As you stock up on water, sandbags, supplies, don’t forget to refill any prescriptions you might need. Even if you aren’t due for a refill, the state Office of Insurance Regulation has issued a notice to all health care providers that they are obligated to waive time restrictions of prescription refills.
On September 4, Governor Rick Scott declared a State of Emergency in those areas and counties that may be impacted by Hurricane Irma. To support our members who live in areas affected by the Declaration and to comply with state law, Insurance Companies will allow members to get their medications filled early upon request.
By statute, in the event of a declared state of emergency or a National Weather Service hurricane warning, insurers must authorize payment to pharmacies for at least a 30-day supply of prescribed medications. This statutory obligation has kicked in with the Governor’s Executive Order for Hurricane Irma, and Florida residents may refill their prescriptions early in all 67 counties.
The memo to insurers reads as follows:
Hurricane Irma – Early Prescription Refill Reminder Notice
DATE: September 5, 2017
TO: All Health Insurers, Managed Care Organizations and Other Health Entities
RE: Florida Law Reminder for Early Prescription Refills
DECLARATION OF EMERGENCY BY GOVERNOR
This notice is a reminder that all health insurers, managed care organizations and other health entities must comply with the provisions of section 252.358, Florida Statutes, which allows for early prescription refills in the event that the Governor issues an Executive Order declaring a State of Emergency or when a county Emergency Operations Center (EOC) is activated. This mandate remains in effect until the Governor’s Executive Order is rescinded or expires. See below for reference materials:
Florida Statute language:
Section 252.358 – Emergency-preparedness prescription medication refills.
—All health insurers, managed care organizations, and other entities that are licensed by the Office of Insurance Regulation and provide prescription medication coverage as part of a policy or contract shall waive time restrictions on prescription medication refills, which include suspension of electronic “refill too soon” edits to pharmacies, to enable insureds or subscribers to refill prescriptions in advance, if there are authorized refills remaining, and shall authorize payment to pharmacies for at least a 30-day supply of any
prescription medication, regardless of the date upon which the prescription had most recently been filled by a pharmacist, when the following conditions occur:
(1) The person seeking the prescription medication refill resides in a county that:
(a) Is under a hurricane warning issued by the National Weather Service;
(b) Is declared to be under a state of emergency in an executive order issued by the Governor; or
(c) Has activated its emergency operations center and its emergency management plan.
(2) The prescription medication refill is requested within 30 days after the origination date of the conditions stated in this section or until such conditions are terminated by the issuing authority or no longer exist. The time period for the waiver of prescription medication refills may be extended in 15- or 30-day increments by emergency orders issued by the Office of Insurance Regulation. This section does not excuse or exempt an insured or subscriber from compliance with all other terms of the policy or contract providing prescription medication coverage. This section takes effect July 1, 2006.
The Governor has issued an emergency order for all counties and many counties have activated their EOC’s.
PLEASE BE GOVERNED ACCORDINGLY
Florida Blue has recently notified us of billing changes. Beginning in October, if premium payment has not been received by Florida Blue by the 10th of the month due, a claims hold will be implemented. A claims hold will prevent providers from being able to verify benefits, and will potentially result in claims payments being declined. If a claims hold has occurred, it may take Florida Blue up to 72 hours to release the hold after payment has been received. It is important that Florida Blue clients remember to 1) pay on time, 2) pay online, and 3) pay as billed so that you do not encounter a hold.
We understand how important your health coverage is to you and your company. Following these simple steps will help ensure that your invoice is paid on time and in full.
As always, should you have any questions or concerns regarding this information, please contact us. We are here to assist you and are happy to answer any questions you may have.
“Call for the generator and kick into business continuity alert mode – a category 5 storm is expected to hit Naples on Thursday.” Word of a Hurricane spread quickly, but did not come from the National Hurricane Center or The Weather Channel. Rather, Gulfshore Insurance announced internally that “a three-day agency-wide disaster preparedness drill designed to simulate a major hurricane in our area” would be held May 24-26.
Life has taught us that practice makes perfect and that it probably is unreasonable to expect everything to be orderly, sane, and fully functioning during or after a disaster. That is why Gulfshore Insurance hosted a multi-day, department-wide, hurricane readiness drill to intensively prepare the agency to deal with the effects of a major storm. The exercise was in preparation for the start of the Atlantic Hurricane season, which began June 1st.
Homeowners aren’t the only ones who are affected by weather catastrophes. As we approach hurricane season, businesses should ensure they have an emergency preparedness plan in place in order to mitigate losses should a storm occur.
1. Develop an emergency response plan.
The last thing you want to deal with is what to do when you have a high expectation for a flood or all the windows are blown out of your buildings and your roof is peeled back like a sardine can. Prepare a plan ahead of time so you can react and activate your catastrophic response team as soon as the storm leaves town.
2. Assess risks to your mission-critical infrastructure.
Think through and evaluate what your potential loss of functions would be in the case of direct or indirect damage. If you are in a single-story ranch office in a flood zone, your potential loss of business capabilities will be very different than if you are on an upper floor of a high rise. Because hurricanes are so vast and the damage ripples out so far from the eye of the storm, hurricane preparation is necessary not just for coastal businesses. Determine what functions you could lose so that you can create a priority list for your disaster planning.
3. Backup your data and test the recovery process.
Don’t assume that your backup technology is working automatically. Take the time to recover information from the backup system to be sure you know both that it works and how to access critical information.
4. Do your research ahead of time.
Even if your business is not damaged by a hurricane, your production capabilities can be interrupted if a company that provides a product or service you depend on is sidelined or wiped out by a storm. Connect with each vendor you work with to be sure it has a backup plan for continuing production in the case of a storm, and if not, find an alternative that you can turn to in a pinch. You should also know which contractors or restoration company you’re going to call before a hurricane strikes. The demand for emergency services surges after a severe windstorm, and the best options may be unavailable if you want too long to call.
5. Talk to your employees.
Have a conversation with your workers to be sure they understand company procedures and that they are personally equipped to manage in the case of a destructive storm impairing normal working routines. In addition, in the event of a hurricane, you can’t always depend on cell phones or landlines working, but you will need to be able to communicate with employees. Create an alternate means of connecting (such as a text message service or social media page) with your staff and be sure to test it out in a non-critical situation. Employee contact information is one of the most important components of any business operation, and it is even more critical in an emergency. Knowing how to reach your employees and vendors is a vital part of helping your business to quickly recover from a disaster.
On March 6, 2017, House Republicans released legislation – The American Health Care Act – as part of the effort to repeal and replace the Affordable Care Act. Debate on the legislation, which consists of two separate bills, is scheduled to begin this week. Before the bills become law, they must be passed in Congress and signed by President Trump. The new law would make significant changes to key provisions of the ACA, such as effectively repealing the employer and individual mandates retroactively to 2016. However, key consumer protections would remain intact, including limits on cost-sharing, the prohibition on pre-existing condition exclusions and dependent coverage to age 26.
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Our team will continue to research and closely monitor legislative changes to provide you with thoughtful direction on how any changes may impact your organization. Our commitment has always been, and will continue to be, client-focused. Look for additional updates in the future.