Sandy, waivers and red tape


As I was listening to the Nov. 1 call about waivers for Medicare, Medicaid and CHIP providers in New York and New Jersey, I couldn’t help but wonder how this all worked out the last time we had a hurricane that caused this much damage.

Hurricane Katrina in 2005?

I made a few calls to industry stakeholders in Alabama and Mississippi, where that hurricane hit hardest. I left a lot of voice mail messages, but I was able to get Michael Hamilton, the executive director of the Alabama DME Association, on the line.

I asked him whether or not these waivers made a big difference for providers that, then during Katrina and now during Sandy, are working 24/7 to make sure their patients have the products and services they need.

Where the waivers came in handy, Hamilton said: They allowed providers to file claims without paperwork that’s usually required in advance; and they allowed providers to service patients that had relocated temporarily.

Other than that, not so much, he said.

“The process is so convoluted and complicated,” Hamilton said. “I’m not sure anyone thought it was worth it.”

At the end of the day, “most of the work was done for free or for cash,” he said.

Hamilton noted that President Barack Obama, during a speech following Hurricane Sandy, promised “No bureaucracy, no red tape” in the government’s response. That’s nice in theory, he said.

“Once they start reading the regulations and figuring out which apply and which don’t, things always get bogged down,” Hamilton said. “That’s the nature of a bureaucracy I guess.”