Hurricanes Harvey, Irma, and Maria will forever live in infamy for their sheer destructive power, but while most of the country was watching the devastation on television, the Centers for Medicare & Medicaid Services was at work on the ground. Though it’s not highlighted often, the CMS has a major role in emergency response situations, Kim Brandt, the CMS’s principal deputy administrator for operations, said at a recent conference.
For example, if the CMS doesn’t waive a lot of its Medicare and Medicaid rules and regulations in response to a disaster, people won’t get proper care, Brandt said at the Health Care Compliance Association’s Healthcare Enforcement Compliance Institute. The CMS can waive quality reporting requirements, conditions of participation, and certification requirements, among others, Brandt said.
However, providers and health-care facilities also have a role to play in disaster situations, Brandt said. Effective emergency preparedness plans are critical for all providers and facilities, she said. A number of elderly patients died at the Rehabilitation Center at Hollywood Hills, Brandt said, which didn’t have an emergency response plan in place.
Switching gears, Brandt touched on the Medicare claims appeal backlog, noting that as of this summer, it was taking 800 days from the time an appeal was filed until it reached the administrative law judge level.
Brandt says the CMS has been engaged in an alternate dispute resolution pilot program, which has helped to resolve some of the backlog. The CMS is also working on preventing the need for future appeals through regulatory reform, and documentation simplification. Making regulatory requirements easier to understand can help reduce the amount of appeals, Brandt said.
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