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HHS Provides Prescription Drug and Durable Medical Equipment Aid

by Barbara Kram, Editor | September 09, 2008
Hurricane Gustav
HHS Secretary Mike Leavitt announced $1 million in individual assistance for Louisiana victims of Hurricane Gustav, through a new Emergency Prescription Assistance Program (EPAP) administrated by the Centers for Medicare & Medicaid Services (CMS).

The program, which has begun providing benefits, is an efficient way for pharmacies to process claims for prescription medications and certain durable medical equipment items for individuals who do not have any form of health insurance coverage and who are from the Louisiana disaster area declared by the President.

Claims for individuals with private insurance, such as employer-sponsored coverage or an individual health insurance policy, are not eligible for payment under the EPAP. Nor are claims for individuals with public insurance, such as Medicare or Medicaid.

"This program is an example of public and private entities working together to improve our nation's ability to respond in emergencies," Secretary Leavitt said. "Over the past year, CMS has worked with pharmacy industry groups and leading technology companies to incorporate their planning and unique capabilities into the program's procedures and processes. The result is a program that is easy to use and provides the extra support that some people need after a disaster."

EPAP covers one-time, 30-day supplies of medications and certain durable medical equipment, such as canes, walkers, wheelchairs and diabetic supplies.

With a written prescription, eligible individuals may receive assistance for essential pharmaceutical and durable medical equipment lost as a direct result of Gustav. The supply can be used to treat an acute condition and to replace maintenance prescription drugs or medical equipment.

For the eligible individuals, the program also would cover, at no cost to the patient, replacements for needed drugs or equipment lost or damaged while in transit, such as from an emergency site to a designated shelter facility.

To assist in the determination of eligibility, pharmacies must check at the point of sale for other forms of health insurance coverage. Only claims with a date of service between Sept. 2 and Sept. 11, 2008 are eligible for processing under the EPAP-Gustav Activation at this time.

Eligible individuals must have a new prescription from a licensed health care practitioner, a current prescription bottle, a prescription phoned in by a licensed health care practitioner, or proof of an existing prescription in order to receive a prescription fill and/or certain durable medical equipment.

Pharmacies must dispense the generic form of medication unless otherwise indicated as brand medically necessary by the licensed health care practitioner.

The HHS Web site is featuring a link to public health and safety information specifically related to hurricanes at www.hhs.gov/hurricane.