September 11, 2019



National Foundation for Infectious Diseases (NFID) Holding Webinar on Meningococcal Disease

The NFID offers professional education activities led by key opinion leaders, designed to provide practical knowledge, tools, and resources.

Join the NFID, in collaboration with the National Association for School Nurses (NASN), for their upcoming webinar, Protecting Young Adults from Meningococcal Disease, on Thursday, September 12, 2019 at 2:00 pm ET.

NFID Medical Director William Schaffner, MD will moderate the webinar, with presentations by Sarah A. Mbaeyi, MD, MPH , medical officer at the Centers for Disease Control and Prevention (CDC), and Christine Amidon, BSN, RN , college nurse at the Wabash College Student Health Center.

At the conclusion of this activity, participants will be able to:

  • Describe the epidemiology of meningococcal disease in the United States
  • Summarize the current ACIP recommendations for meningococcal vaccines
  • Implement strategies to improve meningococcal vaccination

There is no fee to participate in this activity, but pre-registration is required.

Announcements and Requests for Participation from the Summit Quality and Performance Measures Workgroup

Public Comment Opportunity on the CMS Quality Payment Program Proposed Rules (by 5 pm ET on September 27): The Adult Immunization Status measure has been proposed to be included as part of the Merit-based Incentive Payment System (MIPS) and Medicare Shared Savings Program (MSSP) quality reporting requirements for the 2020 performance year.

2020 Child and Adult Core Set Review Workgroup Final Report: CMS/CMCS will use the Workgroup’s recommendations, as well as public comments, to inform decisions about how and whether to modify the 2020 Core Sets. CMCS will release the 2020 Core Sets through a CMCS Informational Bulletin by December 31, 2019.

PQA’s Call for Health Plan or Pharmacy Testers of Pharmacy Data (contact: Lisa Hines)
Immunization Status Assessment within Medication Therapy Management (MTM)
The percentage of patients enrolled within an MTM service who receive an immunization status assessment either within a comprehensive or targeted medication review
Level of Analysis: Health Plan
Data Sources: MTM program encounter data using SNOMED CT and RxNORM or CVX codes
Kickoff pending

Advisory Committee on Immunization Practices (ACIP) Compliance Following Immunization Status Assessment with MTM
The percentage of immunization status assessments that have been completed and are documented as compliant with the ACIP schedule
Level of Analysis: Health Plan
Data Sources: MTM program encounter data using SNOMED CT and RxNORM or CVX codes
Kickoff pending

QPM WG meeting materials are posted on the Workgroup webpage. (NOTE: For NQF Endorsement Process, please reference WG meeting materials on October 2, 2017.)

Make Plans to Attend the NFID’s Clinical Vaccinology Course

Make plans to attend the comprehensive NFID Clinical Vaccinology Course in Washington, DC this fall. Review Advisory Committee on Immunization Practices (ACIP) recommendations and learn how to implement vaccine recommendations to protect against pneumococcal, influenza, and HPV, among others.

Presentation topics include:

  • Influenza Vaccination Recommendations Across the Lifespan
  • Meningococcal Vaccines: Serogroups and Series
  • Primary Prevention of Cancer through HPV Vaccination

View the course website for a detailed agenda, a complete list of speakers, and networking opportunities offered at the course. Registration is available online.

Comments on New Proposed CMS Physician Fee Schedule Changes Due September 27

There is a new regulation coming out of CMS in their re-evaluation of the vaccine administration fees under the physician fee schedule that we want the Summit partners to be aware of.

As you may know, low payment was a primary reason for provider resistance in vaccinating adult (and Medicare adults) in the early 2000s and the Summit advocated hard for a payment increase, which happened in 2005. However, it has now been noted that in the proposed 2020 Medicare Physician Fee schedule, CMS has been reviewing some of the product administration codes over the past few years and is revaluing the codes to eliminate duplication of services. The revaluing of administration codes will result in a 44% decrease in payment for vaccine administration.

CMS’s analysis suggests that a therapeutic injection is most frequently done at the same time as an office visit. In analyzing the therapeutic injection code and the office visit code, CMS found that there was some duplication in practice expense and labor costs. CMS decided to remove the duplication by deleting some of the practice expense and labor costs from the therapeutic injection code. CMS cross walks the value of therapeutic injections to the value for vaccine administration. As a result, the payment for vaccine administration is decreasing. However, this fails to account for the fact that many adult vaccines are given in vaccine-only visits.

This chart shows the magnitude of the decrease. The payment for G0008 and G0009 for the administration of influenza and pneumococcal vaccines will also be affected.

The data is clear that a decrease in the administration fee as calculated above would likely be a disincentive to begin, or continue, immunizing for providers.

The Adult Vaccine Access Coalition (AVAC) is also aware of this and is working on it. However, it is also important the Summit partners are aware.

In addition to the public health concerns that arise when immunization practices are not financially supported, there are real differences between the practice effort and labor costs surrounding a therapeutic injection and vaccines. For example, the labor involved in maintain a vaccine inventory (ordering, refrigeration, temperature monitoring, etc.) is different than the occasional therapeutic injection. These costs are magnified when considering a seasonal vaccine such as influenza, when the offices need to make patients aware of the need to immunize and schedule appointments within a specified time period. And as pointed out earlier, there are times when the vaccine administration is the only service delivered at a visit so there would be no duplication in labor costs or practice expense.

To support immunizers, there are alternative approaches that can be explored. For example, the vaccine administration codes (90471, 90460, 90463, G0008. G0009) can be decoupled from the therapeutic injection codes and a value can be established based on the values that were in place from 2013-2017.

The public comment period ends September 27, 2019 and can be submitted electronically. Follow the ‘‘Submit a comment’’ instructions.


AMGA Publishes Data from its Adult Learning Collaborative on Adult Immunization

AMGA has presented at the Summit meetings on their Adult Immunization Learning Collaborative encompassing 40 healthcare systems. The findings from that experience are now published. Please see:

Impact of a Learning Collaborative Approach on Influenza and Pneumococcal Immunization Rates in US Adults: A Mixed Methods Approach (2019)
Authors: Ciemins, Jerry, Powelson, Leaver-Schmidt, Joshi, Casanova, Kennedy, Penso
Population Health Management, Ahead of Print

Remember CDC’s #HowIRecommend Site

CDC has launched a new website for the #HowIRecommend video series, which features healthcare professionals discussing how they recommend vaccines to patients at various stages of life. In this series, healthcare professionals demonstrate how to make effective vaccine recommendations, address common vaccine questions, and take a team-based approach to vaccination.


Summit calls are held weekly on Thursday at 3 pm ET throughout the influenza season unless cancelled. Call information and an agenda generally are sent the morning of the call. Call summaries are available shortly after each call on the Summit website.

Please email L.J Tan or LaDora Woods if you have any updates on activities to provide to the Summit.

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