Participant and Caregiver Reimbursement PolicyFAST is excited to announce that actor Colin Farrell, the Dwight Stuart Youth Fund and the J. Cox Family Foundation have granted FAST $24,000.00 in funds to provide assistance to the families that will be traveling to Tampa, Florida for the Minocycline in the Treatment of Angelman Syndrome Clinical Trial. These funds will be available to families that request financial assistance, up to a maximum of $1,000 per family, and it will be paid out as reimbursements for documented lodging and transportation expenses that those families incur in connection with the trial.
We hope that families who have the ability to travel to Tampa without reimbursement will decline to participate in the reimbursement program.
This document contains FAST's policy and procedures on reimbursement of travel and lodging expenses for participants in the Efficacy of Minocycline in Angelman Syndrome Clinical Trial. The FAST Board approved this policy on February 4, 2012.
SCHEDULE OF REIMBURSEMENT
In order to receive reimbursement, the FAST Travel Reimbursement Request should be submitted within 60 days upon return from travel. We require original hotel receipt, original airline receipt/invoice or internet printout of airfare charge and if driving, information on beginning and ending location.
- After completion of the first site visit, up to but not to exceed $250.00.
- After completion of the second site visit, up to but not to exceed $250.00.
- After completion of the third and final site visit, up to but not to exceed $500.00.
FAST will reimburse mileage based on the 2012 IRS Standard Mileage Reimbursement Rates of $.23 per mile driven for medical purposes.
Receipts are required for reimbursement for travel (i.e., local and long-distance transportation) and lodging and clinical trial participants will be reimbursed in accordance with the rules within this travel reimbursement policy. This policy will serve as notification of potential reimbursement to families participating in the Minocycline in the Treatment of Angelman Syndrome Clinical Trial. Each participant will be provided reimbursement at the specified rate upon request and complete submission of the reimbursement form and original receipts.
PROTOCOL FOR REIMBURSEMENT
The FAST Clinical Assistance Fund will pay for expenses that are incurred during the visits required to participate in the Efficacy of Minocycline in Angelman Syndrome Clinical Trial; however, expenses that are incurred beyond the approved time period of the visit will not be covered.
- Approved modes of travel are as follows:
- Car: reimbursement will be made based on government medical reimbursement rates for round trip mileage to and from the Efficacy of Minocycline in Angelman Syndrome Clinical Trial site. Reimbursement for rental cars will not be allowed beyond the car mileage reimbursement rate.
- Taxi/Train/Bus: Participants traveling by taxi, train, or bus will be reimbursed if authorized.
- Air: reimbursement will be made for the cost of coach air transportation from the airport nearest to the home of record to the least expensive airport near the Minocycline in the Treatment of Angelman Syndrome Clinical Trial site. If families chose to fly business or first class, in order to be reimbursed for coach fare, they will be required to provide documentation of cost of coach air travel for the dates and travel locations as mentioned above.
- Train: reimbursement will be made for train tickets.
- Bus: reimbursement will be made for bus tickets.
- Lodging: Families may stay at a hotel of their choice; however, families will be reimbursed for lodging expenses, at a maximum of $119.00 per night plus tax until March 31, 2012 and $89.00 per night plus tax from April 1, 2012 through the duration of the trial in accordance with the reduced hotel rates negotiated by FAST and only up to two (2) nights per visit. Click here for additional information on negotiated reduced hotel rates. Families will be reimbursed only for the actual cost of the lodging and does not include meals, drinks, movies or additional nights past the two (2) nights allotted per visit.
- Meals and Drinks: Families will not be reimbursed for food or drinks.
- The families are to arrange and pay their own travel and lodging. The families must keep receipts for reimbursement of lodging and other travel expenses.
- Reimbursement includes payments to research participants and one caregiver to cover allowable expenses they incur while participating in clinical research and is required to follow the Minocycline in the Treatment of Angelman Syndrome Clinical Trial Travel and Other Expense Policy. All eligible receipts from the research subject and caregiver are due to FAST within 60 days following the completion of the research subject's trial obligations. For example, if the clinical trial requires 3 visits, the receipts and request for reimbursement up to the allocated amount must be received by FAST within 60 days AFTER the third visit. However, reimbursement requests may be made as soon as the first visit is completed.
- Name on receipt must match family name or if different, please provide explanation.
- Reimbursement requests (download form) must be submitted to Kena Richert via email at firstname.lastname@example.org or hard copy mailed to 1151 Stone Mountain Drive, Marble Falls, Texas 78654. Please submit original receipts and keep copies as FAST cannot be held responsible for any items not properly routed by the US Postal Service or other carrier. Reimbursements will be made upon receipt of properly executed travel expense forms.
- There will be no pre-payment by FAST of estimated expenses for this trial. Any reimbursement of travel expenses will be paid after the expenses have been incurred.
- There will be no remuneration paid by FAST to research participants or their families, and reimbursement of allowable expenses should in no way be construed as remuneration to the participant or their families.