Proposal Presented for the Master Plan For Aging (#68)
Disclaimer
Throughout the MPA process, more than 100 proposals were developed thanks in particular to thousands of hours of work by external stakeholders and members of the public. These proposals and the MPA Council commentary are being submitted to the Governor and shared with policymakers and the public to inform policymaking. These proposals represent a starting point for discussion. Further discussion is necessary between relevant state agencies and stakeholders to both refine these proposals and assess which may be appropriate to adopt and implement.
Summary
Increase utilization of the Elderly Prescription Insurance Coverage (EPIC) program by addressing stubborn barriers to enrollment, access and retention through program oversight and transparency, simplify program administration, address stigma, improve a lack of adequate outreach and education, as well as culturally and linguistically competent education and outreach to support application assistance.
Justification
The EPIC program provides seniors with co-payment assistance for Medicare Part D covered prescription drugs after any Part D deductible is met. EPIC can help older adults achieve better health outcomes through prescription drug savings and build economic security. Unfortunately, stubborn barriers to enrollment, access, and retention persist. Accessibility, stigma, lack of adequate outreach, education, and application assistance, all impact EPIC enrollment and retention. By improving program oversight and transparency, simplifying program administration, and increasing outreach to increase program utilization, older adults will have better access to necessary medications.
Full Proposal
EPIC provides older adults with co-payment assistance for Medicare Part D covered prescription drugs after any Part D deductible is met. To increase utilization, recommendations include addressing stubborn barriers to enrollment, access, retention, stigma, lack of adequate outreach and education, as well as application assistance.
- Improve program oversight and transparency.
- Reconvene the EPIC advisory committee and EPIC panel under DOH.
- Report any program administrative changes to advisory panel for discussion and feedback prior to implementation.
- Outline and communicate any proposed changes to minimize impact on EPIC members.
- Simplify Program administration:
- Require disclosure of rebates from drug manufacturers where it may affect consumer decisions and therefore EPIC members coverage.
- Education and Outreach:
- Conduct a widespread educational and outreach campaign coordinated with community-based organizations to reach diverse communities who would most benefit but are least likely to know about it.
- Allocate funding for translated materials, language access, and outreach events that would permit the communities to learn more about EPIC.
MPA Council Commentary
This proposal is categorized as near-term. Component 3 of this proposal is currently being implemented. The existing EPIC program provides educational and outreach services as well as application assistance for federal programs. Program applications are currently available in ten languages and online enrollment options are available. Component 1 of this proposal is categorized as long-term. State agency partners can continue to assess the viability of reconvening the EPIC advisory committee and its proposed duties. As a State funded program, any additional EPIC enrollment would have an impact on the State’s Financial Plan, and thus discussions on this proposal would be subject to the annual budget process and the availability of resources.