Copyright © 2016 Albuquerque Journal
Despite receiving more than $1 million in recent weeks for vaccines it purchased for privately insured children, the state Health Department is still owed more than $860,000 for past-due invoices and some doctors continue to tell parents they don’t have the necessary vaccines to immunize their children.
Legislation in 2015 created a mechanism to cover the cost of the vaccines by making it mandatory for companies that insure the children to reimburse the Health Department for the expense. But there’s been a delay in many of those companies making their payments.
Information provided by Health Department spokesman Kenny Vigil shows that around 250 invoices sent out Sept. 1 totaling $264,657 remain unpaid. And bills outstanding from invoices sent out Dec. 1 total $597,277. Invoices range from more than $44,000 billed to Bernalillo County to small bills for around $30, which are owed by companies that insure one or more individuals.
Bernalillo County owes a total of $99,609 on four invoices, which will be paid this week, county spokeswoman Tia Bland said.
“The payment is delayed because of a technical issue that was discovered while attempting to process a new, unbudgeted expense,” Bland said.
The list showed that UNM Hospitals owed $31,292. UNM issued a statement attributing the payment delay to being unfamiliar with the requirement of the new vaccine law. Once the UNM Health Sciences Center leadership “was made aware” of the money owed, the invoice was immediately paid, the statement said.
UNM spokesman Luke Frank said it was an inquiry from the Journal that alerted them to the problem.
After the first billing cycle in September, Vigil said, the department wrote to those billed, explaining the requirements of the new legislation.
The Health Department earlier listed Presbyterian Health Plan as owing $169,000, but then took it off the list when it discovered that Presbyterian had overpaid earlier bills and is current.
The Journal first reported about the vaccine shortage due to nonpayment in early January. And, at that time, the Health Department reported that more than $2 million was outstanding.
Since then, payments such as UNM’s have come in, and Vigil said the department has ordered more supplies, which started reaching some providers last week.
The problem was caused by “a perfect storm,” Vigil said.
When passed, the legislation did not include any start-up funding, and the department has been buying vaccines basically on credit, using its limited budget authority. The limit has been increased incrementally from $8 million to $17 million. But it hasn’t consistently kept pace with demand, leading the department in recent months to tell some providers that they could not fill 100 percent of their orders.
Under New Mexico’s immunization program, the Health Department orders all children’s vaccines, except the flu vaccine, on an as-needed basis, when it receives a request from one of the roughly 400 Vaccine for Children program providers, Vigil said.
The federal government covers the cost of vaccinating uninsured kids or those covered by Medicaid.
Prior to passage of the 2015 Vaccine Purchasing Act, Vigil said, the Health Department covered the cost of vaccines for privately insured children using taxpayer funding. Insurers were supposed to voluntarily reimburse the department, but many didn’t, and there was a $2.5 million shortfall in 2014.
The law was supposed to eliminate that shortfall by making reimbursement mandatory. The act took effect Aug. 28, but didn’t provide funding up-front to purchase vaccines for privately insured kids. The Legislature also cut the immunization program’s general fund money for purchasing vaccines by $600,000 for the current budget year, Vigil said.
Then, reimbursements from insurers did not come in on time.
The law allows the department to report companies who fail to pay an invoice within 30 days to the Office of the Insurance Superintendent and the state Attorney General’s Office. The state can impose a daily penalty of $500.
However, Vigil said since the department is still fine-tuning the data for the new program, it has decided not to enforce the penalty provisions until September this year.
“Before we impose fines we want to make sure all the billing information is correct. But if someone gets a bill, the expectation is that they will pay it,” he said.