COVID-19
Resources for Government Attorneys Working on COVID-19 Legal Issues
The Centers for Medicare & Medicaid Services (CMS) website states “Section 1135 of the Act authorizes the Secretary of the Department of Health and Human Services to waive or modify certain Medicare, Medicaid, CHIP, and HIPAA requirements. However, two prerequisites must be met before the Secretary may invoke the § 1135 waiver authority. First, the President must have declared an emergency or disaster under either the Stafford Act or the National Emergencies Act. Second, the Secretary must have declared a Public Health Emergency under Section 319 of the Public Health Service Act. Then, with respect to the geographic area(s) and time periods provided for in those declarations, the Secretary may elect to authorize waivers/modifications of one or more of the requirements described in Section 1135(b). The implementation of such waivers or modifications is typically delegated to the Administrator of CMS who, in turn, determines whether and the extent to which sufficient grounds exist for waiving such requirements with respect to a particular provider/supplier, or to a group of providers, or to a geographic area.”
The Centers for Medicare & Medicaid Services (CMS) website states “Section 1135 of the Act authorizes the Secretary of the Department of Health and Human Services to waive or modify certain Medicare, Medicaid, CHIP, and HIPAA requirements. However, two prerequisites must be met before the Secretary may invoke the § 1135 waiver authority. First, the President must have declared an emergency or disaster under either the Stafford Act or the National Emergencies Act. Second, the Secretary must have declared a Public Health Emergency under Section 319 of the Public Health Service Act. Then, with respect to the geographic area(s) and time periods provided for in those declarations, the Secretary may elect to authorize waivers/modifications of one or more of the requirements described in Section 1135(b). The implementation of such waivers or modifications is typically delegated to the Administrator of CMS who, in turn, determines whether and the extent to which sufficient grounds exist for waiving such requirements with respect to a particular provider/supplier, or to a group of providers, or to a geographic area.”
For COVID-19-specific information, view the CMS Emergency Declaration Fact Sheet on the COVID-19 1135 Waiver, and please note the instructions for states to submit a request for an 1135 waiver at the bottom of page 3 of the fact sheet. For an example of a state 1135 waiver request, please see Washington’s Request for Waivers Under Section 1135 of the Social Security Act. CMS has posted responses to state waiver requests, such as Florida’s Coronavirus 1135 waiver request, on their current emergencies webpage.
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