CMS: Waiver status issued for New York state in Sandy’s wake

Long-term care facilities and hospitals in New York state will be able to apply for a range of emergency waivers intended to relax regulations and cover unusual payment circumstances created by Hurricane Sandy, according to an emergency response teleconference held Thursday by the Centers for Medicare & Medicaid Services (CMS).

The emergency waiver status of New Jersey is still under consideration and had not been announced as of posting time on Friday. Data is still being gathered to determine if any other states will qualify for any waivers.

Emergency waiver status, which must be requested by the Department of Health & Human Services and approved by the President, allows healthcare facilities a wider berth in the operational and documentation requirements for beneficiaries of Medicare, Medicaid and the Children’s Health Insurance Program.

For New York, the waivers now available will add flexibility in the modes and circumstances of care delivery in the state’s acute care and LTC healthcare facilities, many of whom took in additional patients during evacuations:

  • Flexibility in the rules governing treatment coverage, including prior certification, care delivered out of network and physician state licensure
  • Extensions on documentation requirements, including MDS transmission
  • Temporary lifting of the three-day prior hospitalization requirements for skilling nursing coverage
  • Flexible expansion of the federal rules on certified bed sizes of facilities (but check on state regulations)

New York state’s waiver status is retroactive to Oct. 27, 2012 and is in effect for 60 days. Those needing additional time may apply for extensions and other help at their regional CMS office.

The official document submitted by Health & Human Services Secretary Kathleen Sebelius to Congress October 31 establishing Section 1135 waivers for New York state is available as a PDF on the CMS website at www/

CMS also plans to add an extensive Q&A section to address Sandy-related questions to the website in the next few days. Facilities that have further questions should contact the regional CMS office.

A recording of Thursday’s CMS teleconference will be available until Nov. 7, 2012 by calling 1-855-859-2056 and entering the passcode 64389403.

Topics: Accountable Care Organizations (ACOs) , Advocacy , Disaster Preparedness , Executive Leadership , Medicare/Medicaid , Regulatory Compliance