The Centers for Medicare and Medicaid Services (CMS) has announced that it will support providers and suppliers impacted by Hurricane Helene within the Federal Emergency Management Agency (FEMA) disaster zones, under President Biden’s major disaster declarations. On Oct. 7, 2024, President Biden determined that an emergency exists in Florida due to the emergency conditions resulting from Hurricane Milton beginning Oct. 5, 2024, and continuing. Additionally, on Oct. 8, 2024, Department of Health and Human Services Secretary Xavier Becerra determined that a public health emergency exists in Florida and has existed since Oct. 5, 2024.
Accelerated payments will be made available to Medicare fee-for-service providers that were affected by Hurricane Helene effective Oct. 2, 2024. To apply, Medicare providers in need of this assistance should contact their assigned Medicare Administrative Contractor (MAC). This is to support providers and suppliers that face significant cash flow issues from the unusual circumstances impacting facilities’ operations and potentially prevent them from submitting claims and receiving Medicare claims payments.
Accelerated and advance payments related to Hurricane Helene may be granted in amounts equal to a percentage of the preceding 90 days of claims payments. These payments will be repaid through automatic recoupment from Medicare claims for a period of 90 days following the issuance of the accelerated or advance payment. A demand will be issued for any remaining balance on day 91 following the issuance of the accelerated or advance payment. In addition, CMS has provided certain flexibilities related to provider and supplier fee-for-service Medicare debt.
The U.S. Department of Health and Human Services declared Hurricane Helene a public health emergency, making Section 1135 CMS waivers available to providers in Florida, Georgia, North Carolina, Tennessee and South Carolina. A list of Blanket Waivers for each state can be found on the CMS website.
The CMS encourages beneficiaries and health care providers that have been impacted to seek help by visiting the CMS emergency webpage. For more information on resources available to health care providers and consumers impacted by Hurricane Helene, read the full CMS News Alert.
On Oct. 10, the CMS additional resources and flexibilities available in response to Hurricane Milton in Florida. The CMS is working closely with the state of Florida and federal partners to assist with resources and waivers to ensure health care providers can continue to operate and provide care to those affected by this natural disaster.
For more information on resources for those affected and actions the CMS is taking in response to the hurricane in Florida, read the Oct. 10 CMS News Alert.
CMS announces automatic MIPS extreme and uncontrollable circumstances policy for physicians impacted by Hurricane Francine and Helene
The CMS announced that it will automatically apply a Merit-Based Incentive Payment System (MIPS) extreme and uncontrollable circumstances (EUC) policy to physicians impacted by hurricanes Francine and Helene in designated counties in Florida, Georgia, North Carolina, South Carolina, Tennessee and Louisiana. This means that MIPS eligible clinicians in these areas will be automatically identified and have all four performance categories reweighted to 0% during the data submission period for the 2024 performance period (Jan. 2 to March 31, 2025). This will result in a score equal to the performance threshold, and they’ll receive a neutral payment adjustment for the 2026 MIPS payment year.
However, if MIPS eligible clinicians in these areas submit data on two or more performance categories, they’ll be scored on those performance categories and receive a 2026 MIPS payment adjustment based on their 2024 MIPS final score.
It is important to note that MIPS eligible clinicians participating in MIPS as a group, subgroup, virtual group or Alternative Payment Model (APM) Entity. However, groups, virtual groups and APM Entities can request reweighting through the EUC Exception application. Subgroups will inherit any reweighting approved for their affiliated group; they can’t request reweighting independent of their affiliated group’s status.
The AOA encourages members who have been impacted by a recent natural disaster can apply for a disaster relief grant from the American Osteopathic Foundation (AOF) via its Disaster Relief Program. The funding was made possible through donations to AOF by AOA members and state osteopathic association members. Currently, eligibility is limited to those affected by natural disasters officially declared by FEMA between June and Dec. 2024. To apply for a grant, applicants can fill out AOF’s grant request form.
Members may send questions to physicianservices@osteopathic.org.
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