CMS Announces Resources and Flexibilities to Assist with the Public Health Emergency in the State of Florida

The Centers for Medicare & Medicaid Services (CMS) announced today additional resources and flexibilities available in response to Hurricane Milton in Florida. CMS is working closely with the State of Florida and federal partners to put these flexibilities in place to ensure those affected by this natural disaster have access to the care they need – when they need it most.

On October 7, 2024, President Biden determined that an emergency exists in Florida due to the emergency conditions resulting from Hurricane Milton beginning October 5, 2024, and continuing. Additionally, on October 8, 2024, Department of Health and Human Services (HHS) Secretary Xavier Becerra determined that a Public Health Emergency (PHE) exists in Florida and has existed since October 5, 2024.

CMS stands ready to assist with resources and waivers to ensure hospitals and other facilities can continue to operate and provide access to care to those impacted by the consequences of the hurricane.

The following is key information on resources for those affected and 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: https://cmsqualitysupport.servicenowservices.com/cms_1135

Marketplace Special Enrollment Period (SEP) for Hurricane Victims: During a Federal Emergency Management Agency (FEMA) declared Major or Emergency disaster event, individuals who reside in states served by HealthCare.gov and who miss their existing SEP or who miss enrollment during the Open Enrollment Period are eligible for an SEP to enroll in Marketplace coverage. FEMA-emergency affected individuals will have 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 plan. FEMA-emergency affected individuals must contact the Marketplace Call Center at 1-800-318-2596 or TTY at 1855-889-4325 and indicate they were eligible for an enrollment window but were unable to complete their enrollment due to a FEMA-designated emergency or disaster. For more information, please visit:

• https://www.cms.gov/cciio/resources/regulations-and-guidance/fema_sep

 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

Dialysis Care: CMS is helping people obtain and maintain access to critical life-saving services by activating the Kidney Community Emergency Response (KCER) program and working with End-Stage Renal Disease (ESRD) Network 7, which is responsible under a contract with CMS for assessing the status of dialysis facilities in potentially impacted areas of Florida. This includes assessing impacts related to generators, alternate water supplies, providing education and materials for patients, and more. ESRD Network 7 is also assisting people to receive dialysis services in the location to which they evacuated. CMS, through ESRD Network 7, has also advised people to keep an emergency supply kit on hand in a waterproof bag, containing 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. They have also been instructed to have on hand supplies to follow a three-day emergency diet.

The ESRD Network 7 (Florida) toll-free hotline is 1-800.826.3773.

Additional information is available on the KCER website at www.kcercoalition.com.

Medical Equipment and Supplies Replacements: CMS will permit people with Medicare who have lost or realized damage to their durable medical equipment, prosthetics, orthotics, and supplies as a result of the hurricane to receive replacements of such items and services. This will help to ensure beneficiaries can continue to access the needed medical equipment and supplies they rely on each day. People with Medicare can contact 1-800-MEDICARE (1-800-633-4227) for assistance.

Access to Covered Part D Drugs: There is longstanding guidance around expectations for Part D sponsors in the event of a Presidential declaration of a disaster/emergency or Secretarial declaration of a public health emergency (PHE). During any public health disaster (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, plans will be required to assure that their enrollees have adequate access to drugs dispensed at out-of-network (OON) pharmacies. 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 similarly 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, for instance, lost their drugs, CMS would expect all “refill too soon edits” to be removed.

For more information, visit sections 50.12 and 60.1 of Chapter 5 of the Prescription Drug Benefit Manual.

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.

Recent natural disasters have demonstrated the importance of ensuring accessibility to health and human services for everyone living in the United States, including individuals in need of interpretation and translation services. 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 – PDF, including recommendations, specific action steps, resources, and tips such as to how to identify language needs in a disaster-impacted community to effectively utilizing interpreters. Additional information is available on the HHS OCR website.

CMS will continue to work with the State of Florida and those areas impacted by the hurricane. We encourage beneficiaries and providers of healthcare services that have been impacted to seek help by visiting CMS’ emergency webpage (www.cms.gov/emergency).

To find additional preparedness and response resources for the health sector and emergency management professionals, please visit: https://www.phe.gov/emergency/Tools/Pages/default.aspx