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EPIC Program Gearing Up for October 1 Launch
June 06, 2001
Michigan Department of Community Health Director, James K. Haveman, Jr., today announced that the State Administrative Board has approved the selection of an enrollment broker and pharmacy benefit management company for the Elder Prescription Insurance Coverage (EPIC) program.
"The EPIC program will provide comprehensive prescription coverage for those seniors who are most in need of assistance," said Haveman. "Today marks one more step in the process to implement the EPIC program."
"This program will make a tremendous difference in the lives of seniors," said Michigan Office of Services to the Aging Director, Lynn Alexander. "The benefits in the EPIC program are much broader than what seniors in need currently have available to them."
Currently, low-income seniors who are not enrolled in Medicaid have two programs to assist them with the cost of prescriptions. The Michigan Emergency Pharmaceutical Program for Seniors (MEPPS) is only available to seniors a maximum of three times a year, and the Prescription Drug Tax Credit program offers an annual rebate on prescriptions.
The EPIC program will first provide year-round prescription coverage to seniors enrolled in MEPPS and the Prescription Drug Tax Credit program. After enrolling these groups, established by the legislation to be priority groups, additional enrollment will be determined by program funding. The EPIC program will cover nearly all FDA approved prescription drugs including prescription insulin and diabetic syringes and needles.
The State Administrative Board has approved the selection of First Health Services Corp., of Virginia, to provide enrollment and pharmacy benefit management services for EPIC.
First Health Services is experienced in providing services for similar senior pharmaceutical assistance programs in New York and Pennsylvania, and has recently been selected to administer the nation's first multi-state drug purchasing coalition for the Tri-State Prescription Drug Purchasing Pool (consisting of Maine, New Hampshire, and Vermont). Additionally, First Health Services is the current pharmacy benefits manager for Michigan Medicaid's fee-for-service pharmacy program.
Enrollment activities for the priority groups of seniors in EPIC will begin in late summer, with applications being mailed to seniors who received MEPPS benefits in the last year. Seniors from this group who apply and qualify for EPIC will begin receiving benefits on October 1, 2001. Those who received the Senior Tax Credit this year will be mailed applications for EPIC in autumn, 2001, and those qualifying from this group will begin receiving benefits on December 1, 2001. Open enrollment will follow and will be dependent on fund availability.
The Department of Community Health will work cooperatively with the state's established senior network to provide information about EPIC and to provide seniors with assistance in making application to the program. First Health Services will also staff a hotline that will be operational later this summer to answer questions and provide assistance to seniors regarding EPIC.