Background Part 1: Medicare/Medicaid Emergency Preparedness Rule

In 2016, a new requirement was issued that affects Medicare and Medicaid providers and suppliers resulting in more stringent guidelines of their emergency preparedness plans. Centers for Medicare and Medicaid Services (CMS) recognize that emergency preparedness requirements already exist, but claim they do not go far enough in comprehensively addressing preparedness needs. They also do not address inconsistencies among various healthcare providers. As a result, this regulation went into effect on November 16, 2017 establishing national emergency preparedness requirements for seventeen types of Medicare and Medicaid providers and suppliers (see the below list for affected organizations).

This post is intended to raise awareness of this new regulation and is not intended to be a comprehensive report on all of the details of this regulation. For additional information, Anneal Initiative can be contacted directly at or 785-249-5576.

The new rule, Emergency Preparedness Requirements for Medicare and Medicaid Participating Providers and Suppliers, imposes a mixture of business continuity, continuity of operations (COOP), and emergency planning rules that must be followed, and will be inspected. The rules require four main elements to be present in an emergency preparedness plan:

  1. A risk-based plan that must be updated annually
  2. Policies and procedures customized to fit the plan
  3. A communication plan
  4. A training and testing program

These elements focus on certain aspects of emergency preparedness, and CMS claims they focus on continuity planning, but it is important to keep in mind that not all aspects of business continuity/continuity of operations are covered by this regulation. The rule does not cover matters of recovery of operations, which is an important aspect of a comprehensive business continuity or continuity of operations plan. There are also other items such as determining an organizations’ essential functions or critical business functions that are crucial to having a plan that will work.

Here are some notable highlights from the rule:

  1. While there are more requirements for setting up an emergency preparedness plan, there has been no new funding allocated to offset those costs.
  2. It focuses on an all-hazards approach. While this might introduce more burden, it is actually a helpful approach. When a continuity plan is flexible by taking a broad approach to hazards, it is also likely to be more successful. Continuity planning should focus on dealing with the unavailability of people, resources, or facilities. If a plan is focused on adapting to those three problems, it will significantly increase the ability of an organization to survive unforeseen events or disasters, even if those disasters were not specifically written into the plan.

If you’re questioning whether or not your affected, here is the list of suppliers and providers covered by the new CMS requirements:

  1. Hospitals
  2. Religious Nonmedical Health Care Institutions (RNHCIs)
  3. Ambulatory Surgical Centers (ASCs)
  4. Hospices
  5. Psychiatric Residential Treatment Facilities (PRTFs)
  6. All-Inclusive for the Elderly (PACE)
  7. Transplant Centers
  8. Long-Term Care (LTC) Facilities
  9. Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF//IID)
  10. Home Health Agencies (HHAs)
  11. Comprehensive Outpatient Rehabilitation Facilities (CORFs)
  12. Critical Access Hospitals (CAHs)
  13. Clinics, Rehabilitation Agencies, and Public Health Agencies as Providers of Outpatient Physical Therapy and Speech-Language Pathology Services
  14. Community Mental Health Centers (CMHCs)
  15. Organ Procurement Organization (OPOs)
  16. Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs)
  17. End-Stage Renal Disease (ESRD) Facilities

See our next blog post for more details on these requirements.