Clinic Eligibility Criteria

Your clinic or health center must meet the following eligibility criteria to participate in the replenishment program:

  • Federal non-profit tax exempt status
  • Qualified facility that provides health care to patients regardless of their ability to pay (i.e. FQHC, FQHC-LA, free clinic, community health center)
  • Majority of patients with annual household income at or below 250% Federal Poverty Level (FPL)
  • In compliance with State Board of Pharmacy regulations for dispensing medications
  • Computerized dispensing capabilities with ability to generate monthly dispensing reports
  • Medical Director with current license and DEA number
  • Signed Memorandum of Understanding (MOU) agreeing to follow program parameters
  • Dedicated staff and effective processes and controls in place to perform and document patient eligibility screening according to program requirements
  • Written policies and procedures must be in place for:
    • Patient Eligibility Screening Practices
    • Program/Patient documentation
    • Record Retention
    • Order Management/Prescription Processing
    • Product Receipt and Handling
    • General Dispensing Guidelines
    • Pharmacy/Dispensary Security
    • Procedure for Re-Distribution of Drug to Satellite Facilities (if applicable)
    • Staff Training
    • Billing Exclusion Procedure

Pharmacy services may be provided through a licensed on-site pharmacy or dispensed according to state requirements. Contract pharmacy arrangements will be evaluated on a case by case basis.

For further information about the program or inquiries about enrollment, please contact USAprograms@directrelief.org

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