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VFC-AFIX Quarterly Conference Call Minutes
April 2008

Grantee Roll Call

Present: Alabama, Arkansas, Arizona, California, Chicago, Colorado, Delaware, Florida, Georgia, Idaho, Indiana, Kansas, Kentucky, Massachusetts, Minnesota, Missouri, Montana, North Carolina, North Dakota, Nebraska, New Hampshire, New Mexico, Nevada, New York City, New York State, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, Tennessee, Utah, Virginia, Virgin Islands, Washington, Wisconsin, West Virginia, Wyoming.

Updates & Discussion

VFC - Nancy Fenlon

• Fraud and abuse policy  

The Fraud and Abuse policy review was finished in late February. Unfortunately, there were no submitted policies that CDC could use as a model or a template for the other grantees. The requirements in Module 10 may have provided insufficient detail for the grantees to develop a comprehensive fraud and abuse strategy that could be documented in a written policy. Many grantees stated in their policies that the intervention that they always start with is education. Referral for investigation for possible fraud and abuse is considered only after all educational interventions are exhausted.

Using the information from those grantees that focus on education to correct non-compliant VFC provider situations and the requirements outlined in Module 10, CDC developed a detailed algorithm of the procedural steps to follow from identification of compliance issue(s) to final resolution of the compliance issue. . To test the practicality of the algorithm, 4 grantees were asked to review the algorithm. The grantees felt that using the algorithm would assist them in determining how to deal with VFC non-compliance issues and help them determine when to refer a situation for fraud and abuse investigation. The algorithm is also currently being reviewed by CMS and CDC legal counsel.

To lessen the burden on the grantees for policy rewrites and resubmission to CDC for review and approval and to shorten implementation time so grantees can strengthen their activities with non-compliant providers, CDC will not be approving or disapproving each grantee’s fraud and abuse policy. Grantees should finalize their individual fraud and abuse policies through their state or program process. CDC will require the grantees to use the CDC-developed algorithm as a standard operating procedure for working through provider non-compliance issues with VFC program requirements. The algorithm will be distributed through an all-grantee message the week of 04/21/2008. Grantees should review the algorithm and submit any questions no later than April 28, 2008, to Nancy Fenlon @ ncf1@cdc.gov.

The non-compliance algorithm and submitted questions will be discussed in the workshop “VFC Reference Stacks” at Vaccine University. CDC will take comments throughout the summer on the content of the algorithm, as necessary schedule ad hoc follow-up calls and release the final algorithm for the grantees to implement no later than October 1, 2008.

Afix - Nathan Crawford

• VFC at Vaccine University

Vaccine Management Survey: Making the Grade There will be a session on the Vaccine Management Survey that will include presenting some of the findings from the 2008 survey on 2007 data. and plans for the 2009 survey.

Music 101: singing to the choir. VFC and CMS collaboration overview of the history of collaboration between the agencies, Dr. Lance Rodewald ISD Division Director and Jean Moody-Williams Division Director for CMS will speak on collaboration opportunities between immunization programs and Medicaid agencies and finally there will be a panel made-up of CDC and CMS staff to answer your questions about VFC and/or Medicaid.

• CoCASA

As we progressed through the VFC Management Survey review discrepancies were noted with regards to the percent of providers who were 100% compliant with all 5 administrative questions and 10 Storage and Handling in the VFC Accountability section. When we researched this issue a bug was found in CoCASA that needed to be corrected.

In addition, we noted some functions in CoCASA that could cause inaccurate data to be included in the CoCASA reports that are run to populate the VFC management survey. Currently CoCASA allows a user to skip high priority questions in the VFC site visit questionnaire and save the results. Providers with no answers are grouped with providers who answered the questions correctly-so we cannot accurately determine the number of providers that answered each high priority correctly because of the unknown number of providers in the denominator that did not answer each high priority question. Since it is required to ask all questions in Section One of the VFC site visit questionnaire with the new CoCASA version will require the user to answer the question before allowing them to exit out of the questionnaire.

Another finding made was a user may select and save a VFC site visit and AFIX site visit in the visit information screen under the VFC/AFIX evaluation tab but not enter any further data (either assessment or complete a site visit questionnaire) and those “visit” would be counted as visits in AFIX core report. The new release of CoCASA will require a completed site visit questionnaire or assessment results to be present for in the software for that date for that visit to be counted. These changes are being made to improve the accuracy of the data submitted to CDC in the VFC Management Survey.

• VOFA 2009

A VOFA patch with updated pediatric contact prices and 317 DA targets will be released shortly.

• CoCASA 3.3 (patch)

Updates in 3.3:

• dozen or so small bugs fixed
• % calculation in Core Report
• require completion of site visit questionnaire high priority questions
• require entering data if AFIX visit
• AFIX qualitative visit returned due to high demand
• 4313314
• Status bar for large imports (so will know still running)

• CoCASA Site Visit Categories
Nathan to briefly reminded people of definitions of site visit categories and how to use them in CoCASA (appendix 6 of Ops Guide).


• Vaccine University
  • Agenda update – Nathan highlighted changes from new agenda and one on web. Also announce that final agenda is now on web.
  • Sessions update – briefly highlighted some of the sessions.
  • Library – announced library and invited grantees to bring materials to highlight
    

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