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Emergency Waivers in N.Y., N.J. Relax HIPAA Requirements in Wake of Sandy

Wednesday, November 14, 2012

ALBANY, N.Y.--The Centers for Medicare & Medicaid Services approved so-called Section 1135 waivers for New York and New Jersey Nov. 3 to ease privacy and other requirements for providers who are serving patients affected by Hurricane Sandy.

The waivers cover requirements under Medicaid, Medicare, the Children's Health Insurance Program (CHIP), and the Health Insurance Portability and Accountability Act.

New York's waiver is retroactive to Oct. 27, and New Jersey's is retroactive to Oct. 26. The waivers were approved by Health and Human Services Secretary Kathleen Sebelius under Section 1135 of the Social Security Act, which grants the secretary authority to waive certain requirements during national emergencies.

“Millions of New Yorkers and thousands of patients across the state's health care system were directly affected by the devastation caused by Hurricane Sandy, and we must act quickly to ensure that quality and dependable care is available to all of those in need,” New York Gov. Andrew M. Cuomo (D) said in a statement.

HIPAA Among Affected Rules.

According to Cuomo, the waiver relaxes administrative and recordkeeping rules, including documentation, patient relocation, and billing requirements.

He said New York will be able to bill and claim services in cases where providers are unable to submit the standard documentation; relax requirements for the relocation of patients from damaged facilities to more secure settings; suspend requirements that “potentially limit services and impede the ability of providers to accept new patients”; and expedite approvals for relocating provider operations.

Among the provisions waived were sanctions and penalties for violating certain HIPAA privacy regulations.

The goal of the waivers, according to emergency declarations from HHS, is “to ensure that sufficient health care items and services are available to meet the needs of individuals enrolled in the Medicare, Medicaid, and CHIP programs and to ensure that health care providers that furnish such items and services in good faith, but are unable to comply with one or more of these requirements as a result of Hurricane Sandy, may be reimbursed for such items and services and exempted from sanctions for such noncompliance, absent any determination of fraud and abuse.”

By Gerald B. Silverman  


The New York Section 1135 waiver is available at http://www.cms.gov/About-CMS/Agency-Information/Emergency/Downloads/Hurricane-Sandy-PHE-Declaration-and-Section-1135-Waiver-for-New-York-10-31-12.pdf.

The New Jersey Section 1135 waiver is available at http://www.cms.gov/About-CMS/Agency-Information/Emergency/Downloads/Hurricane-Sandy_PHE-Declaration-and-Section-1135-Waiver-for-New-Jersey-11-1-12.pdf.

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