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Emergency Prescription Assistance Program Deployed in North Carolina Following Hurricane Helene
Key Takeaways
- EPAP provides uninsured patients in North Carolina with free access to medications and medical supplies post-Hurricane Helene.
- The program is managed by Express Scripts and offers a 30-day supply of medications, renewable every 30 days.
Eligible patients can receive a 30-day supply of covered drugs and medical supplies that can be renewed every 30 days for as long as an Emergency Prescription Assistance Program (EPAP) is active.
The US Department of Health and Human Services (HHS) Administration for Strategic Preparedness and Response has activated an Emergency Prescription Assistance Program (EPAP) in North Carolina following the devastation in western parts of the state after Hurricane Helene.1
Image credit: Noel | stock.adobe.com
The hurricane swept across the Southeast between September 26 and 29, disrupting roads, water, electricity, and cell phone service for millions. As of October 5, the death toll stood at 225, making Helene the deadliest hurricane to hit the mainland US since Hurricane Katrina in 2005. About half of the more than 225 victims were in North Carolina.2
Health care and pharmacies have also been massively disrupted in the area, although physicians, pharmacists, nurses, and others are mobilizing to ensure patients still receive the care they need. Insurance providers such as Blue Cross Blue Shield of North Carolina have lifted "refill too soon" limitations and encouraged pharmacies to leverage medication synchronization so that patients do not need to make multiple trips to the pharmacy. Members can also request early prescription refills for lost medications or transfer prescriptions to another pharmacy if their regular location is unavailable.3
The EPAP is intended to further improve access and expediency for patients. The program is administered by Express Scripts on behalf of HHS to adjudicate claims for prescription medications, vaccines, medical supplies, and limited durable medical equipment for uninsured patients impacted by the hurricane. The program differs from state-declared emergencies that trigger the Express Scripts refill-too-soon procedures because the EPAP is supported by HHS and solely intended for patients without insurance coverage in specific impacted zip codes.1
Notably, all prescriptions processed using EPAP have a $0 copay for the patient.1 Patients can receive a 30-day supply of covered drugs and medical supplies that can be renewed every 30 days for as long as EPAP is active. More than 72,000 pharmacies participate in the program.4
“The EPAP program is a godsend for patients with no other resources in terms of acquisition of their medications,” said David Harlow, PharmD, senior vice president of Allied Health Operations at Eastern Carolina University Health, in an email interview with Pharmacy Times. “That being said, it assumes the patient has access to a pharmacy. In Western North Carolina as of today the [North Carolina Department of Transportation] lists more than 700 roads that are impassable or closed, and that number has grown.”
Harlow added that the North Carolina Board of Pharmacy has compiled a list of operating pharmacies in the counties affected by Hurricane Helene, most recently updated at 9:30 AM on October 7.5
Pharmacies that have received notice of the EPAP are automatically enrolled in the network and no further action is required. When patients visit their pharmacy with a prescription for medication or replacement durable medical equipment, pharmacy staff should have the patient to call 855-793-7470 so that Express Scripts can verify their eligibility and create a file. Once eligibility is established, the pharmacist can process the claim immediately.1 Claims should be processed using the following information1:
- BIN: 003858
- PCN: A4
- Rx Group: EPAP1LOCATIONB
- Member ID Number: SSN (if member ID is unavailable)
A pharmacist resource center is available at https://prc.express-scripts.com.
“While the EPAP program is helpful monetarily, it will not solve these folks’ issues without additional initiatives,” Harlow said. “The gravity of the medication challenge will become clearer as the time and effort needed to recover plays out, even with every health care organization like ours providing every ounce of assistance we can.”
