Presidential Emergency Declaration and HHS Section 1135 Waiver Authorization

Secretary Sebelius exercised her waiver authority under section 1135 of the Social Security Act, effective October 23, 2009. The Secretary has delegated to the Centers for Medicare & Medicaid Services (CMS) the determination for a waiver for each case justified by necessity and extent (other than for the Health Insurance Portability and Accountability Act [HIPAA] waivers permitted under section 1135). H1N1 Tracking Tool for State Agency (SA) Staffing: Attachment 1 contains a tracking tool to assist States in reporting any H1N1 influenza impact to their survey and certification activities.