Help and Healing

Healthcare Organizations Respond to Hurricane Katrina

    The American Association of Home Care (https://www.aahomecare.org) is using the Hurricane Katrina Information Center link on its website to help coordinate home care relief efforts as well as to provide a special link to the Red Cross. The Association is asking for donations of equipment or services for those in the Gulf Coast with special medical needs.

    The Durable Medical Equipment Regional Carrier, Region C, has agreed to accept paper claims from providers in hurricane areas. Providers are asked to write DISASTER CLAIM at the top of the claim in bold letters. Supporting documentation stating the nature of the disaster flood claim should be included. Providers are asked to make all reasonable attempts to obtain medical documentation for the claim; if this is not possible, they can submit the claim, dispense the item, and obtain documentation at a later date.

    The Louisiana State Nurses Association (LSNA) is helping coordinate emergency nursing efforts. Nurses with ER, ICU, or other hospital experience should contact LSNA at (800) 457-6378, (225) 201-0993 (keep trying if telephone lines are busy), or lsna@lsna.org.

    The US Department of Health and Human Services (HHS) is coordinating a national medical relief effort by soliciting volunteer physicians, nurses, and other healthcare providers. Physicians and other medical professionals with any state license who can commit to short-term, long-term, or rotating coverage are urgently needed in Louisiana, Mississippi, Alabama, and Florida. The HHS has established a website and toll-free number, (866) KAT-MEDI, to allow healthcare personnel to assist in Hurricane Katrina relief efforts: https://volunteer.ccrf.hhs.gov and (800) 272-2707.

    Louisiana and Mississippi have waived state physician licensure requirements to expedite medical personnel to affected areas. Physicians interested in helping must have a current valid license in another state that has tort liability coverage under Louisiana or Mississippi state medical malpractice acts. To learn how you can volunteer, visit the Louisiana State Medical Society or Mississippi State Board of Medical Licensure websites. A valid medical license, photo ID, Drug Enforcement Administration (DEA) license, and prescription pads are required. For more information, contact https://www.lsms.org.

Enrollment for Medicare Prescription Drug Benefit Begins

    Enrollment for the Medicare Prescription Drug Benefit mandated in the Medical Modernization Act (MMA) begins November 15, 2005 and will continue through December 31. Beneficiaries who enroll during this time period will be eligible to receive prescription drugs when the benefit becomes effective on January 1, 2006.

    Like Medicare Part B, enrollment in this program is voluntary. Beneficiaries must pay a monthly premium of approximately $37, depending on the plan chosen, a co-payment, and a yearly deductible ($250 to $2,250 in 2006). Enrollment before May 15, 2006 will allow beneficiaries to take advantage of lower monthly premiums as the Centers for Medicare and Medicaid Services (CMS) anticipates that premiums will increase. Once the person is enrolled, it will take approximately 2 months for the coverage to become effective.

    The CMS also estimates that the benefit will average approximately $1,300 a year, about half of the CMS-estimated average cost a Medicare beneficiary now pays for prescription drugs. The benefit is available to all Medicare beneficiaries, regardless of their Medicare plan (ie, “traditional” Medicare or Medicare Advantage). Assistance for beneficiaries with limited income (an individual with an annual income of less than $14,355 or a couple living together with an annual income of less than $19,245) will be available. Additional financial benefits include a ceiling on annual out-of-pocket prescription drug expenses of $3,600. Once the beneficiary pays this amount, Medicare coverage increases to 95% for covered drugs, and the beneficiary’s co-payment decreases to 5% for the remainder of the calendar year.

    Many different plans exist within the benefit regarding specific drugs covered, how much the beneficiary has to pay, what pharmacies can be used, and other concerns. Higher monthly premiums may provide additional coverage. Beneficiaries should be educated in order to investigate what plan is right (or wrong) for them and whether they qualify for additional financial benefits.

    The CMS has downloadable educational materials for professionals to help educate Medicare beneficiaries about the basics of the program. The Toolkit for Healthcare Professionals: Medicare Prescription Drug Coverage includes reproducible artwork directed at consumers, a letter from the CMS administrator, a reproducible Fact Sheet (available in English and Spanish), a consumer brochure, an article, and a list of resources.

    The kit is available at: https://www.cms.hhs.gov/medlearn/provtoolkit.pdf.