In its ongoing commitment to increasing vaccination rates across the state, the Pritzker administration is taking action to make vaccines more easily available for low-income children. The Illinois Department of Healthcare and Family Services (HFS) and the Illinois Department of Public Health (IDPH) are announcing the availability of vaccines for children covered under the Children’s Health Insurance Plan through the Vaccines For Children (VFC) program. Ordering vaccines for CHIP-eligible children through the VFC program will increase the number of providers for these vital services and help ensure vaccines are more readily available for low-income children. The VFC program is a federally funded program that provides vaccines for children whose parents or guardians may not be able to afford them. Children who are eligible for the VFC program are younger than 19 years and are either Medicaid-eligible, uninsured, underinsured, or American Indian or Alaska Native.
CHIP is a partnership between the federal and state governments that provides low-cost health coverage to children in families that earn too much money to qualify for Medicaid. Families with children under age 19 who meet insurance and income requirements are eligible.
The programs were separated in 2016, under the previous administration, and vaccines for children covered by CHIP were no longer able to be ordered through the VFC program. Under the new administration, HFS and IDPH have been working together to rejoin the programs and increase provider participation so that all children in Illinois will be able to receive needed vaccines. It is essential to protect children against serious illness by having them vaccinated before they are exposed to potentially life-threatening diseases.
The newly rejoined program will allow providers to obtain vaccines for CHIP children via the VFC program without having to buy vaccines from private sources at market cost and be reimbursed later. As more physician practices, Federally Qualified Health Centers, health departments, and other providers across the state transition into the newly rejoined program, children covered by CHIP will also be able to get their CDC recommended vaccines in their medical home.The two agencies have agreed on HFS pre-payment and reconciliation every six months for vaccines ordered under the new program, putting in place a formal schedule that will ensure the program is fiscally responsible. The agencies are also working with providers to increase information that is entered into the Medical Electronic Data Interchange (MEDI) system and the Illinois Comprehensive Automated Immunization Registry Exchange (I-CARE) to help with reconciliation. The Pritzker administration has proactively met with providers seeking their cooperation to use every opportunity to vaccinate all children by entering each VFC and CHIP dose given into I-CARE, and billing for each dose given. With easier access to vaccines for children covered under CHIP, and increased measures to track vaccines administered, the goal is to get 100% of children in Illinois vaccinated, and eliminate any discrepancies in vaccination tracking and reimbursement.