New Federal, State Reforms to Ease Disaster Relief Kinks

By Foxhall, Kathryn | Drug Topics, October 22, 2007 | Go to article overview

New Federal, State Reforms to Ease Disaster Relief Kinks


Foxhall, Kathryn, Drug Topics


As the emergency phase after Hurricane Katrina passed, there were many people who had worked diligently to get medications to those in need. "There were big pharmacies and little pharmacies," said Chris Worrall, special assistant in the administrator's office of the Centers for Medicare & Medicaid Services. CMS had worked with private industry, he said, and retailers and wholesalers were amazingly responsive and efficient. He cited instances when companies had massive shipments headed to shelters 30 minutes after a phone call about specific needs.

But after all that effort, many of the pharmacies and other industry people had no way of knowing who to bill, whether it was a local board for pharmacy, local government, or the Federal Emergency Management Agency (FEMA). Indeed, some of those payment problems are ongoing to this day, said Worrall, who spoke at the recent Fall Legislative Conference of the National Association of Boards of Pharmacy in Arlington, Va.

New program

That's why the federal agencies have created the "Emergency Prescription Assistance Program" (EPAP), which was approved by FEMA last March, as a payer of last resort to cover medications and some durable medical equipment for people affected by major disasters who have no other coverage, Worrall said. The program has a predefined formulary. The system also includes provisions for communications between government and industry and for facilitation of product donation.

Eligible consumers-who must be from the disaster area-may bring a prescription or a refill to a retail pharmacy. Pharmacies may also deliver to a shelter. Worrall noted that if evacuees went from Louisiana to Maine, the system could serve them. The pharmacy will check eligibility, adjudicate the claims, and dispense the medications with no co-pay.

The EPAP process will pay pharmacies for "eligible clean claims" through a claims processor that will have the contract for that purpose.

Worrall said the program will provide more than 50,000 locations to get necessary medications and equipment, while allowing pharmacists to be first responders without taking on excessive financial risk. …

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