For Pharmacies | For Disaster Affected Individuals
The purpose of the EPAP is to perform the activities related to processing prescription drug claims for medications and durable medical equipment (DME) for designated eligible individuals in a Federally-identified disaster area. EPAP allows any enrolled pharmacy in the United States and its territories to use existing electronic pharmacy systems as an infrastructure to efficiently process prescriptions and DME for individuals that are eligible for the Emergency Prescription Assistance Program (EPAP). This effort is performed under the authority cited in Sections 403 and 502(a) of the Robert T. Stafford Disaster Relief and Emergency Assistance Act (Stafford Act), 42 USC 5170b and 5192(a).
Prescription drugs and durable medical equipment (DME) are critical first line therapies in treating both acute and chronic conditions. For this reason, assuring an adequate and readily available supply should be a priority for emergency planning. The Emergency Prescription Assistance Program (EPAP) was developed to fully leverage private sector resources for efficient prescription drug distribution. The EPAP will provide access, at any enrolled pharmacy in the nation or U.S. territories, to necessary prescription drugs and limited durable medical equipment (DME) for individuals who were affected by a disaster of national significance and have no other drug or DME coverage. Coverage shall be limited pharmaceutical and DME written prescription assistance to a one time fill of up to a 30-day supply for a medication to treat an acute condition, to replace maintenance prescription drugs or medical equipment lost as a direct result of the declared emergency or as a secondary result of loss or damage caused while in transit from the emergency site to the designated shelter facility.
The Pandemic and All-Hazards Preparedness Act (Public Law 109-417) establishes within the Department of Health and Human Services the position of the Assistant Secretary for Preparedness and Response (HHS/ASPR) to serve as the principal advisor to the Secretary on all matters related to Federal public health and medical preparedness and response for public health emergencies. The Office of Emergency Management (OEM) through the EPAP supports the mission to provide pharmaceutical supplies, limited durable medical equipment and personnel sufficient to support disaster response operations.
EPAP activities provide “essential assistance” to support state and local jurisdictions as defined in Section 403 of the Stafford Act, 42 USC 5170b. The President must first issue an Emergency Declaration or Major Disaster Declaration under the Robert T. Stafford Disaster Relief Act, or declare an Incident of National Significance. Once declared, FEMA has the authority to issue a Mission Assignment to Deploy HHS under Emergency Support Function-8, if appropriate. Upon receipt of the FEMA Mission Assignment to Deploy, HHS may activate the EPAP for specific geographical locations.
EPAP provides access, at any enrolled pharmacy in the nation or U.S. territory, to necessary prescription drugs and limited DME for individuals who were affected by a disaster of national significance and have no other drug or DME coverage. EPAP coverage will be issued for identify evacuee populations from specific locations (disaster effected areas by zip) who may be eligible for prescription and DME assistance and dates.
The EPAP will:
Ensure access to covered prescription drugs and DME for eligible individuals who present at a pharmacy with a valid prescription, at no cost to the affected individual.
Implement real-time point-of-sale eligibility checks and system edits for claims where the pharmacist has found no other coverage to limit dispensing of EPAP covered drugs and DME to eligible individuals.
Facilitate legitimate pharmacy claims from new pharmacy locations and other out of network pharmacies on an as-needed basis.