TMA Pushes Back Against Planned Vaccine Payment Cuts
By David Doolittle

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 As the influenza virus continues to spread statewide, the Texas Medical Association and other specialty societies have taken a stand against a plan to cut by almost 36 percent payments to physicians who administer a flu vaccine in their offices.

 

In a letter sent this week, TMA strongly urged the Texas Health and Human Services Commission (HHSC) to reconsider the proposed cuts, which were outlined in the Medicaid Biennial Calendar Fee Review.

The cuts would be tied to quarterly Medicaid payment adjustments and would be effective April 1.

The proposal includes a 35.96-percent payment cut for Fluzone Intradermal, which helps prevent flu in patients ages 19 years and older. In addition, HHSC proposes 33.33-percent cuts to Trumenba, which helps prevent invasive meningococcal disease, and Gardasil 9, a human papillomavirus vaccine.

“Patients are more likely to be vaccinated at the time of a physician office visit than if referred elsewhere for the service,” the letter said. “Yet cutting the amount HHSC will pay for the cost of a vaccine will deter physicians from offering vaccines directly to their patients, undermining Texas’ fight against cancer and the spread of common infectious diseases. It also will undermine our mutual goal of improving the health of Texans.”

In Texas, more than 11,000 people died from flu and its complications during the 2017-18 flu season, including 16 children, the Texas Department of State Health Services (DSHS) reported. This season, which began in September, has not been as severe, but multiple cases are still being reported statewide.

The Texas Academy of Family Physicians, Texas Pediatric Society, Texas Association of Obstetricians and Gynecologists, and American College of Obstetricians and Gynecologists-District XI also signed on to the letter.

Last Updated On

February 12, 2019

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David Doolittle

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Dave Doolittle is editor of Texas Medicine and Texas Medicine Today. Dave grew up in Austin, where he attended culinary school as well as the University of Texas. He spent years covering Central Texas for the Austin American-Statesman newspaper. He is the father of two girls, a proud Longhorn, and an avid motorsports fan.

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