The Health Plan has established a Disaster and Emergency Declaration policy in accordance with state and federal laws and related regulations.

In the event of a Presidential emergency declaration, a Presidential (major) disaster declaration, a declaration of emergency or disaster by a Governor, or an announcement of a public health emergency by the Secretary of Health and Human Services, but or prior to the issuance of, an 1135 waiver by the Secretary, the Health Plan will:

*For any medical emergency please contact 911*

During this period for Medicare Advantage Members:

1. Designate that the emergency/disaster policy begins with declaration of federal/local determination.
2. Continues for 30 days from date of original designation.
3. Allows for Part A, B and C benefits at specified non-network facilities.
4. Waives in full requirement for gatekeeper referrals.
5. Temporarily reduces out of plan approved costs to in-network cost sharing amounts.
6. The Plan will lift "refill-too-soon" edits. Affected enrollees can obtain the maximum extended day supply, if requested and available at the time of refill.

During this period for Medicaid Members (DSNP):

1. Waive all prior authorization requirements for critical Medicaid services (e.g., durable medical equipment and supplies, home health services, hospital services, nursing facility services, chemotherapy, dialysis services, etc.)
2. Early prescription refill edits have been lifted for all maintenance medications (Note: This does not apply to controlled substances)
3. If a recipient requires critical Medicaid services beyond the limits stated in policy to maintain safety and health, providers can furnish the service.
4. If a recipient requires critical Medicaid services beyond the limits stated in policy to maintain safety and health, providers can furnish the service.
5. Retroactively performed screenings or resident reviews must document the reason for delay in the completion of PASRR requirements.
6. The Agency is waiving the PASRR process for recipients who evacuated due to an evacuation order or power outage and are admitted and discharged during the storm.

These measures will remain in place for the duration of the emergency declaration. Disasters or emergencies may be declared by the U.S. Government, the Federal Emergency Management Agency (FEMA), or a state Governor.

Transportation:

There may be long waits for members calling for transportation services, including emergency transportation, in some areas that may be affected by a disaster. If you need transportation and it is not an emergency, please call back at a later date. This will ensure we can help people who are in need right away. If you are experiencing a medical emergency, please contact 911.

OVER THE COUNTER (OTC) ORDERS:

LINKS TO WEATHER RELATED WEBSITES