Current through Register Vol. 63, No. 9, September 1, 2024
(1) Dental administration of vaccines shall
be carried out in compliance with Oregon Board of Dentistry OARs
818-012-0006 and
818-012-0007, OHA
Medical/Surgical OAR 410-130-0255 and Vaccines for
Children (VFC) - OHA Division 46, OARs
333-046-0110 through
333-046-0130.
(2) Requirements for vaccine administration:
(a) The dentist shall have completed a course
of training approved by the Oregon Board of Dentistry;
(b) Vaccines shall be administered in
accordance with the Model Immunization Protocols approved by the Authority;
and
(c) The dentist shall not
delegate administration of vaccines to another person.
(3) Procedures for vaccine administration.
(a) Dentists shall:
(A) Follow Authority approved Model
Immunization Protocols for immunization administration and treatment of severe
adverse events following an administration. Authority Model Immunization
Protocols are located at:
https://www.oregon.gov/oha/PH/PreventionWellness/VaccinesImmunization/ImmunizationProviderResources/Pages/provresources.aspx
(Click Vaccine Administration);
(B)
Maintain written policies and procedures for handling and disposal of used or
contaminated equipment and supplies;
(C) If providing state or federal vaccines,
report the vaccine eligibility code as specified by the Authority, to the ALERT
System outlined in
https://www.oregon.gov/oha/PH/PreventionWellness/VaccinesImmunization/alert/Pages/EnrollNewClinic.aspx;
(D) As administrator of the vaccine, report
to the Authority the information in section 6(a)(A), (B) and (C) of this rule
as applicable to the Authority ALERT Immunization System within fourteen (14)
days of administration;
(E) Report
adverse events, as required by the Vaccine Adverse Events Reporting System
(VAERS) to the Oregon Board of Dentistry, within ten (10) business
days;
(F) Within ten (10) days to
the primary care provider identified by the member; and
(G) If the member does not have a PCP,
providers shall:
(i) Provide the member with a
copy of vaccination administration Documentation;
(ii) Direct toward resources containing more
information;
(iii) Encourage to
become a physician's patient of record for their other health needs;
and
(iv) Document actions in the
member's record.
(b) Dentists or designated staff shall:
(A) Provide Vaccine Information Statements
(VIS) to the member or legal representative with each dose of vaccine covered
by these forms;
(B) Document that
the member or legal representative has read, or has had read to them, the
information provided and that any questions are answered prior to the
administration of the vaccine. The VIS provided shall be the most current
version;
(C) Document the member
record:
(i) Date;
(ii) Site of administration;
(iii) Brand name or NDC number or other
acceptable standardized vaccine code set;
(iv) Dose, manufacturer, lot # (number), and
expiration date of vaccine;
(v)
Name and identifiable initials of administering dentist;
(vi) Address of office where vaccine was
administered, unless automatically embedded in electronic report provided to
the Authority ALERT Immunization System;
(vii) Date of publication of the VIS; and
Date the VIS was provided.
(4) Billing: Vaccines are billed using a
common procedural terminology (CPT) codes on a Professional claim form (CMS
1500) found in the Professional Billing Instructions and the Medical-Surgical
Services Provider Guide located at:
https://www.oregon.gov/OHA/HSD/OHP/Page/Policy-Medical-Surgical.aspx.
(a) Adults: Billing providers shall use
standard professional claim form billing procedures for adults and for any
vaccine that is not part of the VFC program;
(b) Children: VFC vaccines are administered
only to children and adolescents through age eighteen (18) who meet VFC
eligibility criteria. All vaccines for this age group and for conditions
covered by the VFC program shall be obtained through the VFC program. The
Division will not reimburse providers for the administration or purchase of
privately purchased vaccines if the vaccine could have been obtained through
the VFC program. For information about the VFC program or to enroll as a VFC
provider, contact the Public Health Immunization Program. The Oregon VFC
program website can be located at:
https://www.oregon.gov/oha/PH/PREVENTIONWELLNESS/VACCINESIMMUNIZATION/IMMUNIZATIONPROVIDERRESOURCES/VFC/Pages/index.aspx.
(5) The Division reimburses only
for the administration, not the serum, of vaccines available for free through
the VFC Program. Refer to the Current Oregon Immunization Program
State-Supplied Vaccine Billing Codes table for a list of vaccines provided
through the VFC Program.
(6) To
receive reimbursement for vaccine administration, VFC program providers shall
bill the Division:
(a) With the appropriate
vaccine common procedural terminology (CPT) code included; and
(b) Including the appropriate modifier:
SL.
(7) Fee-for-service
providers may bill the Division directly for vaccines provided to members.
Providers may bill the plans directly, as appropriate to member plan
enrollment, for the administration of VFC vaccines if the member is enrolled in
an MCE. Medicaid and CHIP are not considered the "payer of last resort" for
administration of VFC vaccines.
Statutory/Other Authority: ORS
679.543,
414.065 & HB 2220 (2019
Regular Session)
Statutes/Other Implemented: ORS
414.065
