News & Insights


September 27, 2021

Health Headlines – September 27, 2021

CMS to Pay for COVID-19 Booster Shots – In a continued effort to ensure cost is not a barrier to vaccine access, on September 24, 2021, CMS announced that it will pay for Medicare beneficiaries’ COVID-19 booster doses without any cost sharing.  Medicare beneficiaries currently pay nothing for COVID-19 vaccines or their administration, with no applicable copayment, coinsurance or deductible.  This will now also include COVID-19 booster shots following FDA’s recent authorization of the Pfizer COVID-19 booster for high-risk populations.
In addition, COVID-19 booster shots will be covered for nearly all Medicaid and CHIP beneficiaries with no cost sharing. The American Rescue Plan Act of 2021 requires coverage of COVID-19 vaccines and administration for nearly all Medicaid and CHIP beneficiaries without cost sharing.  This will now include COVID-19 boosters for eligible consumers of most commercial health insurance plans.

CMS’s press release can be accessed here. CMS’s COVID-19 provider toolkit can be accessed here, and CDC’s COVID-19 Vaccination Program Provider Requirements can be accessed here.

Reporter, Jasmine Becerra, Atlanta, +1 404 572 3537,


OIG Identifies Disproportionate Use of Chart Reviews and Health Risk Assessments as a Driver of Improper Payments in the Medicare Advantage Program – In a recent report, OIG investigated concerns that some Medicare Advantage (MA) companies leveraged chart reviews and health risk assessments to maximize risk-adjusted payments without beneficiaries receiving care for those diagnoses. OIG concluded these unsupported risk-adjusted payments have been a major driver of improper payments in the MA program and highlighted the need for more targeted oversight.  The full report can be accessed here.