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OPA COVID-19 Vaccines July 7, 2021 Update


CDC COVID-19 Vaccine Administration Related Myocarditis
The U.S. Food and Drug Administration (FDA) updated their COVID-19 Vaccine Emergency Use Authorization (EUA) fact sheets for the Pfizer and Moderna vaccines for patients and providers to include the risks of myocarditis (inflammation of the heart muscle) and pericarditis (inflammation of the tissue surrounding the heart) following vaccination. In addition, the Centers for Disease Control and Prevention (CDC) has updated providers on its clinical considerations regarding myocarditis and pericarditis.

COVID-19 Vaccine Medicare and Medicaid Fee Update for Homebound Patients
CMS announced the increase of the total reimbursement for administering a COVID-19 vaccine to homebound patients. This increase has resulted in an overall total payment of approximately $150 for administering a two-part series COVID-19 vaccine. Additionally, the Ohio Department of Medicaid (ODM) announced that this increase in reimbursement will be matched for all Medicaid patients. This new rate is to offset costs associated with administering the vaccine appropriately in a patient’s home. Rates for Medicaid patients will be adjusted based on geographic locations

Updated Managed Care Programs Announced Pharmacy Incentives for COVID-19 Vaccine Ohio’s Medicaid Managed Care Programs announced additional pharmacy incentives through CSS Health and OutcomesMTM platforms. Pharmacists can now engage further with Ohio’s Medicaid population to have meaningful patient interactions answering their questions and administering the COVID-19 vaccines. Ohio Medicaid patients for the following plans are eligible for this incentive:

Additionally, see this website: that provides valuable resources to patients, including upcoming vaccine events, transportation information, and pharmacy information. For specific details about the incentive programs, please see the following press releases: Outcomes(TM) partners with Medicaid plans to help Ohio Medicaid members get vaccinated and  CareSource Partners with CSS Health to Help Members Get Vaccinated.

Updated Independent Pharmacy COVID-19 Vaccine Incentives for Medicaid Patients 
Independent pharmacies have two options to incentivize Medicaid patients who get their first COVID-19 shot at their pharmacy.

  1. Independent pharmacies can receive Visa gift cards directly to give to patients. Pharmacies that have already ordered these gift cards should receive them by the end of this week. If you are an independent pharmacy vaccinator, please fill out this COVID-19 Medicaid Patient Incentive Survey to provide the number of gift cards needed for 30 days by the close of business on Thursday, 7/8. Thank you to those who have already responded with the projected numbers of gift cards needed.
  2. Pharmacies that cannot use Visa gift cards can also share an incentive flyer created specifically for Medicaid patients to receive a gift card online. Please print and share the COVID-19 Vaccine Incentive Medicaid Flyer with your patients.

Updated Independent Pharmacy COVID-19 Vaccine Incentives for Medicaid Patients Reporting
Independent pharmacies that receive COVID-19 vaccine gift cards for Medicaid patients will be required to track the gift cards along with patient vaccine administration information to the patient’s corresponding managed care program. Send these reports to each corresponding managed care program securely every Monday by the close of business. Please include the following information:

Please ensure that the gift card tracker documents have patient information specific to each managed care plan and that the information is sent securely via email to protect patient data. Vaccinators can use this COVID-19 Vaccine Gift Card Tracker Example.

COVID-19 Vaccine Youth Toolkit
The Ohio Department of Health has created a COVID-19 Vaccine Youth Toolkit. This toolkit Seeks to provide vaccinators with answering questions from younger patients and their guardians. Additionally, there are graphics, posters, signs, and social media templated to deliver targeted messaging.

CMS Pharmacist COVID-19 Toolkit
The Centers for Medicare and Medicaid Services updated their COVID-19 vaccine toolkits for healthcare providers. See this website for updated information for insurers, providers, and Medicare beneficiaries.

Helpful State Vaccine Resources and Information
The following resources are helpful for vaccinators to contact ODH regarding vaccine shipments:

Medicaid Managed Care Plan Provider Services Numbers:

   OPA is working diligently to facilitate communication between state decision-makers and member pharmacists. OPA has created multiple COVID-19 resources, including a COVID-19 Vaccine Information WebpageCOVID-19 Testing Hub, and COVID-19 Resources Webpage, on the OPA website under the Resources drop-down box. For further questions, please contact Myriam Shaw Ojeda, Fellow in Policy and Innovation, at

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