Since May 2010, when funding for state-supplied vaccines for privately insured children was scheduled to end, health plans, insurance carriers, third-party administrators, and Taft-Hartley trusts have paid for vaccines based on a per-dosage assessment.
The Washington State Vaccine Association (WVA), an independent, nonprofit organization created by the state legislature and supported by a private/public partnership, collects these payments and remits the funds to the state. As a result, the state has been able to continue purchasing vaccines at bulk rates for all the state’s children and distribute these vaccines to health care providers at no charge.
What This Means for Payers
- Participation in one of the most efficient and cost-effective systems in the country for purchasing and distributing childhood vaccines.
- Vaccine costs that are below those of private purchase alternatives, as documented by the Centers for Disease Control (CDC).
- Ability to set up your claim processing system for automatic adjudication.
How the Dosage-Based Assessment Process Works
For details on how providers submit HCFA-1500 forms and electronic submissions for administered vaccines, please see For Providers.
Third-Party Administrator (TPA) Registration
Both state-based and out-of-state TPAs are required to register with the Washington Vaccine Association so we can keep you informed of the latest policies, changes, and reductions to vaccine charges. Here’s how:
You can register online directly with the WVA. EXCEPTION: Out-of-state TPAs are exempt from having to register if they:
There is no charge for WVA registration.
- are a member of the BlueCross BlueShield Association, and
- meet their payment obligations to the WVA in a timely manner via Premera BlueCross or Regence BlueShield, in accordance with the BlueCard® system.