WASHINGTON, DC - In an effort to strengthen and expand immunization services and help save lives, U.S. Senator Jack Reed (D-RI) introduced legislation with the goal of ensuring that all Americans are properly immunized with routine vaccines to eradicate preventable diseases and improve public health. Reed's Immunization Improvement Act of 2009 would lower immunization costs and require coverage to include all federally recommended vaccines such as the vaccine for seasonal human influenza, which causes 36,000 deaths per year.

"Vaccinations are critical to protecting us against harmful viruses like measles and polio, preventing the spread of these diseases, and improving public health. Yet too many Americans are left vulnerable to diseases that can be prevented by vaccination. My bill would remove barriers to immunization by expanding coverage to include all routine vaccines and eliminating cost-sharing to make them more affordable. It allows states to purchase vaccines at lower costs; requires Medicare and Medicaid to cover all federally recommended vaccines; and also seeks to require private insurers to offer this basic benefit," said Reed, a member of the Health, Education, Labor and Pensions (HELP) Committee. "Every year, preventive vaccinations help save taxpayers billions of dollars. But more importantly, they save lives."

Routine childhood immunizations prevent over 14 million individual cases of disease and over 33,500 deaths over the lifetime of children born in any given year. However, significant and persistent gaps in public and private health insurance coverage of immunizations remain. Approximately 11% of young children and 21% of adolescents are underinsured for immunizations. Nearly two-thirds of adults are underinsured and 17% have no insurance coverage for immunizations.

"The health care reform debate provides us with the opportunity to eliminate obstacles like lack of insurance and high cost-sharing. We must shift to a system that will make routine preventive care, like immunizations, accessible to all working families," said Reed.

The bill has been endorsed by the American Public Health Association; the Association of State and Territorial Health Officials; Children's Defense Fund; Every Child By Two; First Focus; and Partnership for Prevention.

The Immunization Improvement Act of 2009 would:

Authorize states to purchase adult vaccines under CDC contracts. Current CDC contracts for adult vaccines provide savings that range from 23-69 percent compared to the private sector cost, and relieve states of the burden of having to negotiate their own contracts. These savings allow for the purchase of more vaccines and coverage of more adults.

Authorize a demonstration program to improve immunization coverage. Under this program, CDC will provide grants to states to improve immunization coverage of children, adolescents, and adults through the use of evidence-based interventions. States may use funds to implement interventions that are recommended by the Task Force on Community Preventive Services, such as reminders or recalls for patients or providers, assessments and referrals for participants of public programs, or home visits.

Expand Medicare coverage of recommended immunizations under Part B. Medicare covers influenza, pneumonia, and hepatitis B vaccines under Part B. Other preventive vaccines are eligible for coverage under Part D's prescription drug plans (PDPs). However, the Medicare Payment Advisory Commission (MedPAC) has found that PDPs cover few vaccines, and that physicians have no direct way of billing PDPs. As recommended by MedPAC, the legislation would cover immunizations recommended for routine use by ACIP under Part B.

Expand Medicaid coverage of recommended adult immunizations. The Vaccines for Children program provides immunizations to children who are eligible for Medicaid. The Act provides for Medicaid coverage of adult immunizations that are recommended for routine use by ACIP, and prohibits cost-sharing for such immunizations.

Provide reimbursement for vaccine administration under Medicaid. In addition to covering the cost of vaccines, Medicaid provides reimbursement for their administration. However, the maximum allowable fees for vaccine administration were set in 1994 and have not been updated since. As recommended by the National Vaccine Advisory Committee (NVAC), the Act requires CMS and CDC to review and update the maximum allowable fees and to publish and update the actual fees for vaccine administration paid by each state. In addition, as recommended by NVAC, the legislation provides reimbursement for vaccine administration to children who are eligible for the Vaccines for Children program but not for Medicaid, including uninsured and underinsured children.

Seek to reform private health insurance coverage. The Act requires health plans in the group and individual markets to cover immunizations that are recommended for routine use by ACIP, without any cost-sharing. This provision does not apply to collective bargaining agreements and does not become effective until universal coverage is achieved under health reform legislation.

Improve Immunization Information Systems. The Act clarifies that funding for health IT under the American Recovery and Reinvestment Act can be used to improve and expand immunization registries.