Administrative Code

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Virginia Administrative Code
Title 12. Health
Agency 30. Department of Medical Assistance Services
Chapter 10. State Plan under Title XIX of the Social Security Act Medical Assistance Program; General Provisions

12VAC30-10-50. Pediatric immunization program.

A. The state has implemented a program for the distribution of pediatric vaccines to program-registered providers for the immunization of federally vaccine-eligible children in accordance with § 1928 as indicated below.

1. The state program will provide each vaccine-eligible child with medically appropriate vaccines according to the schedule developed by the Advisory Committee on Immunization Practices and without charge for the vaccines.

2. The state will outreach and encourage a variety of providers to participate in the program and to administer vaccines in multiple settings, e.g., private health care providers, providers that receive funds under Title V of the Indian Health Care Improvement Act, health programs or facilities operated by Indian tribes, and maintain a list of program-registered providers.

3. With respect to any population of vaccine-eligible children a substantial portion of whose parents have limited ability to speak the English language, the state will identify program-registered providers who are able to communicate with this vaccine-eligible population in the language and cultural context which is most appropriate.

4. The state will instruct program-registered providers to determine eligibility in accordance with § 1928(b) and (h) of the Social Security Act.

5. The state will assure that no program-registered provider will charge more for the administration of the vaccine than the regional maximum established by the Secretary. The state will inform program-registered providers of the maximum fee for the administration of vaccines.

6. The state will assure that no vaccine-eligible child is denied vaccines because of an inability to pay an administration fee.

7. Except as authorized under § 1915(b) of the Social Security Act or as permitted by the Secretary to prevent fraud or abuse, the state will not impose any additional qualifications or conditions, in addition to those indicated above, in order for a provider to qualify as a program-registered provider.

B. The state has not modified or repealed any immunization law in effect as of May 1, 1993, to reduce the amount of health insurance coverage of pediatric vaccines.

C. The state Medicaid agency has coordinated with the state public health agency in the completion of this preprint page.

D. The state agency with overall responsibility for the implementation and enforcement of the provisions of § 1928 is the State Public Health Agency.

Statutory Authority

Social Security Act Title XIX; 42 CFR 430 to end; all other applicable statutory and regulatory sections.

Historical Notes

Derived from VR460-01-9.1, eff. October 1, 1994.

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