CMS Announces Flexibilities Due to Hurricane Milton

BALTIMORE, Maryland—The Centers for Medicare and Medicaid Services (CMS) announced additional resources and flexibilities are available in response to Hurricane Milton in Florida. CMS is working with the state of Florida and federal partners to put these flexibilities in place in an effort to ensure those affected by this natural disaster have access to the care they need.

On Monday, Oct. 7, President Joe Biden determined that an emergency exists in Florida due to the conditions resulting from Hurricane Milton. Additionally, on Tuesday, Oct. 8, Xavier Becerra, secretary of the Department of Health and Human Services (HHS), determined that a public health emergency (PHE) exists in Florida and has existed since Saturday, Oct. 5. 

CMS aims to assist with resources and waivers, ensuring hospitals and other facilities can continue to operate and provide access to care to those impacted by the hurricane. The following information outlines the resources available for those affected, as well as actions CMS is taking in response to the hurricane in Florida.

State of Florida Waivers

CMS waivers are available to providers in Florida who have been affected by Hurricane Milton. Health care providers who need additional flexibilities specific to the effects resulting from Hurricane Milton can submit a request to CMS here. 

Marketplace Special Enrollment Period (SEP) for Hurricane Victims

During a Federal Emergency Management Agency (FEMA)-declared major or emergency disaster event, individuals who miss their existing SEP or enrollment during the open enrollment period are eligible for a SEP to enroll in Marketplace coverage. FEMA-emergency-affected individuals are offered up to 60 days from the end of the FEMA-designated incident period to select a new Marketplace plan or make changes to their existing Marketplace plans.

Disaster Toolkit & Support for State Medicaid & CHIP Agencies

CMS has developed an inventory of Medicaid and children’s health insurance program (CHIP) flexibilities and authorities that are available to states that experience disasters. These specific flexibilities intend to support Medicaid and CHIP operations and ensure continuity of coverage for people served through Medicaid and CHIP programs during times of crisis. 

Dialysis Care

CMS has activated the kidney community emergency response (KCER) program and is working with end-stage renal disease (ESRD) Network Seven, which is responsible for assessing the status of dialysis facilities in potentially impacted areas of Florida. These assessments include determining impacts related to generators, alternate water supplies and providing education and materials for patients. Additionally, ESRD Network Seven aims to assist people receiving dialysis services in the location they evacuated to. CMS, through ESRD Network Seven, has advised people to keep an emergency supply kit on hand in a waterproof bag that contains important personal, medical and insurance information; contact information for their dialysis facility; the ESRD network hotline number; and contact information of those with whom they may stay or for out-of-state contacts. In addition, they have been instructed to have on-hand supplies to follow a three-day emergency diet.

Medical Equipment & Supplies Replacements

CMS will permit Medicare beneficiaries who have lost or realized damage to their durable medical equipment, prosthetics, orthotics and supplies due to the hurricane to receive replacements. This will ensure beneficiaries have access to necessary medical equipment and supplies. 

Access to Covered Part D Drugs

During a PHE declaration where beneficiaries are displaced from their place of residence and cannot be reasonably expected to obtain covered Part D drugs at a network pharmacy, CMS will offer plans to assure enrollees have adequate access to drugs dispensed at out-of-network (OON) pharmacies. These plans are required to reimburse beneficiaries up to their usual plan allowance for any payments enrollees make to OON pharmacies. Similarly, if the nature of the disaster requires voluntary or mandatory evacuation, plans will be required to reimburse beneficiaries for OON payments for refills of Part D medications to any beneficiary located in an emergency area, defined as the area in which there has been a Stafford Act or National Emergencies Act declaration and a PHE declaration. For beneficiaries who have lost their drugs, CMS would ensure all “refill too soon” edits to be removed.

Health Information Privacy & Civil Rights Accessibility Resources

During a PHE, the HHS Secretary may waive sanctions and penalties against a covered hospital that does not comply with certain provisions of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) privacy rule in the emergency area and for the emergency period identified in the PHE declaration; to hospitals that have instituted a disaster protocol; and for up to 72 hours from the time the hospital implements its disaster protocol, but not to exceed the time prescribed beyond the period described in section 1135(e) of the Social Security Act. The HHS Office for Civil Rights offers more information on HIPAA during emergency responses.

To help first responders provide on-the-ground language assistance and communicate effectively during disasters and in accordance with federal civil rights laws, the HHS Office for Civil Rights offers a plain language checklist, which includes recommendations, specific action steps, resources and tips on how to identify language needs in a disaster-impacted community and effectively utilize interpreters. Additional information is available on the HHS OCR website.