Legislation Protecting Children's Access To Vaccines Passes Assembly Health Committee, California

Main Category: Immune System / Vaccines
Also Included In: Pediatrics / Children's Health
Article Date: 22 Apr 2009 - 6:00 PST

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A bill requiring health plans to fully reimburse physicians for the cost of immunizations, a measure considered crucial for maintaining the state's high vaccination rates and safeguarding public health, cleared its first legislative hurdle today when it passed the Assembly Health Committee.

Assembly Bill 1201, by Assemblymember Manuel Perez, D-Coachella, moves next to the Assembly Committee on Appropriations. AB 1201, which is co-sponsored by the California Medical Association, also bars health plans from charging patients out-of-pocket expenses for vaccines, a practice that can discourage participation.

"Every parent knows getting vaccines from your pediatrician is more convenient than going somewhere else," said Dr. Richard Pan, a Sacramento pediatrician who is a member of CMA's Board of Trustees. He testified at today's health committee hearing. "But this isn't just a matter of ease, it is about ensuring patients have access to the most important medical advancement in protecting public health. This legislation stops the games played by insurance companies to shun their responsibility regarding vaccine coverage."

A national study published in the December issue of the journal Pediatrics revealed that about one in 10 doctors who vaccinate privately insured children were considering dropping that service largely because they weren't receiving adequate reimbursements.

Oftentimes when a physician no longer offers vaccination services, patients are referred to the local public health clinics for routine shots. These privately insured children end up using the county's safety net services placing them under greater stress and using resources that should be preserved for the uninsured.

Health plans do not typically reimburse the entire cost of providing vaccines. Pediatricians and family practice physicians from around the state have reported the impact of this trend as a decline in patient access to life-saving vaccines. Physicians are faced with making the painful choice of not offering the vaccination at all, subsidizing the cost, or passing the costs on to parents. AB 1201 remedies this by requiring health plans and insurers to fully reimburse physicians for the direct and indirect costs to acquire and administer recommended vaccines.

Pediatric immunizations have proven to be one of modern medicine's most successful, safest and cost-effective ways to protect public health. AB 1201 would stabilize private insurance coverage of vaccines, effectively protecting public health and ensuring continued access to disease preventing diseases.

"Health plans have failed miserably in adequately compensating those tasked to provide vaccines. The system needs to change so that physicians can focus on preventative care," Dr. Pan concluded.

The American Academy of Pediatrics and the California Academy of Family Physicians have joined with CMA to co-sponsor the legislation.

The California Medical Association represents more than 35,000 physicians in all modes of practice and specialties. CMA is dedicated to the health of all patients in California.

Source
California Medical Association