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HURRICANE INFORMATION

Updates from CMS and our carriers for those affected by Hurricane Dorian.
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CMS offers broad support for Florida

The Centers for Medicare & Medicaid Services (CMS) today announced efforts underway to support Florida in response to Hurricane Dorian. Today, Health and Human Services Secretary Alex Azar declared a public health emergency (PHE) in the state. CMS is working to ensure hospitals and other facilities can continue operations and provide access to care despite the effects of Hurricane Dorian. CMS will be waiving certain Medicare, Medicaid, and Children’s Health Insurance Program (CHIP) requirements; creating special enrollment opportunities for individuals to access healthcare quickly; and taking steps to ensure dialysis patients obtain critical life-saving services.

​“Our thoughts are with everyone who is in the path of Hurricane Dorian and CMS is doing everything within its authority to provide assistance and relief to all who are affected,” said CMS Administrator Seema Verma. “We will partner and coordinate with state, federal, and local officials to make sure that in the midst of all of the uncertainty a natural disaster can bring, our beneficiaries will not have to worry about access to healthcare and other crucial life-saving and sustaining services they may need.”

Below are key administrative actions CMS will be taking in response to the PHE declared in Florida:
  • Waivers and Flexibilities for Hospitals and other Healthcare Facilities:  CMS will be temporarily waiving or modifying certain Medicare, Medicaid, and CHIP requirements. CMS will also issue a number of blanket waivers, listed on the website below, and the CMS Regional Office will grant other provider-specific requests for specific types of hospitals and other facilities in Florida. These waivers work to provide continued access to care for beneficiaries. For more information on the waivers CMS has granted, visit: www.cms.gov/emergency.
  • Special Enrollment Opportunities for Hurricane Victims:  CMS will make available special enrollment periods for certain Medicare beneficiaries and individuals seeking health plans offered through the Federal Health Insurance Exchange. This gives people impacted by the hurricane the opportunity to change their Medicare health and prescription drug plans and gain access to health coverage on the Exchange if eligible for the special enrollment period. For more information, please visit https://www.cms.gov/CCIIO/Resources/Regulations-and-Guidance/Downloads/8-9-natural-disaster-SEP.pdf​ https://www.cms.gov/About-CMS/Agency-Information/Emergency/EPRO/Past-Emergencies/Hurricanes-and-tropical-storms.html
  • Disaster Preparedness Toolkit for State Medicaid Agencies:  CMS developed an inventory of Medicaid and CHIP flexibilities and authorities available to states in the event of a disaster. For more information and to access the toolkit, visit: https://www.medicaid.gov/state-resource-center/disaster-response-toolkit/index.html.
  • ​Dialysis Care:  CMS is helping patients obtain access to critical life-saving services. The Kidney Community Emergency Response (KCER) program has been activated ahead of the storm and is working with the End Stage Renal Disease (ESRD) Network of Florida, ESRD NW7, to assess the status of dialysis facilities in the potentially impacted areas related to generators, alternate water supplies, education and materials for patients, and more. They are also assisting patients who have evacuated ahead of the storm to receive dialysis services in the location to which they are evacuating. Patients have been educated to have an emergency supply kit on hand including important personal, medical, and insurance information; contact information for their facility, the ESRD NW hotline number, and contact information of those with whom they may stay or for out-of-state contacts in a water proof bag. They have also been instructed to have on hand supplies to follow a three-day emergency diet. The ESRD NW7 toll-free hotline is 800-826-3773 and the KCER hotline is 866-901-3773. Additional information is available on the KCER website www.kcercoalition.com. 

​During the 2017 and 2018 hurricane seasons, CMS approved special purpose renal dialysis facilities in several states to furnish dialysis on a short-term basis at designated locations to serve ESRD patients under emergency circumstances in which there were limited dialysis resources or access-to-care problems due to the emergency circumstances.


Medical equipment and supplies replacements:  CMS will be temporarily suspending certain requirements necessary for Medicare beneficiaries who have lost or realized damage to their durable medical equipment, prosthetics, orthotics, and supplies as a result of the hurricane. This will help to make sure that beneficiaries can continue to access the needed medical equipment and supplies they rely on each day. Medicare beneficiaries can contact 1-800-MEDICARE (1-800-633-4227) for assistance.
Suspension of Enforcement Activities:  CMS will suspend current survey and enforcement activities for healthcare facilities in Florida, but will continue to investigate allegations of immediate threat to patient health and safety.
Ensuring Access to Care in Medicare Advantage and Part D:  During a public health emergency, Medicare Advantage Organizations and Part D Plan sponsors must take steps to maintain access to covered benefits for beneficiaries in affected areas. These steps include allowing Part A/B and supplemental Part C plan benefits to be furnished at specified non-contracted facilities and waiving, in full, requirements for gatekeeper referrals where applicable.

CMS Central Office and the Regional Offices hosted two Webinars in 2018 regarding Emergency Preparedness (EP) requirements and provider expectations. One was an all provider training on 6/19/2018 (over 3,000 providers participated) and the other an all-surveyor training on 8/14/2018. Both presentations covered the EP Final Rule which included emergency power supply; 1135 waiver process, Best Practices & Lessons Learned from past disasters, and Helpful Resources and more. Both webinars are available at https://surveyortraining.cms.hhs.gov/.

​CMS  also compiled a list of Frequently Asked Questions (FAQs) and useful national emergency preparedness resources to assist State Survey Agencies (SAs), their State, Tribal, Regional, local emergency management partners, and health care providers to develop effective and robust emergency plans and tool kits to assure compliance with the EP rules.  The tools can be located at:
https://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/SurveyCertEmergPrep/Emergency-Prep-Rule.html
https://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/SurveyCertEmergPrep/Templates-Checklists.html

Survey & Certification Group Emergency Preparedness Regulation dated November 2016, Revised 6-1-2017.
CMS Regional Offices have provided specific Emergency Preparedness information to Medicare providers and suppliers through meetings, dialogue and presentations.  The regional offices also provide regular technical assistance in Emergency Preparedness to State Agencies and staff, who, since November 2017, have been regularly surveying providers and suppliers for compliance with emergency preparedness regulations.  
CMS will continue to work with all geographic areas impacted by Hurricane Dorian. We encourage beneficiaries and providers of healthcare services that have been impacted to seek help by visiting CMS’ emergency webpage (www.cms.gov/emergency).

To find additional hurricane preparedness and response resources for the health sector and the latest regarding HHS activities for Hurricane Dorian, please visit: www.phe.gov/dorian.
CMS offers broad support for Puerto Rico with Hurricane Dorian

The Centers for Medicare & Medicaid Services (CMS) today announced efforts underway to support Puerto Rico in response to Hurricane Dorian. Today, Health and Human Services Secretary Alex Azar declared a public health emergency (PHE) in the Commonwealth. CMS is working to ensure hospitals and other facilities can continue operations and provide access to care despite the effects of Hurricane Dorian. CMS will be waiving certain Medicare, Medicaid, and Children’s Health Insurance Program (CHIP) requirements; creating special enrollment opportunities for individuals to access healthcare quickly; and taking steps to ensure dialysis patients obtain critical life-saving services.

​“Our thoughts are with everyone who is in the path of Hurricane Dorian and CMS is doing everything within its authority to provide assistance and relief to all who are affected,” said CMS Administrator Seema Verma. “We will partner and coordinate with federal and local officials to make sure that in the midst of all of the uncertainty a natural disaster can bring, our beneficiaries will not have to worry about access to healthcare and other crucial life-saving and sustaining services they may need.”

​Below are key administrative actions CMS will be taking in response to the PHE declared in Puerto Rico:
  • Waivers and Flexibilities for Hospitals and other Healthcare Facilities: CMS will be temporarily waiving or modifying certain Medicare, Medicaid, and CHIP requirements. CMS will also issue a number of blanket waivers, listed on the website below, and the CMS Regional Office will grant other provider-specific requests for specific types of hospitals and other facilities in Puerto Rico. These waivers work to provide continued access to care for beneficiaries. For more information on the waivers CMS has granted, visit: www.cms.gov/emergency.
  • Special Enrollment Opportunities for Hurricane Victims:  CMS will make available special enrollment periods for certain Medicare beneficiaries. This gives people impacted by the hurricane the opportunity to change their Medicare health and prescription drug plans if eligible for the special enrollment period. For more information, please visit: https://www.cms.gov/About-CMS/Agency-Information/Emergency/EPRO/Past-Emergencies/Hurricanes-and-tropical-storms.html.
  • Disaster Preparedness Toolkit for State Medicaid Agencies: CMS developed an inventory of Medicaid and CHIP flexibilities and authorities available to states in the event of a disaster. For more information and to access the toolkit, visit: https://www.medicaid.gov/state-resource-center/disaster-response-toolkit/index.html.
  • Dialysis Care:  CMS is helping patients obtain access to critical life-saving services. The Kidney Community Emergency Response (KCER) program has been activated ahead of the storm and is working with the End Stage Renal Disease (ESRD) Network of New Jersey, Puerto Rico and the U.S. Virgin Islands, ESRD NW3, to assess the status of dialysis facilities in the potentially impacted areas related to generators, alternate water supplies, education and materials for patients, and more. They are also assisting patients who have evacuated ahead of the storm to receive dialysis services in the location to which they are evacuating. Patients have been educated to have an emergency supply kit on hand including important personal, medical, and insurance information; contact information for their facility, the ESRD NW hotline number, and contact information of those with whom they may stay or for out-of-state contacts in a water proof bag. They have also been instructed to have on hand supplies to follow a three-day emergency diet. The ESRD NW3 toll-free hotline is 888-877-8400 and the KCER hotline is 866-901-3773. Additional information is available on the KCER website www.kcercoalition.com. 

During the 2017 and 2018 hurricane seasons, CMS approved special purpose renal dialysis facilities in several states to furnish dialysis on a short-term basis at designated locations to serve ESRD patients under emergency circumstances in which there were limited dialysis resources or access-to-care problems due to the emergency circumstances.
  • Medical equipment and supplies replacements: CMS will be temporarily suspending certain requirements necessary for Medicare beneficiaries who have lost or realized damage to their durable medical equipment, prosthetics, orthotics, and supplies as a result of the hurricane. This will help to make sure that beneficiaries can continue to access the needed medical equipment and supplies they rely on each day. Medicare beneficiaries can contact 1-800-MEDICARE (1-800-633-4227) for assistance.
 
  • Suspension of Enforcement Activities: CMS will suspend current survey and enforcement activities for healthcare facilities in Puerto Rico, but will continue to investigate allegations of immediate threat to patient health and safety.
 
  • Ensuring Access to Care in Medicare Advantage and Part D.  During a public health emergency, Medicare Advantage Organizations and Part D Plan sponsors must take steps to maintain access to covered benefits for beneficiaries in affected areas. These steps include allowing Part A/B and supplemental Part C plan benefits to be furnished at specified non-contracted facilities and waiving, in full, requirements for gatekeeper referrals where applicable.

CMS Central Office and the Regional Offices hosted two Webinars in 2018 regarding Emergency Preparedness (EP) requirements and provider expectations. One was an all provider training on 6/19/2018 (over 3,000 providers participated) and the other an all-surveyor training on 8/14/2018. Both presentations covered the EP Final Rule which included emergency power supply; 1135 waiver process, Best Practices & Lessons Learned from past disasters, and Helpful Resources and more. Both webinars are available at https://surveyortraining.cms.hhs.gov/.

CMS  also compiled a list of Frequently Asked Questions (FAQs) and useful national emergency preparedness resources to assist State Survey Agencies (SAs), their State, Tribal, Regional, local emergency management partners, and health care providers to develop effective and robust emergency plans and tool kits to assure compliance with the EP rules.  The tools can be located at:
https://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/SurveyCertEmergPrep/Emergency-Prep-Rule.html
https://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/SurveyCertEmergPrep/Templates-Checklists.html
Survey & Certification Group Emergency Preparedness Regulation dated November 2016, Revised 6-1-2017.

CMS Regional Offices have provided specific Emergency Preparedness information to Medicare providers and suppliers through meetings, dialogue and presentations.  The regional offices also provide regular technical assistance in Emergency Preparedness to State Agencies and staff, who, since November 2017, have been regularly surveying providers and suppliers for compliance with emergency preparedness regulations.  

​CMS will continue to work with all geographic areas impacted by Hurricane Dorian. We encourage beneficiaries and providers of healthcare services that have been impacted to seek help by visiting CMS’ emergency webpage (www.cms.gov/emergency).
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Getting care & drugs in disasters or emergencies

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Do you live in a disaster or emergency area?
Seeing your doctor in a disaster or emergency
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CIGNA EXPRESS SCRIPTS IMPLEMENT EMERGENCY PROCEDURES FOR PEOPLE AFFECTED BY HURRICANE DORIAN

30 August 2019 
BLOOMFIELD, Conn., 30 August, 2019 - Global health service company Cigna (NYSE: CI) and its Express Scripts unit are helping residents of Florida affected by Hurricane Dorian by easing some health benefits plan and prescription requirements, and expanding access to a toll-free help line.
Cigna and Express Scripts will continue to monitor the situation and take additional steps to help our customers as needed, in concert with emergency or disaster declarations by local, state and federal authorities, to ensure customers continue to have access to pharmacy and medical care. Cigna may extend the expiration date for these temporary measures and expand the geographic range based on the path Hurricane Dorian takes and local conditions.
For all residents in affected areas, Cigna is providing access to its 24x7 telephone help line staffed with qualified clinicians available to speak with people about how to cope with anxiety, stress or other issues. People who do not have health benefits or employee assistance program benefits with Cigna can call 1.866.912.1687 toll-free.
Cigna Disaster Resource Center provides a list of online resources for physical and mental self-care during challenging times. Resources are available in English and Spanish.
Cigna Customers
  • Pharmacy: to ensure customers continue to have ready access to prescription medications during this potentially difficult time, prescription refill requirements are lifted in affected areas through end of September.
  • Urgent Care and Emergencies: Cigna will temporarily cover out-of-network claims as in-network for urgent and emergency care for impacted customers in affected areas, and relax requirements for health care providers to seek prior authorization for urgent and emergency situations.
  • Medicare Advantage: Cigna’s Medicare Advantage health plan is lifting early refill edits and referral requirements for Medicare Parts A, B and Supplemental Part C customers in the State of Florida per state and federal regulations. Additionally, if those customers require out-of-network services during the declaration, Cigna will allow impacted customers to obtain that care at in-network cost-share. Out-of-Network providers will receive payment at Medicare rates.
  • 24x7 Support for Customers: for questions on pharmacy or medical care, customers may call the number on their customer ID card or call 1.800.244.6224. Smartphone users may access their ID card and other personal health benefits information through the myCigna app, available as a free download at the Apple iTunes App Store and the Android Market on Google Play.
Express Scripts Members
  • Express Scripts has implemented emergency procedures for its members in these areas, including Medicare, Medicaid and TRICARE® beneficiaries, and patients who fill medications via the company’s Accredo specialty pharmacy.
  • Prescriptions: members in affected areas can obtain an early refill or replace any medication lost or damaged as a result of the storm. This override will be available to members in impacted areas through late September.
  • For More Info: members can call the number on the back of their prescription ID card, or visit https://www.express-scripts.com. The Express Scripts mobile app, available for free download, can help members locate nearby pharmacies and manage prescriptions.
Emergency Preparedness Tips
Cigna and Express Scripts remind people to take important storm precautions, including:
  • Print a copy of your medication history and keep it with you in a sealed plastic bag.
  • If you have to evacuate, take your medication with you (as well as your medication list).
  • If you’re running low on medicine, call or visit your local pharmacy now and obtain an emergency supply.
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Humana Takes Actions to Assist Those Who May be Impacted by Hurricane Dorian

​Thursday, August 29, 2019 4:19 pm EDT
MIAMI--(BUSINESS WIRE)--Humana Inc. (NYSE: HUM), one of the nation’s leading health and well-being companies, announced today the actions it is taking to assist its members, employees and communities in Florida who may be impacted by Hurricane Dorian.
To help ensure the safety and well-being of all Floridians, Humana has launched a series of pre-storm actions, including:
  • Waived all requirements for primary care physician (PCP) referrals and prior authorizations for members in counties declared disaster areas.
  • Provided members with the same cost sharing they would receive from an in-network facility even if receiving care outside the network.
  • For members with a pharmacy benefit, suspended restrictions on refills to allow for travel difficulties and evacuations.
  • Opened up our toll-free crisis intervention hotline and counseling services beyond employees and health plan members to include any individual who may need help and support coping with the storm. Humana has counselors and Work-Life specialists available 24 hours a day, seven days a week at 1-888-673-1154 (TTY: 711) to provide free, confidential assistance to anyone needing help and support in coping with the disaster and its aftermath.
Humana Medicare, Medicaid, commercial and TRICARE members with questions about services available to them should call the toll-free phone number on the back of their Humana ID card.
Providers who have questions or need assistance in coordinating care for Humana members should contact the Provider phone number on the back of the member’s ID card.
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United Healthcare and Optum Take Action to Support People in Carolinas and Georgia Preparing for Hurricane Dorian

​8/31/2019 ATLANTA — 
UnitedHealthcare and Optum, the health benefits and services companies of UnitedHealth Group (NYSE: UNH), are taking action to help people in the Carolinas and Georgia who may be affected by Hurricane Dorian. This is in addition to actions taken earlier to support individuals in Florida. 
Support includes assisting health plan participants who may need to make alternate arrangements to access care and early prescription refills, as well as offering a free emotional-support line to help people who might be affected. 
  • Help Finding a Network Care Provider, Early Refills: Plan participants who need help finding a care provider in the UnitedHealthcare network or obtaining early prescription refills can call customer care at the number located on the back of their medical ID cards.

  • For plan participants who may have misplaced their medical ID cards, call 866-633-2446, 8 a.m.-8 p.m. (in the local time zone), Monday through Friday. People enrolled in Medicaid, employer-sponsored and individual health plans (except Medicare) who have a smartphone can download the free Health4Me app, which provides instant access to their ID card, network care providers, their personal health benefits and more. The Health4Me app is available as a free download at the Apple iTunes App Store and the Android Market on Google Play.

  • Free Help Line: Optum, a leading health and behavioral health services company, is offering a free emotional-support help line.

    The toll-free number, 866-342-6892, will be open 24 hours a day, seven days a week, for as long as necessary. The service is free of charge and open to anyone. Specially trained Optum mental health specialists help people manage their stress and anxiety so they can continue to address their everyday needs. Callers may also receive referrals to community resources to help them with specific concerns, including financial and legal matters.

    Along with the toll-free help line, emotional-support resources and information are available online at www.liveandworkwell.com.
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Aetna ready to help members during hurricane season 
​
Hurricane Dorian is a reminder that hurricane season runs through the end of November, and if you live in a hurricane-prone area, you should take steps to prepare for the disruptive weather conditions that these storms can bring. ​In the event of severe weather, Aetna offers resources to members.

​Members impacted by a hurricane can refill their prescriptions early, if needed. Those members who use Aetna’s mail-order pharmacy can either get a prescription at an alternate delivery location or refill a prescription that may have been lost, damaged or destroyed.

​Aetna professionals who have experience dealing with traumatic events are also available to help. The company opens its Resources for Living services to those affected by hurricanes, regardless of whether they are Aetna members or not. Individuals can call 1-833-327-AETNA (1-833-327-2386) for assistance with finding available shelters, accessing government resources and seeking referrals or help coping with the emotional impact of a hurricane.

​Affected members by can also seek emergency care anywhere, as needed. The company monitors the impact hurricanes have on its network doctors, hospitals and other health care providers, and makes further modifications to its policies as necessary to ensure members have access to care.

​If any additional local, state or federal disaster executive orders or regulations are issued related to these catastrophic event, Aetna will adjust its policies to comply.
Aetna members and health care providers affected by any hurricane who need care or other assistance can reach the company at the following toll-free numbers:
  • Aetna Member Services: Call the number printed on your ID card*. If ID card is unavailable, call 1-800-443-AETNA (1-800-443-2386).
  • Rx Member Services and Aetna Rx Home Delivery Customer Service: 1-888-RX AETNA (1-888-792-3862)
  • Aetna Specialty Pharmacy Customer Service: 1-866-782-ASRX (1-866-782-2779)
  • Aetna Student Assistance Program: 1-877-351-7889
  • Aetna Dental: 1-877-238-6200
  • Teladoc: 1-855-756-8708
  • Health care providers should contact the Provider Service Centers:
    – Indemnity and PPO-based benefit plans: 1-888-MD-AETNA (1-888-632-3862)
    – HMO benefit plans: 1-800-624-0756
  • Coventry Health Plans:
    • Commercial HMO and PPO Plans 1-866-847-8235
    • Medicare Advantage Plans 1-800-847-3995
    • Coventry National and First Health Plans 1-800-937-6824
* Members can find replacement ID cards and access to a Personal Health Record on Aetna’s secure member site Aetna Navigator™.  Log in on Aetna’s home page.

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