CMS and TRICARE Announce Exceptions for Areas Impacted by Hurricane Michael

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Because President Trump declared that an emergency existed in Florida on October 9, 2018 and in Georgia on October 10, both as a result of the disastrous Hurricane Michael, the Centers for Medicare & Medicaid Services (CMS) authorized waivers in impacted areas of both states.

These waivers will prevent gaps for those beneficiaries impacted by the emergency in access to care. Health care providers do not have to apply for an individual waiver where this blanket waiver has been issued. For those providers who, however, must apply for a waiver, you can find instructions here.

Generally, the waiver provisions apply to those people who are evacuated, transferred or otherwise dislocated in the states of Florida and Georgia as a result of the effect of Hurricane Michael.

CMS has issued blanket waivers for this emergency for:

  • Skilled nursing facilities– for example, the requirement for a qualifying hospital stay before admittance to these facilities is waived.

  • Home health agencies– provides relief on timeframes related to OASIS transmission.

  • Critical access hospitals– waives both maximum bed number and stay duration.

  • Emergency durable medical equipment, prosthetics, orthotics and supplies– waives the face-to-face requirement as well as new physician’s order and new medical necessity documentation for replacing equipment. 

  • Replacement prescription fills– allows Medicare payment for replacement prescriptions where the medication has been lost or rendered unusable.

  • Home health disaster-related claims– auto-cancellation date of requests for anticipated payment may be extended during emergencies.

You can read the complete CMS MLN Matters®announcement here, including waivers for inpatient psychiatric unit and rehabilitation unit patients.

TRICARE Waiver Affects Referrals from Primary Care Providers

Because of the impact of Hurricane Michael, all TRICARE beneficiaries in Alabama and those in affected areas of Florida and Georgia may see a provider in any location without a primary care provider referral.

This waiver is retroactive to October 8 and effective until October 31. The complete list of affected areas and hurricane emergency information can be found at this TRICARE website.

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