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DHHS Helps Pay Medical Bills for Hurricane Irma Evacuees

By Christopher Cheney  
   September 20, 2017

Dozens of hospital patients who were evacuated from the U.S. Virgin Islands have received care in Puerto Rico that is reimbursable under a federal program.

In response to evacuations linked to Hurricane Irma, federal officials are drawing on the National Disaster Medical System (NDMS) to help pay for patients' bills.

This is the first time the NDMS Definitive Care Reimbursement Program has been activated since the 2010 international response to an earthquake disaster in Haiti. The program reimburses hospitals and other medical facilities for care provided to patients who are evacuated from their communities after a disaster and cannot access care at their local facilities.

The program is overseen by the Department of Health and Human Services (DHHS) Assistant Secretary for Preparedness and Response (ASPR). The federal departments of Defense and Veterans Affairs also participate in the program.

At least 85 patients have received care in Puerto Rico through the reimbursement program, DHHS reported Sunday in a prepared statement. The patients were evacuated from the U.S. Virgin Islands after Hurricane Irma dealt a devastating blow to many Caribbean islands and the Florida Keys last week.

"Hurricane Irma significantly affected access to medical care in the areas hardest hit by the storm, and patients who need care in these impacted areas must rely on facilities in areas spared by the storm," said ASPR Robert Kadlec, MD.

Under the NDMS reimbursement program, patients such as those impacted by Hurricane Irma are transported to NDMS-approved medical facilities. The U.S. Virgin Island patients were taken to Puerto Rico with "resources" drawn from the Department of Defense and the Federal Emergency Management Agency's national ambulance contract, the DHHS prepared statement says.

Services covered through the reimbursement program include:

  • hospital care, which can extend beyond a 30-day stay
  • home care
  • rehabilitation and physical therapy
  • primary care

The reimbursement rate for services provided through the NDMS program are as high as 110% of the Medicare rate, or a similar rate if there is no comparable Medicare benchmark. To participate in the program, medical facilities must have at least 25 licensed beds available for evacuation patients. This year, more than 1,900 hospitals are eligible to participate in the reimbursement program.

In 2010, HHS launched a pair of Federal Coordinating Centers in Atlanta and Tampa under NDMS in response to the Haitian earthquake. With medical facilities devastated in Haiti, 79 Haitians and 10 U.S. citizens were evacuated from Haiti to NDMS-approved facilities for treatment of life-threatening conditions, the Obama administration reported.

In 2012, NDMS played an active role in the response to Hurricane Sandy's impact on New Jersey and New York, according to an ASPR report on the disaster:

  • Oct. 29: Sandy makes landfall and DHHS deploys more 160 staff, including ASPR regional emergency coordinators in three Regional Response Coordination Centers
  • Oct. 31: DHHS Secretary Kathleen Sebelius declares a state of emergency throughout New York and total number of DHHS staff tops 500
  • Nov. 1: Sebelius declares state of emergency in New Jersey, with total number of DHHS staff topping 650
  • Nov. 6: Response under NDMS reaches build-out point, with 1,000 DHHS staff deployed. NDMS resources deployed feature 15 Disaster Medial Assistance Teams in New York and New Jersey, each equipped with medical supplies and staffed by U.S. Public Health Service officers.

NDMS also participates in preparedness and medical support for national events such as presidential inaugurations.


Christopher Cheney is the senior clinical care​ editor at HealthLeaders.

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