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Vaccine Madness?

Question:
 
I have a patient that needs varicella vaccine to go to surgery.  I have it to give to him but he has a infant child and is worried about taking the vaccine.  What is the rule on that?

Thanks
 
Perry

Answer:

First, he does not need varicella vaccine to have surgery. Who said that and why? Regardless, never seen or heard of this being a problem.

Academic questions--
breast milk?
age of baby?
Are there cultural or transgender sensitivity issues[grin]

Index--Vaccine madness?

Flu Policy Part 2

Medicos is trying to clarify its options in the delivery of vaccines to the public.The H1N1 "don't -call-it-swine" flu  of 2009 is a good example of our problem. The government vaccine programs have become a nightmare of conflicting reports, unpredictable policy shifts, non-reimbursable administrative mandates, and constant shortages of one vaccine or another. If Medicos cannot receive vaccines through the federal Vaccines For Children[VFC] program, Medicos must develop a contingency plan to purchase its own vaccines, since the health of  the patients must be preserved. Below, our billing department states that medicaid programs have prohibited payment to physicians who buy these vaccines and give them to patients.
 
There are two major groups to consider--adults and children[0-18]. Tetanus-diphtheria, adult pneumonia, flu, and HepB have always been a service available to adults at Medicos and elsewhere. I never heard of failure to reimburse for these vaccines even from medicaid. Have we been paying for these vaccines and giving them for free?

For example, all adults over age 60 and patient with lung disease are recommended to have pneumonia vaccine. We have never sent these adult patients to the department of public heath for these vaccines. They are given in the office and are billed in the usual way. Am I wrong? I assume that the rest of the discussion applies only to children. Correct?
 
Amy from billing writes
THE VACCINE REIMBURSEMENTS ARE DENIED BY BOTH TENNCARE PLANS (BLUECARE & AMERICHOICE). THEY ONLY PAY FOR THE ADMINISTRATIONS EVEN IF PRIVATE STOCK. LAST YEAR WE HAD 4 PLANS AND THEY EACH WERE DIFFERENT. NOW WE HAVE TWO PLANS AND THEY ARE BOTH ALLOWING/DISALLOWNG ABOUT THE SAME PROCEDURE CODES.

AMY--Billing

Index--vaccine policies

Another Delivery

Bill:

For the second time in my life, one of my patients delivered a healthy baby (2 weeks early) in my office in a regular exam room. I always have a "delivery kit"--some simple instruments to clamp and cut the cord, towels, a suction bulb, etc.  The multiparous mother confused the concept of early labor with too advanced labor, so she came to the office instead of going about 2 miles further to the hospital.  My front desk secretary helped us. I called for an ambulance immediately  when I realized she was fully dilated.  I did not let them in the room, since I did not consider this to be an emergency.  When I was 
done, we wrapped the baby girl (7 lbs) in towels and brought her to the waiting room for the waiting patients to see.  They clapped.

Joe Cama
rural Pa for over 20 years

How many years has it been since Joe Kama came to Memphis with the hope of saving delivery services in rural Towanda Pa.? As an adult learner with years of private practice experience, Joe was "different". He didn't attend the Gran Ole Opry, and never once said yall. But, here's to you Joe! Establishing a private practice which funds a fellowship, has been almost impossible, but these reports make a hard road seem easier. 
 
My thanks to those who have supported me through the years. Stay tuned for the endowment of the SkipFelmar lectureship funded through your donations. Thanks again. Que Dios les bendiga todos!

Wm. MacMillan Rodney MD, FAAFP, FACEP
Clinical Professor of Family Medicine
American Board of Family Medicine Obstetrics
Medicos para la Familia
Memphis, Nashville and rural
www.psot.com
 
 

Index--FM-OB fellowship outcomes