Pharmacy benefit management companies and health benefit plans at WellPoint (NYSE: WLP) today announced revised medical and pharmacy guidelines to help members who are directly impacted by Hurricane Katrina. The revised guidelines will help members quickly access needed medical care and prescription drugs in the wake of the devastation caused by last week’s hurricane.
Members affected by the hurricane should seek medical assistance wherever it is available and have their medications refilled at any pharmacy or shipped to them at an alternative address. In addition, all providers caring for affected members will be considered “in-network” providers and affected members will not be required to satisfy prior authorization, pre-certification or referral requirements during this time.
These revisions apply to affected members who were living in Alabama, Louisiana and Mississippi at the time of the hurricane and who are covered by the following plans:
- Anthem Blue Cross and Blue Shield in Colorado, Connecticut, Indiana, Kentucky, Maine, New Hampshire, Nevada, Ohio and Virginia
- Blue Cross Blue Shield of Georgia
- Blue Cross Blue Shield of Missouri
- Blue Cross Blue Shield of Wisconsin
- Blue Cross of California
- Anthem Prescription Management
- WellPoint Prescription Management
Effective immediately, for the affected members, the health plans are:
- Suspending requirements for prior authorization and pre-certification.
- Suspending requirements for authorization or referral from a primary care physician.
- Allowing the affected members to see any physician necessary to provide access to care.
- Paying all claims as in-network, regardless of whether or not the health care provider is in network.
- Suspending early refill limits and shipping prescriptions to members at alternative addresses.
- Waiving co-payments for prescriptions.
- Suspending utilization management (UM) review of in-hospital cases.
For additional questions, members should call the phone number on the back of their membership card. If they do not have their card, they should call 1-866-800-8776 beginning Thursday, September 8. These medical and pharmacy guidelines are effective through September 30, 2005. At that time, it will be determined if these guidelines need to be extended.
WellPoint is also extending its Employee Assistance Program (EAP) to any medical member currently enrolled in one of its plans without EAP services. EAP includes 24-hour phone counseling for trauma and grief as well as a database of disaster recovery centers and referrals to other resources that may be of help to members. Members may take advantage of this service by calling (800) 999-7222.
