FluMist Coverage Change
Posted on October 18, 2016
Please read the following update related to various Health New England programs and changes that may have an impact on your patients and/or your practice.
Health New England will not pay for FluMist (LAIV4) for the 2016-2017 flu season (CPT code 90672), per CDC and MDPH recommendations:
You may have seen the notice from the Centers for Disease Control and Prevention (CDC) regarding FluMist (intranasal quadrivalent live attenuated influenza virus [LAIV4]) for 2016-2017. The ACIP has made an interim recommendation that FluMist (LAIV4) should not be used for the 2016-2017 flu season. This recommendation was made in light of the poor vaccine effectiveness against influenza A (H1N1) in the U.S. during the 2013-2014 and 2015-2016 seasons. The Massachusetts Department of Public Health (MDPH) is working with the CDC as well as vaccine manufacturers and distributors to procure doses of other inactive influenza vaccines to replace the doses of FluMist that were originally planned to be purchased. ACIP continues to recommend annual flu vaccination, with either the inactivated influenza vaccine (IIV) or recombinant influenza vaccine (RIV), for everyone 6 months and older.
Below are several related web links for additional information:
- mass.gov/eohhs/provider/guidelines-resources/services-planning/diseases-conditions/influenza/aciprecomlaivnot-b-used-during-2016-2017-flu-season.html
- cdc.gov/media/releases/2016/s0622-laiv-flu.html
- www.cdc.gov/mmwr/volumes/65/rr/rr6505a1.htm
If you have any questions about the information in this notice, please contact Health New England Provider Relations at (800) 842-4464, extension 5000. A representative is available Monday through Friday between the hours of 8:00 a.m. and 5:00 p.m.
