COVID-19 Vaccine Administration by Pharmacists, Pharmacy Interns, and Pharmacy Technicians under the Federal PREP Act Declaration and its Amendments

The purpose of this bulletin is to inform Medicaid-enrolled pharmacy providers that, in accordance with stipulations contained within the Public Readiness and Emergency Preparedness (PREP) Act and its amendments, DMAS and all contracted Medicaid Care Organizations reimburse COVID-19 vaccinations administered by pharmacists and pharmacy interns (effective 2/4/2020) and pharmacy technicians (effective 3/11/2021) to Medicaid Members through the pharmacy point-of-sale system. The PREP Act includes requirements such as additional training, CPR certification, recordkeeping and documentation, and reporting that must be met to administer vaccinations under this declaration.
Please refer to the PREP Act Fact Sheet: Expanding the COVID-19 Vaccination Workforce document at https://www.phe.gov/emergency/events/COVID19/Documents/covid19-vaccination-wrkfrc-factsheet-508.pdf for more information on the PREP Act provisions which must be met by all qualified persons before administering COVID-19 Vaccines.
Please refer to the Summary of Legal Authorities for Pharmacists to Administer COVID-19 Vaccine at https://www.vdh.virginia.gov/content/uploads/sites/191/2021/04/Summary-of-Legal-Authorities-for-Pharmacists-to-Administer-COVID-19-Vaccine.pdf for Virginia-specific information.
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PROVIDER CONTACT INFORMATION & RESOURCES |
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Virginia Medicaid Web Portal Automated Response System (ARS) Member eligibility, claims status, payment status, service limits, service authorization status, and remittance advice. |
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Medicall (Audio Response System) Member eligibility, claims status, payment status, service limits, service authorization status, and remittance advice. |
1-800-884-9730 or 1-800-772-9996 |
KEPRO Service authorization information for fee-for-service members.
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Provider Appeals DMAS launched an appeals portal in 2021. You can use this portal to file appeals and track the status of your appeals. Visit the website listed for appeal resources and to register for the portal. |
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Managed Care Programs Medallion 4.0, Commonwealth Coordinated Care Plus (CCC Plus), and Program of All-Inclusive Care for the Elderly (PACE). In order to be reimbursed for services provided to a managed care enrolled individual, providers must follow their respective contract with the managed care plan/PACE provider. The managed care plan may utilize different guidelines than those described for Medicaid fee-for-service individuals. |
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Medallion 4.0 |
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CCC Plus |
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PACE |
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Magellan Behavioral Health Behavioral Health Services Administrator, check eligibility, claim status, service limits, and service authorizations for fee-for-service members. |
www.MagellanHealth.com/Provider For credentialing and behavioral health service information, visit: www.magellanofvirginia.com, email: VAProviderQuestions@MagellanHealth.com,or Call: 1-800-424-4046 |
Provider HELPLINE Monday–Friday 8:00 a.m.-5:00 p.m. For provider use only, have Medicaid Provider ID Number available. |
1-804-786-6273 1-800-552-8627 |
Aetna Better Health of Virginia |
www.aetnabetterhealth.com/Virginia 1-800-279-1878 |
Anthem HealthKeepers Plus |
1-800-901-0020 |
Molina Complete Care
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1-800-424-4524 (CCC+) 1-800-424-4518 (M4) |
Optima Family Care |
1-800-881-2166 www.optimahealth.com/medicaid |
United Healthcare |
and www.myuhc.com/communityplan 1-844-752-9434, TTY 711 |
Virginia Premier |
1-800-727-7536 (TTY: 711), www.virginiapremier.com |