More information regarding the medical practitioner's legal
responsibility under this federal law can be accessed at
www.cdc.gov/vaers
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| 16. |
Can VFC providers charge an office visit and administration fee for
uninsured children eligible for VFC vaccine? |
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Yes. Your office visit fees can continue.
The VFC Program only provides you with free vaccine.
Practitioners are not required to deliver medical services
to uninsured patients who cannot pay in order to maintain their VFC-provider status.
You may charge an administration free for an uninsured patient who is VFC eligible up
to the $16.34 federal cap for administration fees.
However, if the patient you choose to serve is unable to pay the office or administration fee,
he/she may not be denied the VFC vaccine.
In order to receive Medicaid reimbursement for administration of
VFC vaccine to Medicaid and NJ FamilyCare eligible children,
you must be a Medicaid provider, enrolled in the VFC Program,
and submit a properly completed New Jersey Medicaid claim form.
Fee-for-service (FFS) reimbursement for administration will be $11.50 per injection.
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| 17. |
Since underinsured children and insured children are not covered
under VFC, can I still obtain vaccine privately? |
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You will need to order vaccine privately as you have in past
for these children. It is recommended that vaccine which is
privately purchased be separated in a refrigerator away from
the VFC vaccine. Accurate vaccine logs containing specific
lot numbers should be kept to differentiate government
provided vaccine from privately purchased vaccine and will
ensure accurate accountability of the VFC purchased vaccine.
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| 18. |
Are children who have deductibles or co-payments considered
uninsured? |
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Children who have any commercial insurance or non-government
subsidized policies or plans requiring deductibles and
co-payments are considered to be insured and thus are not
federally eligible for free VFC vaccines.
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| 19. |
What is the purpose of the Eligibility/Vaccine Encounter Record forms (IMM-28)? |
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This one form fulfills two primary purposes.
Federal law requires that a VFC eligibility screening
form must be kept in the patient's medical record.
The federal government also requires that states develop a vaccine
accountability plan or system to ensure appropriate and non-fraudulent use of federally funded vaccines.
These forms are to be batched and submitted monthly to the NJDHSS for processing.
No new orders will be accepted or processed for delivery until there is a record of
encounter/eligibility forms having been submitted.
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| 20. |
Where do I send my completed Eligibility/Vaccine Encounter Record forms (IMM-28)? |
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Mail the eligibility/vaccine encounter forms to:
New Jersey Department of Health and Senior Services
Vaccine Preventable Disease Program
,
PO Box 369,
Trenton, NJ 08625
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