Some hospitals billing insurance for coronavirus shots

Bruce Macbeth, of Aberdeen, got two doses of the Moderna vaccine, in January and February, at Hoke Healthcare, in Raeford. Last week, he received a letter from Medicare saying that the hospital had charged the federal insurance program for senior citizens $113 for sticking a needle in his arm twice.

"They’re charging whatever they want just to get income," Macbeth said Thursday.

Hoke Healthcare charged $42.45 for the first dose and $71 for the second dose, he said. He wasn't responsible for any of the cost.

"We have been billing insurance carriers when possible. This is an automated billing function calculated at standard industry rate methodologies, and we are reimbursed a fraction of the costs associated with administering these vaccine clinics to the community," Hoke Healthcare's parent, the Cape Fear Valley Health System, said in a statement.

Medicare paid only $13.86 for the first dose and $22.92 for the second, even lower than the standard rate of $16.94 and $28.39 that the Centers for Medicare and Medicaid Services set for vaccinations done before March 15. Since then, CMS has paid $40 per shot.

“While the actual vaccine doses are supplied in bulk by the government, our costs reflect the time and materials use by pharmacists, nurses, administration and other staff and facilities,” Cape Fear Valley Health said.

Some other area hospitals also are billing insurers for the coronavirus vaccinations.

"Although UNC Health is receiving the actual vaccine for no cost, we incur expenses for storage, handling and distribution," UNC Health said in a statement.

"Duke Health submits its administration fee to patients’ insurance. All major payers, including Medicare and Medicaid, have waived cost-sharing for patients related to the vaccine," the Duke University Health System said in a statement.

But WakeMed said it's not charging to give shots "at this time."

Even though he believes "everybody deserves to get paid," Macbeth questions the price tag hospitals are putting on the process of jabbing someone with a needle.

"Why are you making a profit off of a pandemic? Why are you making a profit off of Medicare?" he asked.