The Centers for Medicare & Medicaid Services (CMS) announced efforts underway to support Puerto Rico in response to recent earthquakes. On January 8, Health and Human Services Secretary Alex Azar declared a public health emergency (PHE) in Puerto Rico that is retroactive to December 28, 2019. CMS is working to ensure hospitals and other facilities can continue operations and provide access to care despite the effects of the disastrous earthquakes. CMS will be waiving certain Medicare, Medicaid, and Children’s Health Insurance Program (CHIP) requirements; creating special enrollment opportunities for individuals to access healthcare quickly; and taking steps to ensure dialysis patients obtain critical life-saving services.
Below are key administrative actions CMS will be taking in response to the PHE declared in Puerto Rico:
Waivers and flexibilities for hospitals and other healthcare facilities: CMS will be temporarily waiving or modifying certain Medicare, Medicaid and CHIP requirements. CMS will also issue a number of blanket waivers listed on the website below, and the CMS Regional Office will grant other provider-specific requests for specific types of hospitals and other facilities in Puerto Rico. These waivers work to provide continued access to care for beneficiaries. For more information on the waivers CMS has granted, visit: www.cms.gov/emergency.
Special enrollment opportunities for earthquake victims: CMS will make available special enrollment periods for certain Medicare beneficiaries. This gives people impacted by the earthquakes the opportunity to change their Medicare health and prescription drug plans if eligible for the special enrollment period. For more information, please visit: https://www.cms.gov/Medicare/Eligibility-and-Enrollment/MedicareMangCareEligEnrol/index
Disaster preparedness toolkit for state Medicaid agencies: CMS developed an inventory of Medicaid and CHIP flexibilities and authorities available to states in the event of a disaster. For more information and to access the toolkit, visit: https://www.medicaid.gov/state-resource-center/disaster-response-toolkit/index.html.
Dialysis care: CMS is helping patients obtain access to critical life-saving services. The Kidney Community Emergency Response (KCER) program has been working with the End Stage Renal Disease (ESRD) Network of Puerto Rico, ESRD NW3, to assess the status of dialysis facilities in the potentially impacted areas related to generators, alternate water supplies, education and materials for patients. They are also assisting patients whose dialysis centers are temporarily closed to receive dialysis services at open locations.
Medical equipment and supplies replacements: CMS will be temporarily suspending certain requirements necessary for Medicare beneficiaries who have lost or realized damage to their durable medical equipment, prosthetics, orthotics and supplies as a result of the earthquakes. This will help to make sure that beneficiaries can continue to access the needed medical equipment and supplies they rely on each day. Medicare beneficiaries can contact 1-800-MEDICARE (1-800-633-4227) for assistance.
Suspension of enforcement activities: CMS will temporarily suspend current survey and enforcement activities for healthcare facilities in Puerto Rico but will continue to investigate allegations of immediate threat to patient health and safety.
Ensuring access to care in Medicare Advantage and Part D: During a public health emergency, Medicare Advantage Organizations and Part D Plan sponsors must take steps to maintain access to covered benefits for beneficiaries in affected areas. These steps include allowing Part A/B and supplemental Part C plan benefits to be furnished at specified non-contracted facilities and waiving, in full, requirements for gatekeeper referrals where applicable.
