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HHS Takes Action to Help Medicare Beneficiaries and Providers in Iowa and Indiana

h otherwise applicable requirements, provided there is no fraud or abuse.

1. CMS will waive certain program requirements for the following institutional providers:

-- Critical Access Hospitals: Allow these hospitals to take more than the

statutorily mandated limit of 25 patients and not count the expected

longer lengths of stay for evacuated patients against the 96-hour


-- Skilled Nursing Facilities: Waive the three-day prior hospitalization

requirement for admission for evacuated patients and relax limitations

on the benefit period for those evacuated patients;

-- Long-Term Care Hospitals: Not count the evacuated patients in

calculating the 25-day average length of stay;

-- Inpatient Rehabilitation Facilities: Not count the evacuated patients in

determining compliance with the 60 percent rule requirement. The 60

percent rule says at least 60 percent of the population in a facility

must be deemed eligible for that facility.

2. CMS will expand the definition of "home" to allow those Medicare beneficiaries who are receiving home health services to receive those services in alternative sites.

3. For the Medicare Part D prescription benefit, CMS will ensure that rules that prevent early refills are waived. This will assist those beneficiaries who left prescriptions in evacuated homes or lost their prescription during the evacuation.

4. Certain sanctions under the Emergency Medical Treatment and Labor Act (EMTALA) will not be imposed for 72 hours after a hospital implements a hospital disaster protocol so long as actions by the hospital do not discriminate among individuals on the basis of their source of payment, ability to pay, or on the basis of race, color, or national origin.

5. Beneficiaries in health plans will be able to go out of network during this emergency. CMS is working with the health insur

SOURCE U.S. Department of Health and Human Services
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