Medicare and Medicaid Rules Changed for Victims of Hurricane Katrina

HHS Waiver Allows Faster Treatment for Disaster Victims

The U.S. Department of Health & Human Services has declared a Public Health Emergency following Hurricane Katrina, and Michael Leavitt, U.S. Secretary of State, has signed a waiver to the Social Security Act that changes the rules for recipients of Medicare, Medicaid and the State Children’s Health Insurance Program (SCHIP), and their health care providers.

Goals of the Waiver

• “Sufficient health care items and services are available to meet the needs of individuals enrolled in the Medicare, Medicaid and SCHIP programs”
• “Health care providers that furnish such items and services in good faith, but are unable to comply with one or more of these requirements as a result of the effects of Hurricane Katrina, may be reimbursed for such items and services and exempted from sanctions for such noncompliance, absent any determination of fraud and abuse”

Waiver Reduces Paperwork, Speeds Treatment
The rules of this waiver provide faster medical care for Medicare, Medicaid and SCHIP recipients who are victims of Hurricane Katrina. Under the waiver:

• Victims of Hurricane Katrina will not need to meet certain conditions of participation or certification.
• Pre-approval requirements have been waived for individual health care providers, including hospitals or other service providers, physicians or other health care practitioners or professionals, health care facilities, and suppliers of health care items or services.
• Physicians and other health care professionals do not need to hold licenses in the state in which they provide services, if they have a license from another state and are not barred from practice in that state or any state in the emergency area.
• Individuals may be redirected to another location to receive a medical screening examination pursuant to a state emergency preparedness plan.
• Individuals who have not been stabilized may be transferred to another location if the transfer arises out of hurricane-related emergency circumstances.
• Medicare Advantage enrollees may use out-of-network providers in an emergency situation.
• Sanctions and penalties may be given to health care providers if they do not comply with the following Health Insurance Portability and Accountability Act (HIPAA) regulations:
  • Health care providers must obtain a patient’s agreement before speaking with family members or friends, and they must honor a patient’s request to opt out of the facility directory.
  • Notices must be distributed regarding privacy practices.
  • Patients must have the right to request privacy restrictions or confidential communications.

For more details, see the Emergency Social Security Waiver.