CMS takes steps to ease emergency

The Centers for Medicare and Medicaid Services (CMS) relaxed some rules and requirements for home health agencies that provide care to patients who were relocated as a result of Hurricane Katrina.

The first step taken was to reassure agencies that the normal burden of documentation is waived and the presumption of eligibility should be made for all patients who were evacuated to neighboring states where no health records exist and no proof of coverage can be presented.

Other changes that will help home health agencies include:

  • Home health agencies that furnish medical services in good faith, but who cannot comply with normal program requirements because of Hurricane Katrina, will be paid for services provided and will be exempt from sanctions for noncompliance, unless it is discovered that fraud or abuse occurred.
  • Crisis services provided to Medicare and Medicaid patients who have been transferred to facilities not certified to participate in the programs will be paid.
  • Programs will reimburse facilities for providing dialysis to patients with kidney failure in alternative settings.
  • Normal prior authorization and out-of-network requirements also will be waived for enrollees of Medicare, Medicaid, or State Children's Health Program managed care plans.
  • Normal licensing requirements for doctors, nurses, and other health care professionals, including home health personnel, who cross state lines to provide emergency care in stricken areas will be waived as long as the provider is licensed in their home state.
  • Certain privacy requirements of Health Insurance Portability and Accountability Act will be waived so that health care providers can talk to family members about a patient's condition even if that patient is unable to grant that permission to the provider.