CMS adds open enrollment period, offers regulatory relief for payers and members in wake of hurricanes

CMS outlined plans to offer payers and their members regulatory relief in wake of three major hurricanes.

CMS has announced special open enrollment periods for all Medicare enrollees and some federal health insurance exchange consumers in the wake of hurricanes Harvey, Irma and Maria, along with other disaster-related policies to help insurance companies in affected areas.

“The lives of millions of Americans have been disrupted and impacted in some way by recent hurricanes,” CMS Administrator Seema Verma said in an email statement.

RELATED: Damage from Hurricane Maria pushes medical services in Puerto Rico to the brink

“Setting up special enrollment periods gives Medicare beneficiaries and individuals seeking coverage on the Federal Exchange the opportunity to access health coverage during this difficult time and when they need it the most. We remain committed to doing all we can to help support the areas and individuals affected by these historic and catastrophic hurricanes.”

This enrollment is in addition to this fall’s open enrollment period and other enrollment periods beneficiaries may have missed. “We will examine the circumstances in the affected areas and may extend the SEP beyond Dec. 31, if needed,” the agency said.

A CMS guidance memo (PDF) also covers extensions to disenrollment rules about extended absences from a service area and failure to pay premiums.

Payers may also get relief if an emergency or major disaster impacts operations and clinical care in a way that would skew Medicare Star Ratings data. Strategies might include alternative sampling approaches or changing timeframes of measurement. The agency said it could even revert to last year’s score if a majority of enrollees are in the FEMA-designated areas and alternative strategies won’t work.

RELATED: Confronting the public health aftermath of Hurricane Irma

CMS has issued several blanket waivers in the impacted areas in the United States Virgin Islands and the Commonwealth of Puerto Rico, as well. “These waivers will prevent gaps in access to care for beneficiaries impacted by the emergency,” according to CMS.

For example, CMS waived the three-day prior hospitalization rule for skilled nursing facilities caring for patients who are evacuated, transferred or dislocated because of Hurricane Maria.

Suggested Articles

Year by year, resistance to extending Medicaid to more low-income Americans in conservative states has given way.

Though a Medicare buy-in plan would likely lower costs for older adults, it could lead to higher premiums for younger people in the exchanges.

The AMA has adopted a new policy that calls on medical schools to incorporate additional training on health economics into their curricula.