Medicare Beneficiaries Should Get Replacement of Any Equipment That is Damaged or Destroyed by Hurricane Florence

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When the President declares a disaster or emergency under the Stafford Act or National Emergencies Act and the HHS Secretary declares a public health emergency under Section 319 of the Public Health Service Act, the Secretary is authorized to take certain actions in addition to his/her regular authorities. For example, under section 1135 of the Social Security Act, the Secretary may temporarily waive or modify certain Medicare, Medicaid, and Children’s Health Insurance Program (CHIP) requirements to ensure that sufficient health care items and services are available to meet the needs of individuals enrolled in Social Security Act programs in the emergency area and time periods and that providers who provide such services in good faith can be reimbursed and exempted from sanctions (absent any determination of fraud or abuse)

In response to Hurricane Florence, the Centers for Medicare and Medicaid Services (CMS), as part of their Hurricanes & Tropical Storms protocol, offers information related to Emergency Durable Medical Equipment, Prosthetics, Orthotics and Supplies for Medicare Beneficiaries Impacted by an Emergency or Disaster.

Replacement of Mobility Supplies, Medical Equipment for Medicare Beneficiaries

The CMS should determine it is appropriate to issue a blanket waiver to suppliers of Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) where DMEPOS is lost, destroyed, irreparably damaged, or otherwise rendered unusable. Under this waiver, the face-to-face requirement, a new physician’s order, and new medical necessity documentation are not required for replacement.

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Suppliers must still include a narrative description on the claim explaining the reason why the equipment must be replaced and are reminded to maintain documentation indicating that the DMEPOS was lost, destroyed, irreparably damaged or otherwise rendered unusable as a result of the hurricane.

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