Frequently Asked Questions for Providers Participating in the Federal Retail Pharmacy Program

On April 5, 2022, CDC issued the following statement:

Due to the lack of supplemental funding from Congress, HRSA stopped accepting claims for reimbursement of costs associated with administering COVID-19 vaccines to uninsured and underinsured individuals as of 11:59 PM ET on April 5, 2022.  CDC strongly encourages providers to stay in the CDC COVID-19 Vaccination Program and CDC expects participating providers will continue to administer these lifesaving vaccines at no cost to patients to ensure equitable access for all individuals.  Where CDC becomes aware of a provider engaging in any of the following, CDC will consider taking any and all appropriate measures, including the possibility of rescinding the CDC provider agreement:

• Administering COVID-19 Vaccine at any out-of-pocket cost to the recipient
• Denying anyone vaccination, or differentially reducing appointment access, based on the vaccine recipient’s coverage status or network status
• Charging an office visit or other fee if COVID-19 vaccination is the sole medical service provided
• Requiring additional medical services to receive COVID-19 vaccination
• Seeking any reimbursement, including through balance billing, from the vaccine recipient

For further information please see CDC COVID-19 Vaccination Program Provider Requirements and Support.

It is CDC’s intention to ensure that all individuals have equitable access to vaccines.   Referring uninsured and underinsured individuals to a different organization for vaccination is considered denying vaccination based on the recipient’s coverage status or network status.  If a provider remains in the CDC COVID-19 Vaccination Program, CDC’s expectation is that providers will not engage in any of the following:

• Administering COVID-19 Vaccine at any out-of-pocket cost to the recipient
• Denying anyone vaccination, or differentially reducing appointment access, based on the vaccine recipient’s coverage status or network status
• Charging an office visit or other fee if COVID-19 vaccination is the sole medical service provided
• Requiring additional medical services to receive COVID-19 vaccination
• Seeking any reimbursement, including through balance billing, from the vaccine recipient

CDC understands that the CDC Provider Agreement for the Federal Retail Pharmacy Program is a voluntary undertaking and may be rescinded by either party with appropriate notice.  As noted in the CDC statement released April 5, CDC strongly encourages providers to continue administering COVID-19 vaccines without costs to patients.  It is CDC’s intention to ensure that all individuals have equitable access to vaccines.  If CDC learns that a provider is engaging in any of the activities listed in that statement, CDC will consider appropriate measures to address the situation, including possibly rescinding that provider’s participation in the Federal Retail Pharmacy Program.

There is no change or amendment to the CDC Provider Agreement signed by providers participating in the Federal Retail Pharmacy Program at this time.  However, CDC strongly encourages providers to continue administering COVID-19 vaccines without costs to patients, and will consider taking any and all appropriate measures, including possibly rescinding providers’ participation in the Federal Retail Pharmacy Program.

CDC will continue to evaluate the CDC COVID-19 Vaccination Program and may consider amending the CDC Provider Agreement for the Federal Retail Pharmacy Program in the future.