CMS Announces Resources, Flexibilities to Assist with Public Health Emergency in Guam and the Commonwealth of the Northern Mariana Islands

Policy Share CMS Announces Resources, Flexibilities to Assist with Public Health Emergency in Guam and the Commonwealth of the Northern Mariana Islands The Centers for Medicare & Medicaid Services (CMS) announced today additional resources and flexibilities available in response to a Public Health Emergency (PHE) in Guam and the Commonwealth of the Northern Mariana Islands (CNMI) due to emergency conditions resulting from Super Typhoon Sinlaku beginning April 11 and continuing. CMS is working closely with Guam and the Northern Mariana Islands and federal partners to put flexibility in place to ensure those affected by this natural disaster have access to needed care. On April 17, 2026, Department of Health and Human Services (HHS) Secretary Robert F. Kennedy, Jr. declared the PHE . CMS will assist with resources and waivers to ensure hospitals and other facilities can continue to operate and provide access to care to those impacted by the super typhoon. The following is key information on resources for those affected and actions CMS is taking. Guam and the Northern Mariana Islands Waivers: CMS’ blanket waivers and other flexibilities are available to affected providers in Guam and the Northern Mariana Islands who have been affected by the super typhoon —retroactively from April 11, 2026. Healthcare providers in need of additional flexibilities specific to the effects resulting from the super typhoon can submit a request to CMS here: CMS 1135 Waiver/Flexibility Request and Inquiry Form. Disaster Toolkit and Support for State Medicaid and CHIP Agencies: To prepare for current and future disasters, CMS developed an inventory of Medicaid and Children’s Health Insurance Program (CHIP) flexibilities and authorities available to states in the event of a disaster to support Medicaid and CHIP operations and ensure continuity of coverage for people served through Medicaid and CHIP programs during times of crisis. For more information and to access the inventory and toolkit, visit: www.medicaid.gov/resources-for-states/disaster-response-toolkit/index.html . Dialysis Care: CMS is helping people obtain and maintain access to critical life-saving services by activating the Kidney Community Emergency Response (KCER) program and working with End-Stage Renal Disease (ESRD) Network 17, which is responsible under a contract with CMS for assessing the status of dialysis facilities in potentially impacted areas of Guam and the Northern Mariana Islands. This includes assessing impacts related to generators, alternate water supplies, providing education and materials for patients, and more. ESRD Network 17 is also assisting people in receiving dialysis services in Guam and the Northern Mariana Islands locations to which they evacuated. CMS, through ESRD Network 17, advises people to keep an emergency supply kit on hand in a waterproof bag containing important personal, medical, and insurance information; contact information for their dialysis facility; the ESRD Network hotline number; and contact information of those with whom they may stay or for out-of-state contacts. They have also been instructed to have on-hand supplies to follow a three-day emergency diet. The ESRD Network 17 (Guam and the Northern Mariana Islands) toll-free hotline is 1-800-232-3773. Additional information is available on the KCER website at: www.kcercoalition.com . Medical Equipment and Supplies Replacements: CMS will permit people with Medicare who have lost or realized damage to their durable medical equipment, prosthetics, orthotics, and supplies because of the super typhoon to receive replacements of such items and services. This will help to ensure beneficiaries can continue to access the needed medical equipment and supplies they rely on each day. People with Medicare can contact 1-800-MEDICARE (1-800-633-4227) for assistance. Access to Covered Part D Drugs: There is longstanding guidance around expectations for Part D sponsors in the event of a Presidential declaration of a disaster/emergency or Secretarial declaration of a PHE. During any PHE declaration, where beneficiaries are displaced from their place of residence and cannot be reasonably expected to obtain covered Part D drugs at a network pharmacy, plans will be required to assure enrollees have adequate access to drugs dispensed at out-of-network (OON) pharmacies. Plans are required to reimburse beneficiaries up to their usual plan allowance for any payments enrollees make to OON pharmacies. Similarly, if the nature of the disaster requires voluntary or mandatory evacuation, plans will similarly be required to reimburse beneficiaries for OON payments for refills of Part D medications to any beneficiary located in an “emergency area,” defined as the area in which there has been a Stafford Act or National Emergencies Act declaration and a PHE declaration. For beneficiaries who have, for instance, lost their drugs, CMS would expect all “refill too soon edits” to be removed. For more informatio