Updated on: November 14, 2012

Some Providers Get a Break from Hurricane Sandy’s Wrath

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Original story posted on: November 13, 2012

Call them “fair-weather” friends, if you will, but the folks at the Centers for Medicare & Medicaid Services (CMS) came off as BFFs to stricken providers in New York, New Jersey and Connecticut during recent days (that’s “best friends forever,” for those of you who unfamiliar with the trendy acronyms of the digital age).

Following the landfall of Hurricane Sandy early on the morning of Tuesday, Oct. 29 — an event that created a storm surge that devastated a huge swath of the East Coast shoreline along New York and New Jersey and forced a number of hospitals to evacuate — CMS issued what it calls a Technical Director Letter (TDL) to RACs and MACs in New York, New Jersey and Connecticut, advising them suspend pre-payment and post-payment audits that would require providers to respond to additional documentation requests (ADRs). The letter was sent on Friday, Nov. 2.

The TDL went on to indicate that, for providers in Federal Emergency Management Agency (FEMA)-designated disaster areas, contractors would not file ADRs nor deny claims due to insufficient documentation for a 60-day period, starting Nov. 2.

For providers located in affected states, but not in a county designated disaster area, there would be a 30 –day suspension, according to the TDL.

“Any claims that would have normally been subject to pre-payment review will be passed through the system for payment,” Stewart Presser of the Greater New York Hospital Association wrote in a Nov. 9 email made available to RACmonitor. “These claims may be subject to post-payment review at a later date.”

FEMA-designated counties in the disaster area included the following, according to the TDL:

  • New York:
    New York City, Nassau, Suffolk, Westchester and Rockland
  • New Jersey:
    Atlantic, Cape May, Essex, Hudson, Middlesex, Monmouth, Ocean and Union
  • Connecticut:
    Fairfield, Middlesex, New Haven, and New London

FEMA later went on to designate all 21 New Jersey counties as disaster areas. A total of 2.7 million residential and commercial properties in the Garden State alone lost power as a result of Sandy, and many of those remained without service for a week or even longer.

Early estimates indicated that Sandy caused $50 billion in damages. Only Hurricane Katrina, which devastated New Orleans in 2005, caused damage assessed at a rate more costly than that in modern history.

“Again, we want to stress that in New York and Connecticut, National Government Services, the MAC for those states, WILL NOT request ADRs for a period of either 30 or 60 days,” Presser added in his email.

Hospitals in several areas most impacted by the storm suffered considerable damage. New York City Mayor Michael Bloomberg this week announced an appropriation of $300 million to the city’s Health and Hospital Corporation to allow it to repair that damage at sites including Bellevue Hospital Center, Coney Island Hospital and the Coler-Goldwater Specialty Hospital and Nursing Facility on Roosevelt Island.

“Our city has never experienced a storm as destructive as Hurricane Sandy, and financing for these repairs is as necessary as it is urgent,” Bloomberg said in a statement. “These … public hospitals are resources that hundreds of thousands of New Yorkers rely on every day, and we are not waiting for federal aid to begin the work of repairing and reopening them. This emergency capital spending is vital investment in our recovery and future.”

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Chuck Buck is the publisher of RACmonitor

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Using Post-Acute Services to Improve Efficiency in the Acute Care Setting

Chuck Buck

Chuck Buck is the publisher of RACmonitor and is the program host and executive producer of Monitor Monday.

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