The department informed long term care (LTC) and pharmacy providers in a July 15, 2005, notice that LTC facilities would be responsible for contacting their pharmacies to obtain influenza vaccine. Following is a link to the notice:
07-15-05: Flu Vaccine (pdf) (html)
As stated in the July 15, 2005, notice, influenza vaccine should be billed to Medicare for those residents who are eligible for Medicare Part B. However, in most cases, the pharmacy will not be able to bill Medicare Part B for the vaccine because the vaccine is not being administered on-site. If a resident has Medicare Part B eligibility, and the pharmacy bills the department, the pharmacy will receive a rejection through the pharmacy point-of-sale system.
The LTC facility will need to purchase the influenza vaccine from their pharmacy for those residents who are eligible under Medicare Part B, and bill Medicare Part B directly. LTC facilities may choose to “roster bill” Medicare for the vaccine. The link to the CMS Web site below provides information to providers on enrolling with Medicare to “roster bill.”
http://www.cms.hhs.gov/medlearn/flupdf.pdf
The pharmacy may bill the Department for those LTC facility residents who are Medicaid-eligible, but are not eligible for Medicare Part B.
Providers wishing to receive e-mail notification, when new provider information is posted by the department, may register at the following HFS Web site at: http://www.hfs.illinois.gov/provrel
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