The Centers for Medicare & Medicaid Services (CMS) today published a final rule that will establish medical emergency preparedness during natural and manmade disasters for healthcare providers serving Medicare and Medicaid beneficiaries. 

The finalized rule, published in the Federal Register, becomes effective Nov. 15. 

CMS cited the August flooding in Louisiana, specifically in Baton Rouge and surrounding areas, which were declared major disasters by President Barack Obama and Louisiana Gov. John Bel Edwards.

CMS said a number of recent disasters have threatened the safety not only of Medicare and Medicaid beneficiaries, but also the general public. 

“Situations like the recent flooding in Baton Rouge, Louisiana, remind us that in the event of an emergency, the first priority of healthcare providers and suppliers is to protect the health and safety of their patients,” CMS Deputy Administrator and Chief Medical Officer Patrick Conway, MD, said. “Preparation, planning, and one comprehensive approach for emergency preparedness is key.”

CMS also said new requirements will mandate that certain participating providers and suppliers plan for disasters and coordinate with federal, state, tribal, regional, and local emergency preparedness systems to ensure that facilities are adequately prepared to meet the needs of their patients during disasters and emergency situations. 

“As people with medical needs are cared for in increasingly diverse settings, disaster preparedness is not only a responsibility of hospitals, but of many other providers and suppliers of healthcare services,” said Nicole Lurie, MD, assistant secretary for preparedness and response for the U.S. Department of Health and Human Services (HHS). “Whether it’s trauma care or long-term nursing care or a home health service, patients’ needs for healthcare don’t stop when disasters strike; in fact, their needs often increase in the immediate aftermath of a disaster.” 

After reviewing the current Medicare emergency preparedness regulations for both providers and suppliers, CMS said it found that regulatory requirements were not comprehensive enough to address the complexities of emergency preparedness. 

Today’s final rule requires Medicare and Medicaid participating providers and suppliers to meet the following four best-practice standards. 

  1. Emergency plan: Based on a risk assessment, develop an emergency plan using an all-hazards approach, focusing on capacities and capabilities that are critical to preparedness for a full spectrum of emergencies or disasters specific to the location of each provider or supplier.
  2. Policies and procedures: Develop and implement policies and procedures based on the plan and risk assessment.
  3. Communication plan: Develop and maintain a communication plan that complies with both federal and state law. Patient care must be well-coordinated within the facility, across healthcare providers, and with state and local public health departments and emergency systems.
  4. Training and testing program: Develop and maintain training and testing programs, including initial and annual trainings, and conduct drills and exercises or participate in an actual mock incident that tests the plan.

CMS also noted that the standards are adjusted to reflect the characteristics of each type of provider and supplier. For example:

  • Outpatient providers and suppliers such as ambulatory surgical centers and end-stage renal disease facilities will not be required to have policies and procedures for provision of subsistence needs.
  • Hospitals, critical access hospitals, and long-term care facilities will be required to install and maintain emergency and standby power systems based on their emergency plans. 

CMS said that healthcare providers and suppliers that must adhere to this rule must comply and implement all regulations by one year after the effective date. 

About the Author

Chuck Buck is the publisher of RACmonitor and the executive producer and program host of Monitor Mondays. 

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