On October 8, 2021, the Centers for Medicare and Medicaid Services (CMS) announced in an HPMS memo issued that effective January 1, 2022 Medicare Advantage Organizations (MAOs) are obligated to begin paying for the COVID-19 vaccine and its administration (including approved booster doses), without cost sharing for Medicare beneficiaries enrolled in their plans.
Currently, the original Medicare Fee-for-Service program is processing and paying for COVID-19 vaccine administration claims for all Medicare beneficiaries, including those individuals enrolled in Medicare Advantage plans. The original Medicare Fee-for-Service program will continue to pay for claims billed with dates of service occurring through December 31, 2021.
Effective with dates of service on or after January 1, 2022, Medicare participating providers or suppliers eligible to bill under Medicare Part B for vaccine administration, including those enrolled in Medicare as a mass immunizer or a physician, non-physician practitioner, hospital, clinic, or group practice will need submit COVID-19 vaccine administration claims provided to Mercy Care Advantage patients to Mercy Care for payment. Do not submit to these claims to the original Medicare Fee-for-Service program for payment, they will be denied.
Network providers and suppliers need to ensure administrative staff responsible for handling billing have been educated on this CMS directive.
Additional Resources
CMS has released a set of toolkits for providers related to COVID-19. Please click on the link to access this information.
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