CMS Emergency Efforts for Hurricane Dorian

CMS has announced that efforts are currently underway to support Florida, Georgia, North Carolina, Puerto Rico and South Carolina in response to Hurricane Dorian and the Public Health Emergencies declared there. CMS is working to ensure hospitals and other facilities can continue operations and provide access to care in the aftermath of Dorian.

Other key actions CMS will take in response to the Public Health Emergency (PHE):

  • Waivers and flexibilities for hospitals and other health care facilities
  • Special enrollment opportunities for hurricane victims
  • Disaster Preparedness Toolkit for state Medicaid agencies
  • Dialysis care
  • Medical equipment and supplies replacements
  • Suspension and enforcement activities
  • Ensuring access to care in Medicare Advantage and Part D

Administrative Relief from Medical Review During a Disaster
As per the Medicare Program Integrity Manual (PIM) CMS IOM 100-08, Chapter 3.8, in the event of a disaster, MACs shall grant temporary MR administrative relief to any affected provider for up to six months. Administrative relief is to be granted to providers on a case-by-case basis in accordance with the following guidelines:

  • The MACs and Recovery Auditors shall make every effort to be responsive to providers who are victims of the disaster and whose medical documentation may be partially or completely destroyed
  • Providers must maintain and submit verification upon contractor request by the MAC or Recovery Auditor that (1) a disaster has occurred, and (2) medical record loss resulted from this disaster to the point where administrative relief from medical review requirements is necessary to allow the provider sufficient time to retrieve copies of, or restore damaged, medical documentation

If your organization meets the guidelines above related to the recent storms, and you are unable to respond to an Additional Documentation Request (ADR) associated with a Targeted Probe and Educate (TPE) Review, please contact the Medical Review Department via the contact information listed on the ADR to request administrative relief.

For more information on Hurricane Dorian and the actions CMS is taking, visit the CMS website.

Please visit CMS' Current Emergency web page for more information and resources.