NOTE: Many people living with serious mental illness are reliant on Medicaid for their services, supports, and treatment. For others, access to treatment is a critical component of their health, a condition that may likely be compromised with the tragedy of Hurricane Katrina.
U.S. Department of Health & Human Services, Centers for Medicare & Medicaid Services
What consumers and families need to know…..
** Health care providers that furnish medical services in good faith, but who cannot comply with normal program requirements because of Hurricane Katrina, will be paid for services provided and will be exempt from sanctions for noncompliance, unless it is discovered that fraud or abuse occurred.
** Crisis services provided to Medicare and Medicaid patients who have been transferred to facilities not certified to participate in the programs will be paid.
** Medicare contractors may pay the costs of ambulance transfers of patients being evacuated from one health care facility to another.
** Normal prior authorization and out-of-network requirements will also be waived for enrollees of Medicare, Medicaid, or SCHIP managed care programs.
** Normal licensing requirements for doctors, nurses, and other health care professionals who cross state lines to provide emergency care in stricken areas will be waived as long as the provider is licensed in their home state.
** Certain HIPPA privacy requirements will be waived so that health care providers can talk to family members about a patient’s condition even if that patient is unable to grant that permission to the provider.
** Hospitals and other facilities can be flexible in billing for beds that have been dedicated to other uses, for example, if a psychiatric unit bed is used for an acute care patient or vice versa.
** Hospital emergency rooms will not be held liable under the Emergency Medical Treatment and Labor Act (EMTALA) for transferring patients to other facilities for assessment, if the original facility is in the area where a public health emergency has been declared.
** Information and frequently asked questions are updated daily at http://www.cms.hhs.gov.
** Contact your insurance company or benefits manager as soon as possible and determine alternative arrangements for your care and service.
** Contact the NAMI state organization in your relocated state for local resources and referrals to provider services that meet the needs of people living with serious mental illness.
** If you are a Medicaid recipient who has evacuated to another state, your Medicaid benefits will still apply as long as you are treated by an out-of-state provider who is willing to accept your state’s Medicaid as payment. For information on securing a transfer of this benefit, call 1-888-342-6207 and for pharmacy benefits related to Medicaid, call 1-800-437-9101.
** If you routinely had your prescriptions filled by a national pharmacy chain (Walgreens, CVS, etc.) your information is in their system. You can go to any store and they will have your history and be able to assist with refills. Take your former prescription bottle to the pharmacy with you for assistance with a refill.
** In the likely event that you do not have access to your regular doctor or clinic and you do not have any refills available, or you do not have access at all to your former medication, find a provider in your relocated area and schedule an appointment. If you have them, take your former prescription(s) with you to a new provider so he/she can have access to at least some of your treatment information. Having a family member or friend present, if possible, will also help to relay previous history to ensure best results.
** For medical pharmacy program benefits, please go to a pharmacy that accepts Medicaid benefits with your Medicaid card and/or call Medicaid at 1-888-342-6207 for temporary enrollment.
** NOTE that Medicaid rules are being laxed for displaced Medicaid recipients and that different states are responding with various strategies. Read below for more detailed information about your current location’s policies.
LOUISIANA RESIDENTS, DID YOU KNOW?
** People in the affected areas who previously didn’t qualify for Medicaid due to income, may now qualify. Guidelines are the same as the traditional guidelines for Medicaid in Louisiana, but because many people are without jobs or homes, their living situations have changed and they now may be eligible for Medicaid.
This Hurricane Katrina Medicaid coverage will be temporary. To learn more, go to:
For an application for this temporary Louisiana Medicaid, go to:
** If you are a displaced resident of Louisiana, have your former prescription bottle, and are in need of mental health medications, please contact 1-225-922-2700 and/or read below for additional information.
** If your medical provider is unsure of how to get your prescriptions filled in other areas, ask them to call 1-800-437-9101 (in Louisiana) or out of state at 1-225-342-1590.
** If your medical provider has questions relating to your benefits or other issues relating to your Medicaid benefits, they can call 1-800-473-2783 (in or out of state).
** People specifically looking for help with patients in nursing homes, hospitals who need to evacuate, or other care units, call 1-225-763-5749.
MISSISSIPPI RESIDENTS, DID YOU KNOW?
** The Mental Health Association of the Capital has a medication fund that will provide financial assistance for the purpose of purchasing mental health medications. Call 1-601-956-2800.
** The University Medical Center in Jackson also has a medication fund that will provide medications to people displaced by the crisis.
ALABAMA RESIDENTS, DID YOU KNOW?
Medicaid and SCHIP Cross State Coordination For Hurricane Katrina Evacuees
States affected by Hurricane Katrina are working with CMS to develop procedures for handling Medicaid and SCHIP enrollment and benefit issues.
For updated Alabama information and links to resources of other states go to www.medicaid.state.al.us, click on HURRICANE-RELATED INFORMATION.
Current Medicaid and SCHIP Enrollees
Enrollees should remain in the program they are currently enrolled.
Ex: A Louisiana (LA) Medicaid enrollee in Alabama (AL) will remain enrolled in LA Medicaid.
For Medicaid, providers will need to enroll in the network of the state from which the recipient is enrolled, i.e. Alabama providers need to enroll in the LA and Mississippi (MS) Medicaid network to be reimbursed for treating these enrollees.
LA SCHIP (LaCHIP) is a Medicaid expansion, enrollee and provider issues are the same as for Medicaid. LA Medicaid eligibility can be checked through the Alabama Medicaid web site. Provider network application for both the Alabama and LA networks are also available at that site.
MS SCHIP is a stand alone program utilizing the Blue Cross Blue Shield (BCBS) of MS network. Out of state providers should call BCBS of MS @ (877) 870-3110 for approval of services. ALL Kids has asked BCBS of AL to help facilitate getting these children services as needed.
For ALL Kids enrollees who have evacuated to other states, BCBS of AL will pay out of state claims for ALL Kids enrollees with a county of residence of Baldwin, Choctaw, Mobile, Sumter, Clarke and Washington. This measure has been put in place until September 30, 2005 and will be extended if needed.
Uninsured Evacuees who may be eligible for Medicaid or SCHIP: Residents from other states who are in AL temporarily, who may now be eligible for Medicaid or SCHIP, need to be enrolled in the program of their state of residence. There is an expedited process and form being developed for this purpose.
If the family will be staying in AL permanently, then they may apply for AL Medicaid or ALL Kids using the joint application.
REGARDING MEDS IN ALABAMA
The Board of Pharmacy will be closely monitoring Hurricane Katrina and its effect on pharmacy services throughout the state. Many people will be without pharmacy services in the worst hit areas. The Board will ask that in the event that an individual is unable to obtain their medication from their usual pharmacy during this emergency situation, that you apply the Emergency Prescription Refill criteria.
680-X-2-.26 Emergency Prescription Refill
1. If a pharmacist received a request for a personal prescription refill, the original of which is maintained in the pharmacy files, and the pharmacist is unable to readily obtain refill authorization from the prescriber, the pharmacist may dispense a one-time emergency refill of up to a 72 hour supply of the prescribed medication, provided that:
a. The prescription is not a medicinal agent listed in Schedule II appearing in Title 20 Chapter 2.
b. The prescription is not a medicinal agent listed in Schedule III appearing in Title 20 Chapter 2.
c. The medication is essential to the maintenance of life or the continuation of therapy in a chronic condition.
You can obtain more information by visiting: http://www.albop.com/
DISPLACED LOUISIANA RESIDENTS IN TEXAS, DID YOU KNOW?
**Louisiana officials are enrolling Texas pharmacies as Louisiana providers, allowing Louisiana Medicaid recipients to access medications. To enroll, pharmacies will need to fax in enrollment forms posted at http://www.hhsc.state.tx.us/HCF/vdp/vdpstart.html. Pharmacies needing to verify eligibility can do so by calling 1-800-473-2783. Texas is broadcasting this information both through HHSC and the Texas Pharmacy Association. In addition, health care providers can verify the Medicaid and CHIP enrollment information for individuals from Louisiana and obtain procedures to process claims by calling 1-800-473-2783.
** IN DALLAS: People seeking social services can call 211, the free hotline for referrals operated by the Community Council of Greater Dallas.
DISPLACED LOUISIANA AND MISISSIPPI RESIDENTS IN ALABAMA, DID YOU KNOW?
The Alabama Medicaid Agency is coordinating efforts to provide essential services for Medicaid recipients who have migrated to Alabama from Louisiana and Mississippi.
Alabama Medicaid providers should feel confident regarding reimbursement of services to displaced Medicaid recipients from Louisiana and Mississippi. Please note that providers will be paid based on out-of-state coverage policies established by the Medicaid programs in those state.
For additional information, contact:
• Nursing Home Services - (334) 242-5684
• Pharmacy Services - (334) 242-5050
• Medical Services - (334) 353-5533
Louisiana Residents in AL – If a Louisiana Medicaid recipient goes to a mental health facility in Alabama please as the provider to complete a provider form and fax it to (225) 216-6335. Links to provider forms are available on MASA's website at www.masalink.org. Questions regarding Louisiana Medicaid may be directed to (225) 216-6370.
Mississippi Residents in AL - If a Mississippi Medicaid recipient goes to a mental health facility in Alabama, please ask the provider to use the application available by utilizing the Mississippi Medicaid Web Portal for enrollment at this time.
• Provider Enrollment - Mississippi Medicaid http://msmedicaid.acs-inc.com.
• Mississippi Medicaid Home Page http://msmedicaid.acs-inc.com/index.jsp
There is also a toll free number: (800) 884-3222 or (601)-206-3000 for more information regarding enrollment services. General pharmacy questions for Mississippi Medicaid can be directed to (866) 759-4108.
THOSE CURRENTLY RECEIVING MEDICATIONS - PATIENT PRESCEIPTION DRUG ASSISTANCE PROGRAMS
Boehringer Ingelheim Pharmaceuticals, Inc.
Bristol-Myers Squibb Company
Eli Lilly and Company
Forest Pharmaceuticals, Inc.
IVAX Pharmaceuticals, Inc.
Janssen Pharmaceutica, Inc.
Ortho-McNeil Pharmaceutical, Inc.