HHS Provides Prescription Drug, Durable Medical Equipment Assistance

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HHS Secretary Mike Leavitt today announced up to $2 million in individual assistance for victims of Hurricane Ike from affected counties in Texas, through a new Emergency Prescription Assistance Program (EPAP) administrated by the Centers for Medicare and 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 Texas emergency 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 the public and private sector working together to improve our nation’s ability to respond to emergencies,” Secretary Leavitt said. “People without health insurance affected by this storm will be able to more easily get their needed prescriptions no matter where they evacuate to.”

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

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With a written prescription, eligible individuals may receive assistance for essential pharmaceutical and durable medical equipment lost as a direct result of Ike. 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. 12 and Sept. 22, 2008 are eligible under for processing under the EPAP-Ike 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.

Eligibility for the EPAP – Ike Activation is limited to individuals who meet the criteria above and are a resident of the following counties in Texas: Aransas, Bexar, Brazoria, Brooks, Calhoun, Cameron, Chambers, Cherokee, Collin, Comal, Dallas, Denton, El Paso, Ellis, Fort Bend, Galveston, Hardin, Harris, Hidalgo, Hunt, Jackson, Jefferson, Jim Wells, Kenedy, Kleberg, Kaufman, Liberty, Lubbock, Matagorda, Navarro, Nueces, Orange, Refugio, San Patricio, Smith, Van Zandt, Victoria, Walker, Waller, Wharton, Willacy, and Wood.

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