This bill requires many public and private health plans to cover certain vaccines and to not charge cost sharing for them. The rule applies to vaccines that had a recommendation from the Advisory Committee on Immunization Practices (ACIP) for the person involved as of October 25, 2024. It covers group health plans, individual health insurance, ERISA plans, Medicare, Medicaid, and CHIP. The bill includes vaccines that are later updated or changed through an FDA-approved supplement to a biologics license application.
For group and individual plans and some statutory provisions, the coverage requirement applies for plan years during enactment or beginning on or after enactment and before January 1, 2030. For Medicaid and CHIP provisions, the required coverage period runs from enactment through December 31, 2029. The bill does not require coverage if a vaccine is given during the minimum interval established under section 2713(b). For Medicare, if ACIP later revokes a recommendation after October 25, 2024, Medicare must use the most recent recommendation that was in effect before that revocation. The bill also adds rules to Medicaid and the pediatric vaccine distribution program so changes after October 25, 2024 that remove recommendations do not affect coverage during the stated period. It also requires that certain state benchmark plans include adult vaccines described in the bill.
No publicly available information.
No publicly available information.