Starting Oct. 1, Medicaid and the Children’s Health Insurance Program (CHIP) will cover only COVID-19 vaccines that have been fully approved by the Food and Drug and Administration (FDA) and that comply with recommendations by the Centers for Disease Control and Prevention’s (CDC’s) Advisory Committee on Immunization Practices (ACIP).
The Centers for Medicare & Medicaid Services (CMS) announced the change June 27, explaining that it does not interpret the coverage required by the Inflation Reduction Act to include vaccines that FDA has authorized under emergency use authorization but not approved.
The amendment applies to both fee-for-service and managed care Medicaid programs.
The agency says that mandatory coverage of all FDA-approved, ACIP-recommended adult vaccinations without cost sharing not only will improve access to vaccinations for adult Medicaid and CHIP beneficiaries but also prevent hospitalizations and deaths and reduce costs associated with preventable infections.
Although COVID-19 cases and hospitalizations have dwindled and the public health emergency ceased in May, the CDC is monitoring the circulation of a new subvariant, EU.1.1., which accounts for 1.7 percent of national COVID-19 cases as of July 3.
Visit the America’s Essential Hospitals coronavirus resource page for more information about the pandemic.
Contact Senior Director of Policy Erin O’Malley at eomalley@essentialhospitals.org or 202.585.0127 with questions.
