Or. Admin. Code § 410-123-1262

Current through Register Vol. 63, No. 11, November 1, 2024

Section 410-123-1262 - Dental Administration of Vaccines

(1) Dental administration of vaccines shall be carried out in compliance with Oregon Board of Dentistry OARs 818-012-0006 and 818-012-0007, OHA Medical/Surgical OAR 410-130-0255 and Vaccines for Children (VFC) - OHA Division 46, OARs 333-046-0110 through 333-046-0130.

(2) Requirements for vaccine administration:

(a) The dentist shall have completed a course of training approved by the Oregon Board of Dentistry;

(b) Vaccines shall be administered in accordance with the Model Immunization Protocols approved by the Authority; and

(c) The dentist shall not delegate administration of vaccines to another person.

(3) Procedures for vaccine administration.

(a) Dentists shall:

(A) Follow Authority approved Model Immunization Protocols for immunization administration and treatment of severe adverse events following an administration. Authority Model Immunization Protocols are located at: https://www.oregon.gov/oha/PH/PreventionWellness/VaccinesImmunization/ImmunizationProviderResources/Pages/provresources.aspx (Click Vaccine Administration);

(B) Maintain written policies and procedures for handling and disposal of used or contaminated equipment and supplies;

(C) If providing state or federal vaccines, report the vaccine eligibility code as specified by the Authority, to the ALERT System outlined in https://www.oregon.gov/oha/PH/PreventionWellness/VaccinesImmunization/alert/Pages/EnrollNewClinic.aspx;

(D) As administrator of the vaccine, report to the Authority the information in section 6(a)(A), (B) and (C) of this rule as applicable to the Authority ALERT Immunization System within fourteen (14) days of administration;

(E) Report adverse events, as required by the Vaccine Adverse Events Reporting System (VAERS) to the Oregon Board of Dentistry, within ten (10) business days;

(F) Within ten (10) days to the primary care provider identified by the member; and

(G) If the member does not have a PCP, providers shall:

(i) Provide the member with a copy of vaccination administration Documentation;

(ii) Direct toward resources containing more information;

(iii) Encourage to become a physician's patient of record for their other health needs; and

(iv) Document actions in the member's record.

(b) Dentists or designated staff shall:

(A) Provide Vaccine Information Statements (VIS) to the member or legal representative with each dose of vaccine covered by these forms;

(B) Document that the member or legal representative has read, or has had read to them, the information provided and that any questions are answered prior to the administration of the vaccine. The VIS provided shall be the most current version;

(C) Document the member record:

(i) Date;

(ii) Site of administration;

(iii) Brand name or NDC number or other acceptable standardized vaccine code set;

(iv) Dose, manufacturer, lot # (number), and expiration date of vaccine;

(v) Name and identifiable initials of administering dentist;

(vi) Address of office where vaccine was administered, unless automatically embedded in electronic report provided to the Authority ALERT Immunization System;

(vii) Date of publication of the VIS; and Date the VIS was provided.

(4) Billing: Vaccines are billed using a common procedural terminology (CPT) codes on a Professional claim form (CMS 1500) found in the Professional Billing Instructions and the Medical-Surgical Services Provider Guide located at: https://www.oregon.gov/OHA/HSD/OHP/Page/Policy-Medical-Surgical.aspx.

(a) Adults: Billing providers shall use standard professional claim form billing procedures for adults and for any vaccine that is not part of the VFC program;

(b) Children: VFC vaccines are administered only to children and adolescents through age eighteen (18) who meet VFC eligibility criteria. All vaccines for this age group and for conditions covered by the VFC program shall be obtained through the VFC program. The Division will not reimburse providers for the administration or purchase of privately purchased vaccines if the vaccine could have been obtained through the VFC program. For information about the VFC program or to enroll as a VFC provider, contact the Public Health Immunization Program. The Oregon VFC program website can be located at: https://www.oregon.gov/oha/PH/PREVENTIONWELLNESS/VACCINESIMMUNIZATION/IMMUNIZATIONPROVIDERRESOURCES/VFC/Pages/index.aspx.

(5) The Division reimburses only for the administration, not the serum, of vaccines available for free through the VFC Program. Refer to the Current Oregon Immunization Program State-Supplied Vaccine Billing Codes table for a list of vaccines provided through the VFC Program.

(6) To receive reimbursement for vaccine administration, VFC program providers shall bill the Division:

(a) With the appropriate vaccine common procedural terminology (CPT) code included; and

(b) Including the appropriate modifier: SL.

(7) Fee-for-service providers may bill the Division directly for vaccines provided to members. Providers may bill the plans directly, as appropriate to member plan enrollment, for the administration of VFC vaccines if the member is enrolled in an MCE. Medicaid and CHIP are not considered the "payer of last resort" for administration of VFC vaccines.

Or. Admin. Code § 410-123-1262

DMAP 66-2019, adopt filed 12/26/2019, effective 1/1/2020; DMAP 50-2021, amend filed 12/24/2021, effective 1/1/2022; DMAP 52-2022, minor correction filed 04/27/2022, effective 4/27/2022; DMAP 65-2024, minor correction filed 02/21/2024, effective 2/21/2024

Statutory/Other Authority: ORS 679.543, 414.065 & HB 2220 (2019 Regular Session)

Statutes/Other Implemented: ORS 414.065