HHS Responds to Sandy, Issues Blanket Waivers of Conditions of Participation

Pursuant to Soc. Sec. Act sec. 1135, HHS Secretary Kathleen Sebelius has declared a public health emergency and issued blanket waivers of conditions of participation and other requirements of Medicare, Medicaid, and the Children’s Health Insurance Program for the duration of the emergency. The waivers apply to health care facilities and practitioners, including hospitals, nursing facilities, physicians, and suppliers in New York and New Jersey.

The waived requirements include conditions of participation, coverage for payment, including license to practice in the state where services are furnished, limits on out-of-network payments for services furnished to Medicare Advantage plan members, the screening and stabilization requirements of the Emergency Medical Treatment and Active Labor Act (Soc. Sec. Act sec. 1867), physician self-referral prohibitions, and certain privacy requirements under the Health Insurance Portability and Accountability Act (HIPAA) (P.L. 104-191).

The EMTALA waivers apply to redirections, relocations or transfers pursuant to a state emergency preparedness plan, by hospitals in the specific geographic area that the President has designated as a disaster area, and that are operating under a disaster protocol. In addition, the EMTALA and HIPAA waivers are time-limited; they may not exceed 72 hours from the hospital’s implementation of the disaster protocol. The remaining waivers will apply for the duration of the disaster period and may be renewed for 60 days if necessary. The waivers excuse compliance where the inability to comply is the result of the disaster.