Spotlight on CMS & HHS Updates to Combat Disasters

1. Spotlight on CMS & HHS Updates to Combat Disasters Presented By Kristin J. Webb-Hollering

2. Today’s Webinar Agenda • The who, what, when, where, and why of a Public Health Emergency • An overview of the Stafford Act and federal declarations • The reimbursement guidelines of the 1135 Waiver • CMS restrictions, exceptions, and more during and after a disaster • The lowdown on timetables, extensions, geography, and state information • Coding and billing resources for submitting claims after a catastrophic event • The HIPAA rules under an 1135 Waiver and Public Health crisis • Health IT basics on securing health records and systems • How the National Disaster Medical System Definitive Care Reimbursement Program works • Provider information on compliance and reimbursement relief efforts in the wake of Hurricanes’ Harvey, Irma, and Maria

3. Emergency Declarations Before, during, or after a natural disaster like Hurricane Irma, the governor of a U.S. state or territory declares a State of Emergency. Here is the timeline of how an “emergency” is declared. • First, a governor issues a State of Emergency due to a disaster that devastates an area in a state or territory. During this time, some municipal and/or state executive, judicial, and legislative services may be suspended. 40px X • The State of Emergency tells the federal government that the state needs additional resources to handle the incident. • Next, the President of the United States acknowledges that an emergency exists under the Stafford Act or the National Emergencies Act.

4. What is the Stafford Act? Stafford ActThe Stafford Act, which is DefinitionsDefinitions of emergency and catastrophes such as hurricanes, floods, earthquakes, fires, and the like. short for the Robert T. Stafford Disaster Relief and Emergency Assistance Act, allows federal organizations to assist state and local governments after the President of the United States declares a natural disaster an emergency. major disaster fall under Title I, Section 102 of the Act. It is interesting to note that “emergency” relates to any occasion when state or local governments need federal help. A “major disaster” refers specifically to natural

5. Public Health Emergency Overview WHO • Usually, after the President establishes an emergency under the Stafford Act, then the Secretary of the Department of Health and Human Services (HHS) declares a Public Health Emergency (PHE). WHAT • The HHS Secretary determines there’s a PHE under Section 319 of the Public Health Service Act (PHSA).

6. Public Health Emergency Overview WHEN • A Section 319 PHE is good for a duration of 90 days, but it may be shortened by the the HHS Secretary if it’s determined an emergency no longer exists. WHERE • The PHE covers the state and/or local areas referenced in the HHS Secretary’s declaration under Section 319 of the PHS Act only.

7. Public Health Emergency Overview Why • The Secretary determines that there’s a high risk of disease and disorder due to the emergency or disaster. The hazards are significant enough to declare the PHE. Under Section 319 of the PHSA, the Secretary can now offer grants, do investigations, support state and local healthcare efforts, and waive certain federal requirements that may be compromised due to the disaster.

8. From Emergency to the 1135 Waiver The President declares an emergency or disaster under the Stafford Act or the National Emergencies Act for the impacted areas or state. A disaster or emergency occurs. A state of emergency is called by a governor. Once the PHE is determined, Section 1135 of the Social Security Act authorizes the HHS Secretary to waive or modify certain Medicare, Medicaid, CHIP, and HIPAA requirements. The HHS Secretary declares a Public Health Emergency under the Public Health Service Act, Section 319.

9. Public Health Emergency Fun Fact The Secretary of the Department of Health and Human Services can determine a Public Health Emergency under Section 319 of the Public Health Service Act without the Presidential declaration of an emergency under the Stafford or National Emergencies Acts. However, for certain federal health programs’ regulations that fall under the Social Security Act (i.e. Medicare, Medicaid, CHIP) to be waived with an 1135 Waiver, the President must declare an emergency under the Stafford or National Emergencies Act and the HHS Secretary must declare a Public Health Emergency under Section 319 of the Public Health Service Act.

10. Review the requirements that must be met to make the 1135 Waiver possible . . . Requirements can now be waived or modified under section 1135 of the Social Security Act. Presidential declaration under Stafford or National Emergencies Act HHS Secretary determination of a Public Health Emergency