Implementation of the Medicare influenza vaccination benefit--United States, 1993.

Influenza is a major cause of debilitating illness and premature death in the United States, particularly among persons aged > or = 65 years and those with chronic conditions such as lung or heart disease, diabetes, and cancer. Medicare reimbursement for excess hospitalizations during influenza epidemics ranges from $750 million to $1 billion (1). In May 1993, influenza vaccination became a covered Medicare benefit after its potential cost-effectiveness was established by the Medicare Influenza Vaccine Demonstration (2). During the fall of 1993, the Health Care Financing Administration (HCFA) initiated an information campaign to promote use of the influenza vaccination benefit, implemented simplified billing procedures, and improved electronic billing capabilities. However, reports during the 1993-94 influenza season suggested problems experienced by state and local health departments in implementing the new benefit. To characterize public influenza vaccination programs and problems with implementing this benefit, in the spring of 1994, CDC collected information from all 63 state and local health departments receiving federal immunization grants. This report summarizes the reports from these programs.