Dear Friends and Colleagues,
We hope you are hanging in there as you navigate the many changes and challenges COVID-19 has brought to your lives. We at the Virginia Health Care Foundation are grateful every day to be working with you, who are so dedicated to helping uninsured and medically underserved Virginians obtain needed health care.
The 1:1 application assistance you are providing to help those with chronic diseases either obtain free PAP medicines or full coverage from Medicaid is making a tremendous difference for folks. Suddenly, there are so many more Virginians who need your help as tens of thousands have become unemployed because of COVID. Your creative approaches to serving them remotely or at an appropriate social distance are remarkable. Your commitment is inspiring.
As a result, we’ve devoted this quarter’s newsletter to making sure you’re informed about the many positive changes occurring because of COVID-19. Some maximize health coverage and expedite food assistance to those affected by COVID job loss. Others provide new resources for medical, behavioral health, and dental providers.
We dedicate this newsletter to you and thank you for all you are doing to help your patients during these unprecedented times.
Sincerely,
Debbie Oswalt & the VHCF Team
TPC
will Host Online Medication Assistance Program Roundtables in Response to Navigating COVID-19
Take time out to connect with your colleagues from across the state in these changing times.
The focus of these online meetings will include tools & resources about how to operate a Medication Assistance Program remotely, reaching out to those who are newly unemployed, broader eligibility for PAP
medications and more!
Since we are unable to host regional in-person roundtables, we have opened up registration statewide for each of the four on-line gatherings to maximize the opportunities for participation.
Register now
for one of the upcoming sessions to secure a spot on your preferred day!
Confirmation details will be sent by email as we approach these dates.
- May 6 (10:00-11:30am)
- May 7 (9:30-11:00am)
- May 8 (9:30-11:00am)
- May 12 (1:00-2:30pm)
Operating a Medication Assistance Program Remotely? The
TPC
Medication Web App Can Help!
Most clinics have implemented social distancing measures. Some have implemented alternating work schedules. Some Medication Assistance Caseworkers
(MACs)
are working from home. More and more providers are seeing patients via telehealth appointments. The
TPC
Web App was made for times like these. It is a great tool to identify available medications even at a distance.
Providers, MACs, volunteers and other clinic staff can search for free and low-cost medicines right at their fingertips! Search by brandname, generic, class and subclass and determine if a medication is available for free from
TPC
or a low fee!
Drug Shortages as Result of COVID-19
While there are currently no drugs approved by the U.S. Food and Drug Administration
(FDA)
to treat COVID-19, access to some medications may be disrupted or delayed as a result of the COVID-19 pandemic.
On March 25, 2020, Virginia’s Health Commissioner issued a
memo
regarding a
surge in demand
for drugs commonly used to treat malaria, lupus, rheumatoid arthritis, HIV, bacterial infections that has been caused by the mistaken belief that they can treat COVID-19. The memo includes guidance to prescribers to avoid further disruptions and shortages
.
On another front, medications typically used for asthma like albuterol inhalers are being prescribed for COVID-19 patients with respiratory issues. This is seen as preferable to using nebulizers which can increase the risk of the virus being aerosolized. This shift could lead to supply issues for patients who get inhalers and similar products from PAPs.
It could be
helpful to order inhaler refills now,
as you are able. You can run the Patient by Medication report in
TPC
to help you identify patients who have been prescribed an inhaler. The Reorder reports will help identify when patient refills are due.
The U.S. Food and Drug Administration
(FDA)
continues to closely monitor the drug supply chain. It maintains a searchable list of medications that are in short supply. Be sure to share this information with providers and stay up-to-date with the latest drug shortages
here
. The database includes an option to download current drugs shortages into Excel and indicates if a drug is currently in shortage, resolved from a shortage or if a drug will be discontinued.
PAP Updates - Expanding Access to Medications & Helping More Patients
Many PAP programs are responding to COVID-19 with temporary eligibility changes, including interim assistance, to help those facing severe financial hardships. There may also be programs that are experiencing high call volume through the customer support call centers or processing delays due to limited staff resources and/or high demand. Here are some highlights and other updates. These are also regularly added to the
TPC
user message board.
Americares
has temporarily expanded eligibility criteria to assist uninsured people whose income is
≤ 400%
of the federal poverty level; people who are underinsured, which includes those with Medicaid, Medicare or private insurance coverage, whose income is
≤ 400%
of the federal poverty level AND have no prescription drug coverage OR cannot afford the prescription co-pay; people who are facing a severe financial hardship directly resulting from the COVID-19 pandemic. This can include individuals who are unable to work or individuals with family members who are unable to work due to lay-offs, business closures, serious health conditions, and/or caring for a loved one. It can also include individuals who are working reduced
hours.
AZ&Me
may send additional doses of product in shipments over the coming weeks. Refills may also ship earlier than originally scheduled to ensure patients continue to have uninterrupted access to medication.
Rx Outreach
,
a non-profit pharmacy, traditionally serves those earning less than 400% of the Federal Poverty Level. The company has temporarily extended the discount program, however, to assist individuals and families who are facing severe financial hardships because of COVID-19. To see expanded guidelines and to enroll, visit
www.rxoutreach.org
and click on COVID-19.
Check out the Research section of
TPC
for more information on recent changes including medication additions, medication removals, PAP eligibility, contact information changes, form updates and more!
Medicaid/FAMIS Eligibility for Those Newly Unemployed
Virginia Medicaid covers comprehensive health and mental health services, including testing and treatment for COVID-19.
Many Virginians who have lost their jobs or been furloughed as a result of COVID-19 are now eligible for Virginia’s Medicaid or FAMIS programs. Even those who have been denied in the past may now qualify.
Current monthly income and family size are the only criteria used to evaluate financial eligibility for this comprehensive insurance coverage. For example, the following would be income eligible:
- Single adult Virginians with a monthly income up to $1,469 (annual income up to $17,609)
- Adults in a household of three with a monthly income of $2,499 (annual income up to $29,974) may be eligible.
- Children in families earning up to $2,680 for a family of three (annual income up to $38,776).
Home, land and retirement savings do not count as income. COVID-19 stimulus checks and additional federal unemployment do not count as income for Medicaid/FAMIS eligibility.
VHCF-funded Outreach Workers provide remote, free, one-on-one help to those who want to learn about, apply for, or renew Medicaid/FAMIS coverage. To reach an Outreach Worker in your area, visit the
Cover Virginia
website. If there is no Outreach Worker in your community, patients can apply
online
or via phone: 855.242.8282.
Medicaid Renewals
During this time, coverage will not be cancelled when:
- A member ages out (at ages 19, 21, 26 and 65)
- After a woman’s 60-day post-partum period
- A member does not complete the renewal process
Now Available - Track Medicaid Renewals in
TPC
The Medicaid Details section of
TPC
on the patient Detailed Profile now includes the ability to track a new Medicaid Application vs a renewal application. As patient renewals are entered into
TPC,
select the Application Type from the new drop-down menu as New or Renewal and continue with other data entry as previously available. The Medicaid Application Enrollment Summary Report has been updated and now includes a filter on the parameter screen to display All, New or Renewals.
Many Changes to Virginia’s Medicaid/FAMIS Programs to Ensure Coverage and Care During COVID-19
The Virginia Department of Medical Assistance Services (
DMAS
) has moved quickly to identify and remove potential policy and program barriers in order to maximize availability of coverage. Highlights follow:
- No Medicaid/FAMIS cases will be closed during this health emergency, unless the client requests the case to be closed, the client dies or the client permanently moves out of state
- The appeal process has been modified to increase flexibility (keep coverage while appeal is pending, phone hearings, can reschedule hearings)
- Out-of-network authorization requirements have been relaxed
- Use of telehealth (phone and video visits) is billable and encouraged. Telehealth and technical requirements are relaxed
- Co-pays have been eliminated for Medicaid/FAMIS-covered services
- Members can fill a 90-day supply of many routine prescriptions
- No pre-approvals are needed and approval extensions are automatic for many critical medical services
- If a Virginia Medicaid member is temporarily living in another state during this health emergency, the member stays enrolled in Virginia Medicaid during this time
- Outreach will occur to higher risk populations and older members to review critical needs
DMAS is posting information on COVID-19 on both
Cover Virginia
and on the
DMAS
website. The information on Cover Virginia’s page is more focused on Medicaid/FAMIS benefits and client-focused information. Go to
CoverVA.org
and look for the red COVID-19 button at the top of the page.
Health Insurance from the Federal Marketplace
Many Virginians may now be eligible to obtain health insurance from the Federal Health Insurance Marketplace due to COVID-related job loss or a reduction in hours. Individuals in households with household income up to up to 400% FPL may also qualify for financial assistance from the Marketplace. While the 2019 Open Enrollment period for the Marketplace has ended, these Virginians may be eligible for a Special Enrollment Period, which would allow them to apply for coverage outside of Open Enrollment. For more information about who may qualify for a Special Enrollment Period, including for Loss of Health Insurance, go to the
Marketplace
page on this website or visit
www.healthcare.gov
.
VHCF launches COVID-19 Resource Page
VHCF's new
COVID-19 Resource Page
contains a wide array of resources for those seeking information or help during this time of COVID. It contains topics such as personal health, medication assistance, Medicaid/FAMIS coverage, unemployment, child care, food and other many other resources.
Please let us know if it is missing something that would be helpful to you.
