We want to express our deepest sympathy and compassion for all those impacted by Hurricane Helene's profound repercussions and the ongoing aftermath. Numerous members of The Bedrock Group family are situated in the affected regions, and we are actively uniting as a company to assist in every possible way. For now, we can provide essential updates from CMS, the Center for Medicare and Medicaid Services, and other Health outlets to those affected.
Hurricane Helene Medicare Updates:
In response to Hurricane Helene, Medicare has implemented several updates to support those beneficiaries who are affected by the disaster, particularly in Florida, Georgia, North Carolina, South Carolina, and Tennessee. These updates include the following:
Access to Out-of-Network Providers: In areas where local healthcare providers are unavailable due to the hurricane, Medicare beneficiaries are permitted to seek care from out-of-network providers. This ensures that they can still receive necessary medical attention despite the damage caused by the storm. This policy helps to minimize any disruptions in their treatment.
Telehealth Services: Medicare has expanded access to Telehealth services. This is especially important for individuals who are unable to travel to healthcare facilities due to infrastructure damage or evacuation orders.
Public Health Emergency Support: CMS is working closely with hospitals and healthcare facilities to ensure they can continue to support operations and provide necessary care. Additional resources are being deployed to assist those affected, including Medicare billing and claims adjustments and processes for providers in the affected areas.
Accelerated and Advance Payments: To help providers and suppliers face any disruption, Medicare offers accelerated payments to Medicare Part A providers and advance payments to Medicare Part B suppliers in affected areas.
Fee-for-Service Flexibilities (FFS): The Centers for Medicare and Medicaid Services, CMS, has introduced special flexibilities for Medicare Fee-for-Service (FFS) beneficiaries in the impacted states. The flexibilities include waivers and relaxed regulations to ensure continued access to healthcare services, which provide easier access to prescription refills and medical care during the emergency period.
Prescription Flexibility: Information obtained from Florida Healthcare Association Early prescription refill limits for maintenance medications (excluding controlled substances) have been lifted to ensure that individuals maintain access to critical medications.
Prescription Refills: Beneficiaries can receive emergency refills for prescriptions if medications are lost or damaged during the storm.
Waivers for Providers: More information obtained from FHCA explains that Medicaid and Medicare providers in the affected areas, including Florida and Georgia, benefit from a range of waivers. These include the suspension of prior authorization requirements for services, allowing more flexible care delivery.
Emergency Resources for Dialysis Patients: According to HomeCare Magazine, Medicare has activated the Kidney Community Emergency Response (KCER) program to ensure continued care for patients requiring dialysis. This includes assessing dialysis facilities and providing resources for displaced patients.
Medical Equipment Replacement: Beneficiaries who lost or had their medical equipment damaged due to the hurricane can get replacements for essential items, for example, wheelchairs and oxygent tanks.
Skilled Nursing Facilities (SNF) Coverage: According to CMS, Medicare is waiving the typical requirement for a three-day hospital stay before covering SNF services. This waiver allows those displaced by Hurricane Helene to receive necessary care without meeting the usual criteria, which can be vital for those evacuated from hospitals or nursing homes due to the emergency.
Hospitals: Medicare is allowing hospitals to expand care areas by using non-traditional spaces for patient care, such as dining rooms or meeting spaces.
Hurricane Helene Medicaid Updates:
Below are some of the Medicaid-related changes made in response to Hurricane Helene to support those in the devastated areas.
Facility Overcapcity Rules: Medicaid-accepting facilities are taking in displaced patients, which may exceed their licensed capacity under specific emergency provisions.
Transportation Services: Medicaid transportation vendors have been instructed to continue providing services to beneficiaries as long as they are operational. This policy is crucial for individuals needing transportation to medical appointments, especially those with chronic conditions or requiring dialysis.
Prior Authorization Waivers: Medicaid has waived all prior authorization requirements for critical services, ensuring beneficiaries can receive necessary care without administrative delays. This policy aims to simplify access to hospital care, nursing facilities, and home health services.
Prescription Refill Flexibility: Similar to Medicare, Medicaid has lifted early refill restrictions on maintenance medications to allow beneficiaries to obtain essential prescriptions during and after Hurricane Helene. This policy does not apply to controlled substances.
We will continue to update this blog when we receive new information. CMS Emergency Response links are listed below. However, we here at The Bedrock Group may be able to help answer your Medicare questions as well. You can go to https://www.bedrockfg.com/scheduleappointment to request a complimentary review.
We are eager to assist in any way possible. Therefore, if you, a family member, or a loved one have any questions, please don't hesitate to request a call or a visit.
CMS Emergency Response Links:
States of Florida, Georgia, North Carolina, Tennessee, and South Carolina Waivers: CMS waivers are available to providers in Florida, Georgia, North Carolina, Tennessee, and South Carolina who have been affected by Hurricane Helene. A list of Blanket Waivers for each state can be found at: https://www.cms.gov/about-cms/what-we-do/emergency-response/current-emergencies. Healthcare providers who need additional flexibilities specific to the effects resulting from Hurricane Helene can submit a request to CMS here: https://cmsqualitysupport.servicenowservices.com/cms_1135
Special Enrollment Opportunities for Hurricane Victims: CMS will make available special enrollment periods for eligible individuals to enroll in coverage through the Health Insurance Marketplace. This gives people impacted by the hurricane the opportunity to enroll in coverage if they miss their original special enrollment period. For more information, please visit: https://www.cms.gov/CCIIO/Resources/Regulations-and-Guidance/Downloads/8-9-natural-disaster-SEP.pdf.
Disaster Toolkit and Support for State Medicaid and CHIP Agencies: To prepare for current and future disasters, CMS has developed an inventory of Medicaid and Children’s Health Insurance Program (CHIP) flexibilities and authorities available to states in the event of a disaster to support Medicaid and CHIP operations and ensure continuity of coverage for people served through Medicaid and CHIP programs during times of crisis. For more information and to access the inventory and toolkit, visit: https://www.medicaid.gov/state-resource-center/disaster-response-toolkit/index.html
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