HHS OIG Warns Providers Not to Balance Bill Patients for COVID-19 Vaccinations

On April 15, 2021, the Department of Health and Human Services Office of Inspector General (OIG) issued a statement reminding providers and the public that the COVID-19 vaccine must be administered at no cost to recipients. The OIG has received complaints that providers are charging patients when administering the vaccines. Providers who have collected payment are warned that they must refund the charges and discontinue fees in the future. The following requirements apply for all participating vaccine providers:

• must administer COVID-19 Vaccine with no out-of-pocket cost to the recipient;
• may not deny anyone vaccination based on the vaccine recipient’s coverage status or network status;
• may not charge an office visit or other fee if COVID-19 vaccination is the sole medical service provided;
• may not require additional medical services to receive COVID-19 vaccination;
• may seek appropriate reimbursement from a program or plan that covers COVID-19 Vaccine administration fees for the vaccine recipient, such as:
  • vaccine recipient’s private insurance company
  • Medicare or Medicaid reimbursement
  • HRSA COVID-19 Uninsured Program for non-insured vaccine recipients; and

• may not seek any reimbursement, including through balance billing, from the vaccine recipient.

The OIG also reminds providers that COVID-19-related fraudulent schemes are rampant and encourages providers to inform their patients of these types of schemes and how to protect themselves.