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Medicare payment dispute may stymie flu shots.

THE EFFORT to get as many people as possible immunized against influenza in the coming season may be stymied before it starts, thanks to what some physicians regard as inadequate reimbursement for administration of the vaccine. With considerable fanfare this summer, the Medicare program announced that for the first time it would reimburse its beneficiaries for influenza vaccinations. But even as the word went out that the agency expected as many as 15 million of the 36 million Medicare beneficiaries to line up for their free flu shots, there was rumbling that some physicians had decided not to participate in the program because the fee they receive from the Health Care Financing Administration (HCFA) fails to cover their costs of giving it. How many physicians are in fact proposing not to participate in the program is unknown. But, says David Fedson, MD, "I have been told by the American Lung