Florida Medicare rules eased due to hurricane

Florida healthcare providers now have access to a set of Medicare waivers following the federal public health emergency triggered by Hurricane Isaias. However, the telehealth provisions included in the waivers introduce minimal new changes. Instead, the most significant adjustments involve Medicare Advantage network policies, prescription refill policies, and equipment replacement guidelines.

Health and Human Services Secretary Robert F. Kennedy Jr. announced the emergency on October 13, with its effects retroactively applied to October 6 in Florida. This action came after President Donald Trump declared an emergency on October 9. Hurricane Isaias struck land near Destin around 9:30 p.m. that same evening, classified as a Category 2 storm with winds reaching 105 miles per hour.

Medicare Waivers

The emergency declaration encompasses 27 counties, as stated by Governor Ron DeSantis’ administration. The Centers for Medicare & Medicaid Services (CMS) released its waiver list on October 15, permitting the use of audio-only communication for evaluation and management services as well as behavioral health consultations. Additionally, the waivers eliminate geographic restrictions for telehealth services, allowing Medicare beneficiaries to receive care in their homes.

Many of these telehealth flexibilities were already established through the Consolidated Appropriations Act of 2026, extending Medicare’s home-based, geographic, and audio-only service rules through December 31, 2027. These blanket waivers take effect automatically, eliminating the need for individual provider applications.

Medicare Advantage Network Rules

For medical offices, the most impactful changes relate to Medicare Advantage plans. Once a disaster is declared, federal regulations mandate that these plans cover Part A and Part B services from non-contracted providers, waive referral requirements, and apply in-network cost-sharing rates. This means a practice outside a patient’s usual network may treat them at standard in-network pricing during the emergency period.

Before declining patient care or citing out-of-network fees, staff should verify each plan’s disaster-specific terms. For example, Optimum HealthCare’s notice for Hurricane Isaias outlines coverage details for members in specific counties, including Citrus, Hillsborough, Pasco, and Pinellas.

This period runs up to 60 days after the incident period ends.

Practices should save the waiver list and document storm-related visits.

Refill Limits and Equipment Replacement

Florida’s state laws also ease prescription refill restrictions. Executive Order 26-202 activates a section of Florida Statutes requiring insurers to suspend “refill too soon” restrictions and provide at least a 30-day supply for remaining medications. This waiver applies to refill requests made within 30 days, with extensions possible in 15- or 30-day increments.

On the federal level, CMS directs Part D plans to cover out-of-network pharmacy fills for displaced beneficiaries and remove refill restrictions for those who lost their medications. Medicare patients who destroyed or damaged durable medical equipment during the storm can request replacements by calling 1-800-MEDICARE.

Residents in states using HealthCare.gov, including Florida, who missed enrollment deadlines due to the FEMA-declared disaster qualify for a special enrollment period lasting up to 60 days after the emergency’s end. Practices in affected areas should retain the CMS waiver list and train front desk staff on Medicare Advantage disaster policies.

They must also document storm-related visits, particularly those involving out-of-network Medicare Advantage encounters. Providers needing additional flexibility beyond standard waivers can submit CMS’ 1135 waiver request form. These blanket waivers remain active until the public health emergency concludes or is no longer necessary.

However, HIPAA relief is not guaranteed. CMS clarified that its limited HIPAA sanctions waiver applies only to hospitals with activated disaster protocols, and only for up to 72 hours. Understanding these waivers and flexibilities will help physician offices effectively assist patients during the recovery phase.