State and Federal Regulatory Bodies Address Hurricane Harvey

Date: August 30, 2017

State and federal regulatory bodies have relaxed some rules to help physicians and facilities respond to patients during Hurricane Harvey relief efforts.

The following is an overview of some of the measures. This is provided for informational purposes only and does not serve as legal advice.

Texas Department of Insurance
The Texas Department of Insurance (TDI) released the following guidance related to commercial health insurance plans and out-of-network benefits:

Because of the potential storm damage to local, regional, and state-wide utilities and infrastructure, many insureds, enrollees, or certificate holders could be forced to evacuate their residence locations and health care service areas. Restrictions on insureds, enrollees, or certificate holders will result in many storm victims being without necessary health care or dental services. Insureds, enrollees, or certificate holders should not be left without their necessary health care or dental services during a disaster or threat of imminent disaster. Under these circumstances, it is the opinion of the Texas Department of Insurance that all health insurance companies and health maintenance organizations should waive penalties and restrictions on insureds, certificate holders, or enrollees when these insureds, enrollees, or certificate holders obtain necessary emergency and nonemergency health and dental services out-of-network as a result of the disaster through the duration of the governor's proclamations. Additionally, health insurance companies and health maintenance organizations should not deny payment for necessary emergency and nonemergency health and dental services that are obtained out-of-network as a result of the threat of imminent disaster through the duration of the governor's proclamations.

Click here to view TDI’s full statement.

Texas Medical Board
The Texas Medical Board (TMB) has issued guidance related to expedited approval of physicians and other types of providers from other states to help with Hurricane Harvey relief efforts in Texas.

Click here to view the TMB instructions.

Texas Department of Licensing and Regulation (TDLR)
Per TDLR: 

In accordance with Section 418.016 of the Texas Government Code, Governor Greg Abbott has temporarily suspended all necessary statutes and rules to allow licensed health care providers employed by a hospital and who are in good standing in another state to practice in Texas to assist with disaster response operations.

This suspension is in effect until terminated by the Office of the Governor or until the Hurricane Harvey disaster declaration is lifted or expires.

Hospitals must submit to TDLR by email each out-of-state provider’s name, license type, state of licensure, and license identification number to: Harvey@tdlr.texas.gov

TDLR licenses the following health care providers:

  • Athletic Trainers
  • Orthotists and Prosthetists
  • Podiatrists (Effective 9/1/17)

If you have questions or need assistance, please call (800) 803-9202 between the hours of 7:00 a.m. – 6:00 p.m. CST or email Harvey@tdlr.texas.gov

Hospitals – Department of State Health Services
DSHS offered the following guidance: 

In accordance with section 418.016 of the Texas Government Code, the Office of the Governor temporarily suspends all necessary statutes and rules to allow health care providers employed by a hospital and licensed and in good standing in another state to practice in Texas in order assist with the Tropical Depression Harvey disaster response operations. Hospitals must submit to the applicable licensing entity each out-of-state provider’s name, provider type, state of license, and license identification number.

This suspension is in effect until terminated by the Office of the Governor or until the Tropical Depression Harvey disaster declaration is lifted or expires.
Licensed health care professionals should contact their Texas licensing boards for more information on the approval process.

Texas hospitals may contact Pamela Adams, Program Specialist, Facility Licensing Group at (512) 834-6600, extension 2607 or at pamela.adams@hhsc.state.tx.us with any questions.

Texas Department of Insurance – Division of Workers’ Compensation
TDI-DWC issued a bulletin related to Workers’ Comp issues during the hurricane response. An excerpt includes:

For the duration of the Governor’s disaster proclamation, and with reference to claims involving workers’ compensation claimants residing in a county included in the Governor’s disaster proclamation insurance carriers must provide or continue to provide:

      • Processing and delivery of benefit checks and necessary medical care, services, and supplies, including physical therapy, pharmaceutical benefits, and medical equipment,
      • Waiver of penalties and restrictions related to necessary emergency and non-emergency health care provided out-of-network,
      • Coverage of payment for necessary emergency and non-emergency health care services obtained out-of-network,
      • Extended deadlines for medical examinations,
      • Authorize payment to pharmacies for up to a ninety day supply of any prescription medication, subject to the remaining number of days authorized by the prescribing provider, for individuals regardless of the date upon which the prescription had most recently been filled, and
      • Expedited change of address processing.

Click here to read the full bulletin.

HIPAA Sanctions and Penalties During a Declared Emergency
The U.S. Department of Health and Human Services (HHS) issued a bulletin related to HIPAA rules in the immediate aftermath of the hurricane.

The following is an excerpt from the bulletin:

The Secretary of HHS has declared a public health emergency in Texas and Louisiana following the President’s declaration that a disaster exists in the States of Texas and Louisiana. Under these circumstances, the Secretary has exercised the authority to waive sanctions and penalties against a covered hospital that does not comply with the following provisions of the HIPAA Privacy Rule:
  • the requirements to obtain a patient's agreement to speak with family members or friends involved in the patient’s care. See 45 CFR 164.510(b). 
  • the requirement to honor a request to opt out of the facility directory. See 45 CFR 164.510(a). 
  • the requirement to distribute a notice of privacy practices. See 45 CFR 164.520. 
  • the patient's right to request privacy restrictions. See 45 CFR 164.522(a). 
  • the patient's right to request confidential communications. See 45 CFR 164.522(b).
When the Secretary issues such a waiver, it only applies: (1) in the emergency area and for the emergency period identified in the public health emergency declaration; (2) to hospitals that have instituted a disaster protocol; and (3) for up to 72 hours from the time the hospital implements its disaster protocol. When the Presidential or Secretarial declaration terminates, a hospital must then comply with all the requirements of the Privacy Rule for any patient still under its care, even if 72 hours has not elapsed since implementation of its disaster protocol.

Click here to read the full bulletin.

Map of Pharmacies Open
The Texas Medical Association published a map of the pharmacies that are open during the hurricane recovery.
Click here to view it.