In a Change Request (CR 8098) issued May 3, 2013, the Centers for Medicare & Medicaid Services (CMS) indicated that, effective October 1, 2013 - for implementation on October 7, 2013 - Medicare systems will prevent non-hospice providers from providing vaccines to hospice patients. While a hospice may provide influenza, pneumococcal, and hepatitis B vaccines to hospice-enrolled beneficiaries who request them, and may bill the Part B Carrier for both the vaccine and an administration fee, any other provider will be denied reimbursement.