State issues rates for immunization programs (Mandated Assessments for RI Healthcare Programs)

The State of Rhode Island (the State) recently announced the 2016 assessment rates for the Rhode Island Vaccine Assessment Program (RIVAP), an immunization program for children and adults that provides vaccination medication at lower costs than would otherwise be available.

This is a follow up to an article from the August issue of The Broker Brief.

What will be the charge for each assessment?

The charges for the RIVAP assessments will be as follows:

  • Child immunization rate: $20.59 per child per month
  • Adult immunization rate: $3.70 per adult per month

BCBSRI will remit payment of these assessments to the State on behalf of our fully insured and self-insured accounts. Self-funded accounts will be invoiced for these assessments on a quarterly basis.

When will these assessments begin to appear on self-funded accounts’ invoices?

These assessments will be displayed as separate line items on self-funded accounts’ claims invoices beginning in late January 2016.

How often will these assessments be invoiced?

The assessments will be invoiced quarterly in the months of January, April, July, and October. As directed by the State, the assessment is based on retrospective membership data from the previous quarter. For example, fourth quarter 2015 enrollment data will be used to calculate the assessment for the invoices sent to self-insured accounts in late January 2016; first quarter 2016 enrollment data will be used for the April invoices, and so on.

They will appear on self-funded claims invoices as follows:

  • Infant child immunization: “State of RI Mandate Assessment – Infant Child Immunization”
  • Adult immunization: “State of RI Mandate Assessment – Adult Immunization”

Self-funded accounts should contact their dedicated Finance representative (listed on the bottom of their invoice) with any questions about how their immunization assessments were calculated.