HME Hurricane Hotline

IMPORTANT NOTE FROM PEGGY WALKER:

Lost or destroyed equipment (patient owned) is replaceable. Bill paper claim or ,if able, electronic - Clearly stating DISASTER CLAIM at top of page or in narrative field.

Supplies lost can be replace in middle of month or when needed.

Palmetto will accept paper claims.

There will be a 28 day payment floor as required by HIPAA for hardcopy claims (Note: this is being addressed by industry to see if we can get this reduced!)

Please note if you have any difficulties or questions call Peggy at 800-401-3643 or e-mail Walkerp321@aol.com.

Palmetto has indicated that they are also looking at some relief for those suppliers who have lost everything even under the capped rental items.

There are no words to express the concerns myself, my family and friends here have for our members and all of those affected by this disaster. Our thoughts & prayers are with them all.

I will keep everyone posted.

God Bless
Peggy Walker, RN

Question

"Where can dealers go to obtain CMN's, scripts, etc. if they end up needing to service patients from the hurricane area? Patients will not have any documentation......the places that do have the documentation are gone..."

Peggy Walker

Suppliers will not be required to have copies of CMNs, orders, etc. during this disaster. However, you will want to put through your "best efforts" to obtain full information from patient relating to previous address, etc. I note that Palmetto GBA has a comment on their web site (see link) relating to a few issues but not all is updated yet. I am maintaining contact with PGBA and will keep VGM updated with any new information. The Ombudsmen at PGBA will be available for questions shortly.

Additional tips:

Suppliers we need to verify that the patient is on Medicare, and the person you are delivering the items to is the correct beneficiary. (Some may not even have a copy of their SS card but do the best you can!)

Supplies that are lost or destroyed (e.g., the beneficiary evacuated): The beneficiary may pick up supplies before the month's drop shipment date.

Lost or destroyed patient owned equipment: Equipment will be replaced by Medicare, if no other insurance is proven to be primary (such as beneficiary flood insurance, etc.)

Capped rental items supplied by suppliers other than original (evacuated patients) will be paid exactly the same as any other transfer of suppliers, but without having to obtain all the documentation in advance.

Palmetto GBA will accept paper claims for those providers affected by the disaster. Bill hard copy with "Disaster Claim". These will be subject to the 28 day payment floor.

Documentation may be requested from suppliers in the future. Example: Records from the beneficiary indicate they submitted a claim to their own insurance/FEMA, or perhaps an insurance report indicating that they have lost HME, and that the particular item was not covered under another insurance plan.

Providers who have lost records should follow the same procedures as if you were filing a regular insurance claim. Try to itemized the list of current beneficiaries that were lost.

Take pictures of the damage. Make sure this is documented for future audits. (You may be requested to provide records five years from now). You may wish to keep copies of a news paper article to show where the storm actually hit. (I know that sounds a little nit picky but it is best to be safe than sorry!!).

If you have any other questions call Peggy at 800-401-3643

The Board of Pharmacy will be closely monitoring HURRICANE KATRINA and its effects on pharmacy services through out the state. Many people will be without pharmacy services in the worst hit areas.

The Board would 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.

If a pharmacist received a request for a 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:
1. The prescription is not a medicinal agent listed in Schedule II appearing in Title 20 Chapter 2.
2. The prescription is not a medicinal agent listed in Schedule III appearing in Title 20 Chapter 2.
3. The medication is essential to the maintenance of life or the continuation of therapy in a chronic condition.

The Board has confirmed their understanding that measuring an oxygen supply is not as precise as most medications, and they have a request in line for the Governor's attention for an extension of this authority for thirty days. Watch the Alabama Board of Pharmacy web site, albop.com, for additional information.

I have a camper in Austin, TX to loan to a hurricane family who needs a place to stay.. It has has 2 king size beds, A/C, stove, fridge, slide-out dining area, etc... If you know some nice folks in need who might be interested in hanging out in the Austin, TX area for a while, shoot me a line. I can have it set up at a local state park or rv park of their choice pretty quickly.

Email craig.high@travismedical or craighigh@grandecom.net

Thanks,
Craig

Craig High, BS, ATS
Travis Medical Sales Corp.
Austin, TX

Lee Conn reports that the American Red Cross has opened at least one center where medical supplies and equipment will be accepted, at The Summit, on Highway 280 at I-459 in Birmingham. After refusing merchandise donations initially, accepting only cash, it appears that transportation may be available for equipment. Call your local Red Cross office for information.