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Individuals residing in and around Libby with certain medical conditions resulting from a public health emergency will be able to receive additional medical benefits as part of a coordinated effort among several Federal agencies, the Centers for Medicare & Medicaid Services (CMS) has announced.
Libby is the site of a vermiculite mine, which operated from the 1920s to 1990. Asbestos was released throughout the Libby area over many decades, and the Environmental Protection Agency determined that the conditions constituted a public health emergency on June 17, 2009.
People who developed medical conditions as a result of exposure to this environmental health hazard are eligible for Medicare under the Affordable Care Act’s “Exposure to Environmental Health Hazards” provision.
The Medicare Pilot Program for Asbestos-Related Disease is an innovative new program and is designed to provide comprehensive, coordinated, cost effective services not normally covered under Medicare. The new pilot program will begin on July 1.
Up until this time, individuals affected by the environmental emergency in Libby have received additional benefits through temporary grant programs administered by the State of Montana and the Health Resources and Services Administration (HRSA). These grant programs will be replaced by the Pilot Program, which will provide enhanced benefits to those eligible for Medicare under the “Exposure to Environmental Health Hazards” provision. The Affordable Care Act requires the establishment of a pilot to serve affected individuals as their medical condition warrants. CMS and HRSA have collaborated on a smooth transition to the new Pilot program.
The Medicare Pilot Program for Asbestos-Related Disease may cover items and services Medicare does not normally cover such as:
• Special home care services
• Special medical equipment
• Help with travel to get care
• Special counseling, for example, help quitting smoking
• Nutritional supplements
• Prescription drugs not covered by Medicare drug plans (Participants in the Pilot Program must be in a Medicare drug plan to receive this benefit.)
Individuals participating in the Pilot Program will also be able to work with a nurse case manager to coordinate their health benefits and ensure cost-effective care.
CMS, and its Medicare Administrative Contractor for Montana, have designed the case managers’ role to take advantage of expertise on health conditions within the affected communities and to maximize the efficiency of care delivery and treatment. Patients will be able to receive individualized care planning.
To participate in the Medicare Pilot Program for Asbestos-Related Disease, one must meet the following requirements:
• Qualify for Medicare under the Affordable Care Act’s “Exposure to Environmental Health Hazards” provision
• Live in Lincoln or Flathead County, Montana
• Have Medicare Part A (Hospital Insurance)
• Have Medicare Part B (Medical Insurance)
Individuals can call 1-888-469-9464 to enroll in the pilot by phone or visit the website www.noridianmedicare.com/ard beginning June 14.
“The new Libby Pilot program will provide necessary, coordinated services to people with a critical need resulting from the environmental emergency in Libby, Montana and the surrounding area”, said Donald Berwick, CMS Administrator.