Or. Admin. R. 410-123-1262 - Dental Administration of Vaccines

Current through Register Vol. 60, No. 12, December 1, 2021

(1) Dental administration of vaccines shall 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) For the purpose of this rule, the following definitions apply:
(a) "Model Standing Orders" means prewritten orders and specific instructions for administration and frequency of a given medication (vaccines) to a person in clearly defined circumstances.
(b) "Vaccines for Children" (VFC) means a federal program that provides vaccine serums at no cost to providers for clients ages 0 through 18.
(3) The Health Services Division (Division) covers immunizations as recommended by the Advisory Committee on Immunization Practices (ACIP) and approved by the Oregon Immunization Program. The approved ACIP recommendations are found in Guideline Note 106 of the Health Evidence Review Commission's Prioritized List of Health Services as referenced in OAR 410-141-0520, www.oregon.gov/OHA/HPA/DSI-HERC (click "Current Prioritized List").
(4) Providers shall follow the (ACIP) guidelines for immunization schedules. Exceptions include:
(a) On a case-by-case basis, provider may use clinical judgment in accordance with accepted medical practice to provide immunizations on a modified schedule, and;
(b) On a case-by-case basis, provider may modify immunization schedule in compliance with the laws of the State of Oregon, including laws relating to medical and non-medical exemptions for immunizations.
(5) Requirements for vaccine administration:
(a) The dentist shall have completed a course of training approved by the Oregon Board of Dentistry;
(b) Vaccines shall be administered in accordance with the Model Standing Orders approved by the OHA; and
(c) The dentist shall not delegate administration of vaccines to another person.
(6) Procedures for vaccine administration.
(a) Dentists shall:
(A) Follow OHA approved Model Standing Orders for immunization administration and treatment of severe adverse events following an administration. OHA Model Standing orders are located at: https://www.oregon.gov/oha/PH/PreventionWellness/VaccinesImmunization/ImmunizationProviderResources/Pages/provresources.aspx (Click Vaccine Administration);
(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 OHA, to the ALERT System outlined in https://www.oregon.gov/oha/PH/PreventionWellness/VaccinesImmunization/alert/Pages/EnrollNewClinic.aspx;
(D) As administrator of the vaccine, report to the OHA the information in section 6(a)(A), (B) and (C) as applicable to the OHA ALERT Immunization System within fourteen (14) days of administration;
(E) Report adverse events, as required by the Vaccine Adverse Events Reporting System (VAERS) to the Oregon Board of Dentistry, within ten (10) business days;
(F) Within 10 days to the primary care provider identified by the patient; and
(G) If the patient does not have a PCP, providers shall:
(i) Provide the patient with a copy of vaccination administration documentation;
(ii) Direct toward resources containing more information;
(iii) Encourage to become a physician's patient of record for their other health needs; and
(iv) Document actions in the patient's record.
(b) Dentists or designated staff shall:
(A) Provide Vaccine Information Statements (VIS) to the patient or legal representative with each dose of vaccine covered by these forms;
(B) Document that the patient 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.
(C) Document the patient record:
(i) Date;
(ii) Site of administration;
(iii) Brand name or NDC number or other acceptable standardized vaccine code set;
(iv) Dose, manufacturer, lot #, 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 OHA ALERT Immunization System;
(vii) Date of publication of the VIS; and
(viii) Date the VIS was provided.
(7) Billing: Vaccines are billed using a common procedural terminology (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/Page/Policy-Medical-Surgical.aspx.
(a) Adults: Billing providers shall use standard professional claim form billing procedures for adults and for any vaccine that is not part of the VFC program.
(b) Children: VFC vaccines are administered only to children and adolescents through age eighteen (18) who meet VFC eligibility criteria. All vaccines for this age group and for conditions covered by the VFC program must be obtained through the VFC program. The Division will not reimburse providers for the administration or purchase of privately purchased vaccines if the vaccine could have been obtained through the VFC program. 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.
(8) The Division 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 for a list of vaccines provided through the VFC Program.
(9) To receive reimbursement for vaccine administration, VFC program providers must bill the Division:
(a) With the appropriate vaccine common procedural terminology (CPT) code included; and
(b) Including the appropriate modifier: SL.
(10) Fee-for-service providers may bill the Division directly for vaccines provided to clients. Providers may bill the plans directly, as appropriate to member plan enrollment, for the administration of VFC vaccines if the client is enrolled in an MCE. Medicaid and CHIP are not considered the "payer of last resort" for administration of VFC vaccines.
(11) Effective 1/1/2013 the Regional Maximum amount is $21.96. For all fee for service providers, the Division reimburses the Regional Maximum amount for the administration of VFC vaccines.

Notes

Or. Admin. R. 410-123-1262
DMAP 66-2019, adopt filed 12/26/2019, effective 1/1/2020

Statutory/Other Authority: ORS 679.543, 414.065 & HB 2220 (2019 Regular Session)

Statutes/Other Implemented: ORS 414.065

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