The Centers for Medicare & Medicaid Services (CMS) today announced efforts underway to support California in response to wildfires across the state. On August 26, 2020, U.S. Department of Health and Human Services (HHS) Secretary Alex Azar declared a public health emergency (PHE) in California, retroactive to August 14, 2020. CMS is working to ensure hospitals and other facilities can continue operations and provide access to care despite the effects of the wildfires. CMS provided numerous waivers to health care providers during the current coronavirus disease 2019 (COVID-19) pandemic to meet the needs of beneficiaries and providers. These waivers will be available to health care providers to use during the duration of the COVID-19 PHE determination timeframe and for the wildfires PHE. CMS will be waiving certain Medicare, Medicaid, and Children’s Health Insurance Program (CHIP) requirements; creating special enrollment opportunities for individuals to access healthcare quickly; and taking steps to ensure dialysis patients obtain critical life-saving services.
“Our thoughts are with everyone who is in the path of these massive and destructive wildfires and CMS is doing everything within its authority to provide assistance and relief to all who are affected,” said CMS Administrator Seema Verma. “We will partner and coordinate with state, federal and local officials to make sure that in the midst of all of the uncertainty these wildfires can bring, our beneficiaries will not have to worry about access to healthcare and other crucial life-saving and sustaining services they may need.”
Below are key administrative actions CMS will be taking in response to the PHE declared in California:
Waivers and Flexibilities for Hospitals and other Healthcare Facilities: CMS has already waived many Medicare, Medicaid, and CHIP requirements for facilities. The CMS San Francisco Survey & Enforcement Division, under the Survey Operations Group, will grant other provider-specific requests for specific types of hospitals and other facilities in California. These waivers work to provide continued access to care for beneficiaries. For more information on the waivers CMS has granted, visit: www.cms.gov/emergency.
Special Enrollment Opportunities and Medicare Flexibilities: CMS will be providing beneficiaries affected by the California wildfires a Special Enrollment Period (SEP) that gives them an additional opportunity to add, drop or change their Medicare health and prescription drug plan in the event they were eligible for another election period and were unable to make an election because of the wildfires. For more information on special enrollment periods, visit: https://www.cms.gov/Medicare/Eligibility-and-Enrollment/MedicareMangCareEligEnrol/index.html
Disaster Preparedness Toolkit for State Medicaid Agencies: CMS developed an inventory of Medicaid and CHIP flexibilities and authorities available to states in the event of a disaster. For more information and to access the toolkit, visit: https://www.medicaid.gov/state-resource-center/disaster-response-toolkit/index.html.
Dialysis Care: CMS is helping patients obtain access to critical life-saving services. The Kidney Community Emergency Response (KCER) program has been activated and is working with the End Stage Renal Disease (ESRD) Network 18 (Southern CA) and the Health Services Advisory Group (HSAG) for ESRD Network 17 (Northern CA) to assess the status of dialysis facilities in the potentially impacted areas related to generators, alternate water supplies, education and materials for patients and more. They are also assisting patients who have evacuated ahead of the wildfires to receive dialysis services in the location to which they are evacuating. Patients have been educated to have an emergency supply kit on hand including important personal, medical, and insurance information; contact information for their facility, the ESRD Network hotline number, and contact information of those with whom they may stay or out-of-state contacts in a waterproof bag. They have also been instructed to have supplies on-hand to follow a three-day emergency diet. The ESRD Network 18 hotline is 1-800-637-4767, the HSAG Network 17 hotline is 1-800-232-3773, and the KCER hotline is 1-866-901-3773. Additional information is available on the KCER website www.kcercoalition.com.
Medical equipment and supplies replacements: Under the COVD-19 waivers, CMS suspended certain requirements necessary for Medicare beneficiaries who have lost or realized damage to their durable medical equipment, prosthetics, orthotics and supplies as a result of the PHE. This will help make sure beneficiaries can continue to access the needed medical equipment and supplies they rely on each day. Medicare beneficiaries can contact 1-800-MEDICARE (1-800-633-4227) for assistance.
Ensuring Access to Care in Medicare Advantage and Part D: During a PHE, Medicare Advantage organizations and Part D Plan sponsors must take steps to maintain access to covered benefits for beneficiaries in affected areas. These steps include allowing Part A/B and supplemental Part C plan benefits to be furnished at specified non-contracted facilities and waiving, in full, requirements for gatekeeper referrals where applicable.
Emergency Preparedness Requirements: Providers and suppliers are expected to have emergency preparedness programs based on an all-hazards approach. To assist in the understanding of the emergency preparedness requirements, CMS Central Office and the Regional Offices hosted two webinars in 2018 regarding emergency preparedness requirements and provider expectations. Both presentations covered the Emergency Preparedness Final Rule which included emergency power supply, 1135 waiver process, best practices and lessons learned from past disasters, helpful resources and more. Both webinars are available at https://qsep.cms.gov/welcome.aspx.
CMS also compiled a list of FAQs and useful national emergency preparedness resources to assist State Survey Agencies (SAs), their State, Tribal, Regional, local emergency management partners, and health care providers to develop effective and robust emergency plans and tool kits to assure compliance with the emergency preparedness rules. The tools can be located at:
CMS Regional Offices have provided specific emergency preparedness information to Medicare providers and suppliers through meetings, dialogue and presentations. The regional offices also provide regular technical assistance in emergency preparedness to state agencies and staff, who, since November 2017, have been regularly surveying providers and suppliers for compliance with emergency preparedness regulations.
Additional information on the emergency preparedness requirements can be found here:
CMS will continue to work with all geographic areas impacted by the wildfires. Beneficiaries and providers of healthcare services that have been impacted are encouraged to seek help by visiting CMS’ emergency page (www.cms.gov/emergency).
For more information about the HHSPHE, visit: