LEGISLATIVE RESOLUTION memorializing the United States Congress to enact
S. 1003, the Immunization Improvement Act of 2009, which includes a
provision moving Medicare vaccine coverage to Part B

WHEREAS, It is the sense of this Legislative Body to raise awareness to
policy makers and stakeholders regarding the need to consolidate the
coverage of all preventive vaccines under Medicare Part B; and
WHEREAS, There are three vaccines (influenza, pneumococcal and hepati-
tis B) that are expressly covered under Medicare Part B by statute; with
the creation of Medicare Part D, new vaccines as well as all other
commercially-available vaccines not already reimbursed under Medicare
Part B, are covered under Part D; and
WHEREAS, In large part, problems arise from the fact that preventive
vaccines are commonly administered in the physician office setting; and
WHEREAS, Under Part D, the physician's office typically is considered
an "out-of-network" pharmacy; this means that Medicare beneficiaries
must pay the full cost upfront at the time of the vaccination and subse-
quently submit a paper claim for reimbursement; and
WHEREAS, As a result, covering preventive vaccines under Medicare Part
D is having a chilling effect on patient access to these vaccines, espe-
cially for low-income seniors; and
WHEREAS, The adverse impacts on patient access are due to the finan-
cial burden on individuals of paying the full cost of the vaccine and
related services upfront coupled with the uncertainty of not knowing
whether or when the Part D plan will reimburse for the claim; CMS has
recognized this problem and suggested that Medicare beneficiaries
purchase these vaccines from in-network pharmacies and transport the
product to their physician's office; and
WHEREAS, Such fundamental problems with access to vaccines under Part
D resulted in the Medicare Payment Advisory Commission (MedPAC) making
the following unanimous recommendation in June 2007: The Congress should
permit coverage for appropriate preventive vaccines under Medicare Part
B instead of Part D; and
WHEREAS, In 2008, Congress enacted the Medicare Improvements for
Patients and Providers Act (MIPPA); Section 101 creates a new authority
for the Secretary to cover additional preventive services that are not
expressly named within the Social Security Act; and
WHEREAS, Section 101 provides that eligibility is based on whether the
U.S. Preventive Services Task Force (USPSTF) supports the preventive
service with either a grade A or B recommendation; the USPSTF - an inde-
pendent panel of experts in primary care and prevention - regularly
reviews scientific evidence to develop recommendations designed to help
clinicians evaluate clinical preventive services; and
WHEREAS, Currently, Medicare beneficiaries have limited access to
preventive vaccines under Medicare Part D due to technical, administra-
tive barriers; these barriers are especially significant for individuals
with low incomes; policy makers should consolidate all preventive
vaccines under Medicare Part B; now, therefore, be it
RESOLVED, That the Congress of the United States be and hereby is
respectfully memorialized by this Legislative Body to enact S. 1003, the
Immunization Improvement Act of 2009, which includes a provision moving
Medicare vaccine coverage to Part B; and be it further
RESOLVED, That copies of this Resolution, suitably engrossed, be tran-
smitted to the President of the Senate of the United States, the Speaker
of the House of Representatives, the Centers for Medicare and Medicaid
Services, and to each member of the Congress of the United States from
the State of New York.