Patient Administration, Reimbursement, and Repatriation

1
Patient Administration, Reimbursement, and
Repatriation

• Presentation 8 (panel)
• Paul J. Brannigan

2
Patient Tracking

• Unresponsive patients, no medical records or ID,
  mental health issues (often all three)
• Difficult following patients after they left PRA
• Sent to hospital, but not admitted
• Sent to nursing home (NDMS or not?),
• Discharged from hospital to nursing homes (still
  in NDMS or not?), and
• Discharged prior to any repatriation program
• All in the absence of ANY program support.

3
Patient Tracking (cont.)

• Tracking of hospital patients from non-NDMS
  flights is whose responsibility?
• Tracking of accompanying non-medical attendants
  (family, friend, caregiver) of NDMS patients?
• Need national forms and tagging system!
• Mass Evacuation Tracking System (ESFs 68)
• FCC Case Management is a Big Deal

4
NDMS Billing Questions

• Step One All questions should be addressed to
  FEMA at 800-872-NDMS (6367)
• Step Two Leave a message. Do not expect anyone
  to call you back.
• Step Three Toll free number discontinued with no
  replacement
• Step Four ?
• NOTE An internet-based reimbursement process
  was discontinued the previous year

5
NDMS Reimbursement Process

• 8/29 - Katrina landfall
• 9/29 - FEMA mission assignment to HHS for
  repatriation and reimbursement
• Many, many meetings and emails between FEMA, HHS,
  CMS, and partners
• Today Interagency Agreement still unsigned
  reimbursements not started. Soon
• Annex F it is expected that language emphasizes
  lack of preparedness

6
Repatriation

• DoD assets will not be used. GPMRC not involved.
  Annex E worthless.
• Where did the patient come from?
• Deceased patients/remains? NRC Center not
  involved conflicting information
• Dependent upon the States of TX and LA. Who is
  the State POC? BUT hospital discharge planners
  should contact receiving facilities directly.
  Which?
• FEMA Contract (CareFlight) not operational until
  Oct 15th. Evacuees wanting or requiring
  repatriation prior to this date were on their
  own.

7
Other Issues

• What is ICMOP?
• If CRAF not implemented here, is there ANY
  possibility of it ever being activated? Modify?
• Is TRAC2ES for the VA-DoD Contingency only?
• Neither HHS (lead for ESF 8), nor FEMA NDMS staff
  (non-DMAT), nor receiving regional FEMA RRCCs
  involved in NDMS evacuations until the
  evacuations were over and they needed to be in
  charge to reimburse the agencies that were.
• ???????

8
The Future

• Funding
• Exercises (both sending and receiving)
• Plan revision
• Training
• Programmatic Support (plaques, shirts, pins)
• Plan Rewrite, from assumptions to conclusions
• Mass Evacuation plan
• Include nursing homes and mass care agencies
• New MOAs and can we expect support from the
  medical community?

9
Questions?

• Paul J. Brannigan
• VAMC Atlanta
• 1670 Clairmont Road, Rm GC-133
• Decatur, GA 30033
• Office 404.417.2988
• Cell 678.409.4937
• Pager 888.226.4487
• Nextel DC 1542352773
• Paul.Brannigan_at_va.gov