On Friday, August 25th, Hurricane Harvey made landfall in Texas, bringing with it unimaginable destruction, mainly in the form of severe flooding throughout the eastern portion of the state. Due to the sheer size of the storm, many hospitals quickly became overcrowded, prompting a change in the overall structure of the facilities.

Under certain rules outlined by the Centers for Medicare & Medicaid Services (CMS), areas struck by a disaster are exempt from a number of otherwise binding laws. According to these guidelines, disasters are defined as events of such scale that they cause “enough damage to destroy medical records, interrupt normal mail service, or otherwise significantly limit a provider’s daily operations.” The disaster-stricken areas are divided into those indirectly affected (mail service or other methods of record transfer are interrupted) and those directly affected (records are physically destroyed). Depending on how significant the interruption is, the practice can receive varying degrees of exemptions.

These waivers, which went into effect on August 26th after Texas was upgraded to public health emergency status, allow for numerous changes designed to streamline hectic post-disaster operations. For example, these adjustments eliminate the payment limits for Medicare Advantage payments who are forced to receive treatment from providers or facilities outside the network. Other waivers include the ability to transfer a patient to another facility even if the patient has not been stabilized, provided that the catastrophe warrants the transfer.

Due to the urgent nature of disasters, facilities in the affected areas receive these exemptions automatically without the need to submit a formal request. That is not to say, however, that all rules are off the table. If the facility is guilty of committing abuse or fraud during the disaster period, they can still be held accountable for their actions in the form of audits and fines after the state of emergency has passed.