Countermeasures Injury Compensation Program: Electronic Submissions
Primary source
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Issuing agencies
Abstract
The Public Readiness and Emergency Preparedness Act (PREP Act) authorized the Secretary of Health and Human Services (Secretary) to establish the Countermeasures Injury Compensation Program (CICP or Program). This Program provides benefits to certain persons who sustain serious physical injuries or death as a direct result of administration or use of covered countermeasures identified by the Secretary in declarations issued under the PREP Act. In addition, the Secretary may provide death benefits to certain survivors of individuals who died as the direct result of such covered injuries or their health complications. In accordance with 42 CFR 110.41, the Department of Health and Human Services is issuing this notice to inform the public that the CICP is accepting electronic Request for Benefits package submissions through the Injury Compensation Programs web-based portal. Completed Request for Benefits Forms, Letters of Intent, copies of completed Authorization for Use or Disclosure of Health Information forms, medical records, and any supporting documentation for CICP Request for Benefits packages can be submitted electronically at https://injurycompensation.hrsa.gov.
Full Text
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<title>Federal Register, Volume 87 Issue 121 (Friday, June 24, 2022)</title>
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[Federal Register Volume 87, Number 121 (Friday, June 24, 2022)]
[Notices]
[Page 37877]
From the Federal Register Online via the Government Publishing Office [<a href="http://www.gpo.gov">www.gpo.gov</a>]
[FR Doc No: 2022-13550]
[[Page 37877]]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Health Resources and Services Administration
Countermeasures Injury Compensation Program: Electronic
Submissions
AGENCY: Health Resources and Services Administration (HRSA), Department
of Health and Human Services.
ACTION: Notice.
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SUMMARY: The Public Readiness and Emergency Preparedness Act (PREP Act)
authorized the Secretary of Health and Human Services (Secretary) to
establish the Countermeasures Injury Compensation Program (CICP or
Program). This Program provides benefits to certain persons who sustain
serious physical injuries or death as a direct result of administration
or use of covered countermeasures identified by the Secretary in
declarations issued under the PREP Act. In addition, the Secretary may
provide death benefits to certain survivors of individuals who died as
the direct result of such covered injuries or their health
complications. In accordance with 42 CFR 110.41, the Department of
Health and Human Services is issuing this notice to inform the public
that the CICP is accepting electronic Request for Benefits package
submissions through the Injury Compensation Programs web-based portal.
Completed Request for Benefits Forms, Letters of Intent, copies of
completed Authorization for Use or Disclosure of Health Information
forms, medical records, and any supporting documentation for CICP
Request for Benefits packages can be submitted electronically at
<a href="https://injurycompensation.hrsa.gov">https://injurycompensation.hrsa.gov</a>.
DATES: This notice is effective immediately.
FOR FURTHER INFORMATION CONTACT: Dr. George Reed Grimes, Director,
Division of Injury Compensation Programs, Health Systems Bureau, HRSA,
5600 Fishers Lane, 08-N146B, Rockville, MD 20857. Phone calls can be
directed to 1-855-266-2427 (1-855-266-CICP). This is a toll-free
number.
SUPPLEMENTARY INFORMATION: Request for Benefits Forms (or Letters of
Intent) must be filed within 1 year of the date of the administration
or use of the covered countermeasure that is alleged to have caused the
injury. The filing date for Request Forms submitted electronically is
the date the Request Form is submitted electronically at <a href="https://injurycompensation.hrsa.gov">https://injurycompensation.hrsa.gov</a>. 42 CFR 110.42(c). For Request Forms not
submitted electronically, the filing date is still the postmark date. A
legibly dated receipt from a commercial carrier, a private courier
service, or the U.S. Postal Service will be considered equivalent to a
postmark.
In addition to the Request for Benefits Forms, requesters are also
required to submit copies of the Authorization for Use or Disclosure of
Health Information forms they submitted to their medical providers.
Requesters must also arrange to have their providers submit the
following medical records:
(1) All medical records documenting medical visits, procedures,
consultations, and test results that occurred on or after the date of
administration or use of the covered countermeasure; and
(2) All hospital records, including the admission history and
physical examination, the discharge summary, all physician subspecialty
consultation reports, all physician and nursing progress notes, and all
test results that occurred on or after the date of administration or
use of the covered countermeasure; and
(3) All medical records for 1 year prior to administration or use
of the covered countermeasure as necessary to indicate an injured
countermeasure recipient's pre-existing medical history.
To submit documentation online, individuals may navigate to the
Injury Compensation Programs website (<a href="https://injurycompensation.hrsa.gov">https://injurycompensation.hrsa.gov</a>) and follow the steps on ``How to Create an
Account'' to create a <a href="http://Login.gov">Login.gov</a> account. Steps to create an account are
also directly available here: <a href="https://injurycompensation.hrsa.gov/DICPSubmit/Interface/Common/LoginAssistance">https://injurycompensation.hrsa.gov/DICPSubmit/Interface/Common/LoginAssistance</a>.
Once an account is created, individuals can submit a new Request
for Benefits package or upload additional documents for an existing
request.
Alternatively, Request for Benefits Forms, medical records, and any
documentation to supplement a Request for Benefits package can continue
to be sent by mail to the CICP at the following address: Health
Resources and Services Administration, Countermeasures Injury
Compensation Program, 5600 Fishers Lane, 08N186B, Rockville, Maryland
20857.
When the CICP receives a Request for Benefits package online or by
mail, the CICP will send the requester a letter confirming receipt of
the claim, providing them with a case number, and informing them if any
additional documentation is required. Additional documentation may be
submitted by mail or by uploading the documents electronically,
regardless of the initial filing method used. For more information or
support, requesters may contact CICP directly by email at <a href="/cdn-cgi/l/email-protection#8cefe5effccce4feffeda2ebe3fa"><span class="__cf_email__" data-cfemail="4b2822283b0b2339382a652c243d">[email protected]</span></a>
or by phone at 1-855-266-2427 (1-855-266-CICP).
Diana Espinosa,
Deputy Administrator.
[FR Doc. 2022-13550 Filed 6-23-22; 8:45 am]
BILLING CODE 4165-15-P
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</html>This is legal information, not legal advice. Laws vary by jurisdiction and change frequently. Always verify current law with official sources and consult a licensed attorney in your jurisdiction for advice on your specific situation.