Or. Admin. Code § 410-123-1262 - Dental Administration of Vaccines
(1) Dental administration of vaccines must 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 licensed provider must have completed
a course of training approved by the Oregon Board of Dentistry;
(b) Vaccines must be administered in
accordance with the Model Immunization Protocols approved by the Authority;
and
(c) The dentist must not
delegate administration of vaccines to another person.
(3) Procedures for licensed providers
administering vaccines:
(a) Must report to
ALERT within fourteen (14) days of administration;
(A) Follow the Authority approved Model
Immunization Protocols for immunization administration and treatment of severe
adverse events following an administration. The Authority Model Immunization
Protocols are located at:
https://www.oregon.gov/oha/PH/PreventionWellness/VaccinesImmunization/ImmunizationProviderResources/Pages/provresources.aspx
(see Vaccine Administration section);
(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;
(b) Report adverse events within
ten (10) business days to the:
(A) Vaccine
Adverse Events Reporting System (VAERS);
(B) Oregon Board of Dentistry; and
(C) Primary Care Provider (PCP) identified by
the member. If the member does not have a PCP, providers must:
(i) Provide the member with a copy of
vaccination administration documentation;
(ii) Direct the member toward resources
containing more information;
(iii)
Encourage the member to become a physician's patient of record for their other
health needs; and
(iv) Document
actions in the member's record.
(c) Dentists or designated staff must:
(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 must be the most current
version; and
(C) Document in 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; and
(vii) Date of publication of the VIS; and
Date the VIS was provided.
(4) Vaccines are billed using 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/Tools/Medical-Surgical%20Services%20Provider%20Guide.pdf
Coverage is as follows:
(a) EPSDT
beneficiaries:
(A) VFC vaccines are
administered only to children and adolescents through age eighteen (18) who
meet VFC eligibility criteria;
(B)
All vaccines for this age group and for conditions covered by the VFC program
must be obtained through the VFC program; and
(C) The Authority does not reimburse
providers for the administration or purchase of privately purchased vaccines if
the vaccine may have been obtained through the VFC program.
(b) Non-EPSDT beneficiaries:
Billing providers must use standard professional claim form billing procedures
for adults and for any vaccine that is not part of the VFC program;
and
(c) 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 Authority 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 in the Immunization Billing
Resources section for a list of vaccines provided through the VFC
Program.
(6) To receive
reimbursement for vaccine administration, VFC program providers must bill the
Authority with the appropriate vaccine CPT code and the modifier SL.
(7) FFS providers may bill the Authority
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 a Managed Care Entity (MCE). Medicaid
and Children's Health Insurance Program (CHIP) are not considered the "payer of
last resort" for administration of VFC vaccines.
Notes
Statutory/Other Authority: ORS 679.543, 414.065 & HB 2220 (2019 Regular Session)
Statutes/Other Implemented: ORS 414.065
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