The Med Diva

An insider's guide to Medicare Part D and more

Archive for the category “Drug Access During Emergencies”

Online tool helps people locate open pharmacies in storm-affected areas

During a disaster or emergency event, it is critical for people who take life-saving medications or drugs that control chronic conditions to have access to those medicines. I discovered this firsthand when my mom came to stay with me during Hurricane Sandy. She originally planned on staying only one night—she was overly optimistic about the power coming back on at her house—but when she heard the power was going to be off for at least a few more days, Mom began to panic a bit. She only brought a two-day supply of her medication, and was worried about having to skip a few days without it.

Luckily I know a thing or two about Medicare Part D, and was able to explain the situation to the CVS pharmacist in town. Even though my mom had just refilled her medication a few days earlier at her local CVS, the pharmacist was able to override Medicare’s  “Refill too soon” claim rejection because of the emergency situation. Within 10 minutes, Mom had her medication in hand.

We were very fortunate in that my home town did not sustain any damage, so I knew there would be no trouble getting her medication. But what about the less fortunate people in areas like Staten Island, Rockaway Beach, and Long Beach Island, where so many homes are in ruins? How would people know where to go to get the medication they needed?

I started to do some digging on the subject, and came across the Rx Response’s Pharmacy Status Reporting Tool.  The website provides real-time information about open pharmacies in storm-affected areas.  Granted, one needs Internet access via computer or smart phone to use the site, but it’s still a good tool for those employees and volunteers in emergency management and at emergency shelters who are trying to help people find the closest open pharmacy.

According to the site, Rx Response works with the National Council for Prescription Drug Programs (NCPDP) and pharmacy clearinghouses responsible for processing pharmacy payments. Once a request is made by a state emergency or public health official to begin pharmacy status reporting, Rx Response requests a list of all NCPDP pharmacies within an affected disaster area as well as a daily list of all pharmacies that are billing within the affected area. Once the data is processed, Rx Response displays a graphical, searchable map and downloadable Excel file of all known pharmacies, all open pharmacies, and any known affected/closed pharmacies.

The site is a bit clunky and not very user-friendly, but the concept is a good one that is much needed in this age of frequent storm surges. If anyone knows of a better site with this type of information, please let me know. With Sandy Part II expected to hit the northeast today and tomorrow, a lot of people may unfortunately be searching again for an open pharmacy.

When Frankenstorms Like Hurricane Sandy Hit: How Medicare Part D Plans Prepare for Disaster

Medicare Part D coverage emergencySince I work for a Medicare Part D plan with pharmacy operations based in New Jersey, I thought I’d give you an inside scoop on how Medicare Part D plan sponsors prepare for their members’ prescription drug needs when government-defined emergencies such as hurricanes and tornadoes are declared.

Today I received several emails at work about Hurricane Sandy, which the media has dubbed “Frankenstorm.”  Some of these communications instructed employees on how to prepare in case they cannot make it to work on Monday (for example, we must bring our laptop computers home and log in on a regular basis over the weekend for updates). Other emails alerted us to what the company is doing to make sure Medicare beneficiaries will continue to get the medication they need if this storm does strike as hard as the weather forecasters say it will.

Right now as I write this post, we have a team that is constantly monitoring the path of Hurricane Sandy, which is forecasted to impact Florida and the northeast over the next several days. We are also preparing our Customer Service and Pharmacy Services staff to handle expected increases in volume due to the storm.

You are entitled to replacement medication at any time when disaster strikes

If it appears that the storm could impact access to pharmacies or require evacuation, beneficiaries residing in those areas will be allowed to order replacement medication, even if they recently filled their prescriptions. In other words, we will override the systems that normally reject prescription drug claims when a member’s drug is refilled too soon.

For example, let’s say you filled a 30-day prescription for your blood pressure medication last week. Under normal conditions, most Part D plans would reject the claim if you tried to refill this prescription next week. We call this a “Refill Too Soon” claim rejection. But when the government declares an emergency, beneficiaries are entitled to get refills immediately without disruption. So, for example, if you lose your medication during a flood or other disaster, or you can’t get access to your medications because the roads to your home are blocked, you can order a refill and your claim will not be rejected at the pharmacy.

As I post this from the comfort of my home right now, employees at my company are sending fax messages to all the retail pharmacies in our network, reminding them of this policy and instructing them on how to obtain override codes and enter claims in the event of a disaster declaration. In the meantime, our teams will keep working and monitoring the storm all weekend and throughout the week to make sure everyone is prepared for the worst.  Stay safe.

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