Chesterton Tribune                                                                                   Adv.

Indiana ending low cost shots for insured children

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INDIANAPOLIS (AP) — Some doctors fear that fewer children across Indiana will receive important vaccinations under a new state policy barring county health departments from giving low-cost immunizations to youngsters who are covered by insurance.

The new State Department of Health policy taking effect July 1 is intended to reserve vaccinations for the most needy. Under the policy, the state will ask doctors to stop referring insured patients to county health clinics.

“It’s one thing to expend everything that you’re provided for the cause of the public,” State Health Commissioner Gregory Larkin told The Indianapolis Star. “It’s another thing to expend public health dollars unnecessarily for an insured population and you run out for everyone. ... If we don’t have the funds, we won’t be able to provide the immunizations.”

It’s not certain that the new policy can be enforced. State officials acknowledge that they are relying on a good-faith effort by doctors and health providers to steer the insured away from county health departments and patients being honest about whether they are insured.

Still, the change has doctors worried about children getting all the shots they are supposed to have to attend school.

“Why would you put more barriers up to kids being vaccinated?” said Dr. Sarah Stelzner, co-president of the Indiana chapter of the American Academy of Pediatrics.

Larkin said the state has no choice. Indiana receives about $90 million from the federal government for vaccines for uninsured, underinsured and Medicaid-eligible children and the state adds $11 million. For the past two years, that’s just barely been enough.

The change could leave those covered by insurance policies with high deductibles facing bills in the hundreds of dollars for vaccinations in a doctor’s office.

A pre-kindergarten visit, for instance, can run about $600 for vaccines. By contrast, county health departments typically charge only a nominal fee for shots.

Dr. Mary McAteer, a Carmel pediatrician, said she has seen high deductibles drive more insured patients to the county health department for the vaccinations.

“The health department was a great resource for those people that were underinsured,” McAteer said. “When they don’t get to go there, it’s going to be a huge impact. They’re going to have to make some big decisions.”

Marion County Health Department director Virginia Caine said the agency will continue to vaccinate all comers, but for those who have insurance, it will bill their insurance company as of July 1. Caine said the department also will raise its administrative fee from $10 to either $20 or $30.

Parents might also be asked to sign a document if they say they don’t have insurance.

“We’re going to have to take it on faith,” Caine said. “There’s no way we can do an investigation to decide if they have insurance.”

About a third of the patients whom Dr. Paula Gustafson sees in her Shelbyville office go to the county health department for their vaccinations, especially for more expensive ones such as Gardasil, a vaccine against human papillomavirus. The three shots required can run into the several hundreds of dollars, Gustafson said.

“Right now people have difficulty paying their medical bills, and I can see this would only add to that,” she said. “For people who have to make a choice on how to spend money, they may go without it.”

Posted 6/9/2011




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