H1N1 Preparedness

Tufts Health Plan monitors communications about novel H1N1 influenza from federal government and federal public health agencies. The information below is current as of November 9, 2009, and will be updated as additional information is available.

Antiviral Guidance and Health Advisory
The CDC has issued a one-page document titled Quick Facts for Clinicians on Antiviral Treatments for 2009 H1N1. This summary sheet includes important information to clear up some common misconceptions about the timing and appropriate use of antiviral medications for H1N1 flu. Influenza antiviral medications can reduce the severity and duration of the illness and can reduce the risk of influenza-related complications, including severe illness and death.

Key Issues for Clinicians Concerning Antiviral Treatments for 2009 H1N1, produced by the Health Alert Network CDC Health Advisory, notes that not all people recommended for antiviral treatment are being treated. The document provides facts for clinicians to consider when deciding whether a patient needs to be treated with antiviral medication.
Tufts Health Plan has suspended the Tamiflu (oseltamivir) dispensing limits for all members younger than age 18. The dispensing limit remains in place for members age 18 and older.

Vaccine Availability
The federal government will provide states with H1N1 vaccine and supplies at no cost.

The Massachusetts Department of Public Health (MDPH) will be responsible for directing the shipment of all H1N1 vaccine in the Commonwealth. All public and private provider sites interested in receiving and administering H1N1 vaccine must register online at the MDPH Web site.

The State of Rhode Island Department of Health requires every facility that will store and administer the H1N1 vaccine to register online at their Web site. All providers who treat patients with chronic, underlying medical conditions are strongly encouraged to enroll so that patients at the highest risk for complications from H1N1 influenza can be vaccinated.

Who Should be Vaccinated
Based on the epidemiology of the H1N1 influenza virus, the CDC has issued recommendations that the following populations receive H1N1 vaccine:

• Pregnant women
• Household contacts and caregivers for children younger than 6 months of age
• Healthcare and emergency medical services personnel
• All people from 6 months through 24 years of age
• Children from 6 months through 18 years of age
• Young adults 19 through 24 years of age
• Persons aged 25 through 64 years who have health conditions associated with higher risk of medical complications from influenza

Reporting Adverse Events Following Vaccination
CDC is asking every provider to assist with the monitoring the safety of H1N1 vaccine by reporting any suspected adverse events promptly and accurately to the Vaccine Adverse Event Reporting System (VAERS). The Massachusetts Department of Health has distributed a letter to providers with information on reporting to VAERS.

Reimbursement for H1N1 Vaccine Administration
Administration of the H1N1 vaccine is covered for members of all Tufts Health Plan commercial products, regardless of where the member receives the vaccine.

No reimbursement will be provided for the H1N1 vaccine, as it is supplied free of charge by the federal government.

Tufts Health Plan reimburses contracted providers for the administration of H1N1 vaccine. Office visit copayments do not apply and no referral is needed for administration of immunizations. Billing information regarding H1N1 is documented in Tufts Health Plan’s Immunization Payment Policy.

CDC Information
The CDC is monitoring and reporting influenza disease activity in the United States and reporting summaries on their Web site. See 2009 H1N1 Flu: Situation Update. The CDC also publishes findings of key flu indicators in a report called FluView. Providers can register to receive updates of that information by email.

Influenza predisposes individuals to bacterial community-acquired pneumonia. The CDC has issued interim guidance on which groups should be vaccinated with the 23-valent pneumococcal polysaccharide vaccine (PPSV23) to prevent pneumococcal infections during novel influenza A (H1N1) outbreak.


October 1, 2009
Updated November 9, 2009