Judul : Clarification on CMS Emergency Preparedness Rule Regarding 1135 Waivers
link : Clarification on CMS Emergency Preparedness Rule Regarding 1135 Waivers
Clarification on CMS Emergency Preparedness Rule Regarding 1135 Waivers
CMS has been receiving 1135 waiver requests from some facilities that received deficiencies under the Emergency Preparedness Rule deficiency for: failure to develop an emergency preparedness policy to address the facility's role under an 1135 waiver.An 1135 waiver can only be considered when the following has occurred:
1. The President declares a disaster or emergency under the Stafford Act or National Emergencies Act
2. The Health and Human Services Secretary declares a public health emergency under Section 319 of the Public Health Service Act
In a disaster, these waivers are meant to prevent gaps in access to care - to allow reimbursement during an emergency or disaster even if providers can't comply with certain requirements that would under normal circumstances bar Medicare, Medicaid or CHIP payment.
To meet the emergency preparedness rule requirement - to develop an emergency preparedness policy to address the facility’s role under an 1135 waiver, the facility should be able to demonstrate, in your policies and procedures, an awareness of the 1135 waiver process and what may be required in the event of needing an 1135 waiver (which the provider would request through the state and regional office).
If a facility were to request an 1135 waiver in the event of this type of a disaster, it is helpful to clearly state, in any format the facility chooses, information that will address the scope of the issue and the impact of the disaster including the following basic information:
- Provider name/type
- Full address (including county/city/town/state) CCN (Medicare provider number).
- Contact person and his or her contact information for follow-up questions should the Region need additional clarification.
- Brief summary of why the waiver is needed. For example:
Our critical access hospital (CAH) is the sole community provider without reasonable transfer options during the emergency event (e.g. flooding, tornado, fires, or flu outbreak). CAH needs a waiver to exceed its bed limit by X number of beds for Y days/weeks (be specific).
- Consideration - Type of relief your facility is seeking from regulatory requirements or regulatory reference that the requestor is seeking to be waived.
In a disaster event health, a facility wanting to request an 1135 waiver, should submit your request to the Health Facilities and Emergency Medical Services Division. There is no specific form or template to use when submitting a request. The request should be sent to:
Thom Miller
Branch Chief, Certification, Licensing, Enforcement and Records
ThomasLMiller@state.co.us
Telephone: 303-692-4978
Fax: 303-753-76214
For reference materials, please review the guidance on the CMS website, particularly, www.cms.gov/emergency and www.phe.gov/emergency. Both sites contain examples of the most recently approved 1135 waivers, for example, hurricanes Maria, Harvey and IRMA.
Additional information on 1135 waivers can also be found at https://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/SurveyCertEmergPrep/1135-Waivers.html. Facilities may want to include these websites and some of the materials you'll find there as resources in your emergency preparedness plan.
If you have questions about the regulations, please contact Melanie Roth at Melanie.Roth-Lawson@state.co.us or 303-692-2819.
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