Richard H. Hughes, IV, Member of the Firm in the Health Care & Life Sciences practice, in the firm’s Washington, DC, office, was quoted in The New York Times, in “CDC Contradicts Kennedy and Keeps Advice That Children May Get Covid Shots,” by Christina Jewett. (Read the full version – subscription required.)
Following is an excerpt:
Days after Health Secretary Robert F. Kennedy Jr. announced that Covid shots would be removed from the federal immunization schedule for children, the Centers for Disease Control and Prevention issued updated advice that largely countered Mr. Kennedy’s new policy. ..
The C.D.C.’s determinations can be influential in setting insurance and public benefit coverage. It remains unclear how private health insurers and Medicaid will approach coverage of the Covid vaccine for pregnant women. A Covid shot costs about $130 out of pocket, which does not include a service fee to the facility or person administering the service. The total bill can exceed $200.
And the policy change on consultations with doctors or providers is likely to create barriers for children hoping to get a vaccine at a retail pharmacy, said Richard Hughes IV, a lawyer with Epstein Becker & Green who has advised vaccine companies. There is little privacy in pharmacies for consultations, and states differ in the scope of services pharmacists are permitted to perform.
“It is problematic,” he said. “It varies a lot by state and can create some issues for sure.”
The recommendation for “shared decision-making” with a health care provider is also likely to give some private insurers reason to withhold coverage, Mr. Hughes said. Insurers prefer clearer language — like they “must” or “shall” cover the vaccines — from the federal government’s experts, he added.
“The way it’s worked, in terms of coverage and access, has been a real challenge,” he said.
