The watchdog agency is warning of possible violations of the nation’s vaccination program.

The U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) recently sent out a press release on COVID vaccination providers. In it, the OIG stated that:

“All organizations and providers participating in the CDC (Centers for Disease Control and Prevention) COVID-19 Vaccination Program:

  • Must administer the COVID-19 vaccine with no out-of-pocket cost to the recipient;
  • May not deny anyone a vaccination based on the vaccine recipient’s coverage status or network status;
  • May not charge an office visit or other fee if the COVID-19 vaccination is the sole medical service provided;
  • May not require additional medical services to receive COVID-19 vaccination;
  • May seek appropriate reimbursement from a program or plan that covers COVID-19 vaccine administration fees for the vaccine recipient, such as:
    • Vaccine recipient’s private insurance company;
    • Medicare or Medicaid reimbursement;
    • HRSA COVID-19 Uninsured Program for non-insured vaccine recipients; and
  • May not seek any reimbursement, including through balance billing, from the vaccine recipient.”

The OIG went on to clarify what providers could bill for:

“OIG is aware of complaints by patients about charges by providers when getting their COVID-19 vaccines. Providers that charge impermissible fees must refund them and ensure that individuals are not charged fees for the COVID-19 vaccine or vaccine administration in the future. Consistent with the CDC Vaccination Program, providers are permitted to bill third-party payers (such as Medicare, Medicaid, the HRSA COVID-19 Uninsured Program, or a private insurer) for an administration fee, in accordance with the payer’s applicable billing rules.”

What should you do if your provider tries to bill you for providing your vaccination? You can report potential fraud by calling or emailing the OIG at:
Calls: (800) 424-9071

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