Emergency Preparedness Transfer Agreement

April 9, 2021

The concept of mutual support is well established and is considered a “support standard” in most emergency disciplines. The aim of this mutual assistance agreement is to help hospitals make emergency interventions by authorizing the mutual aid hospitalization system (HMAS). H-MAS lends medical personnel, medicines, supplies and equipment, or assists in the evacuation of hospitals, including the reception of transferred patients. The HHS rules currently provide that, under The Conditions of Medicare Coverage, CSA maintains either a written transfer agreement with a “participating Hospital in Medicare, or a non-participating local hospital meeting the conditions for payment of emergency services”, or ensure that any physician who provides services to the CSA has initiation privileges in such a hospital. Under the final rule, CSAs are no longer specifically required to maintain a formal hospital transfer contract or to ensure that their physicians retain the privileges of admission to a particular hospital. Instead of the written transmission agreement, the final rule generally requires CSAs to maintain an effective procedure for transferring patients who require emergency treatment to the hospital. CMS believes that the change in the requirements for the hospital transfer agreement is appropriate because of the “low transfer load” and “the burden that CSAs entail in the event of local hospital competition issues.” CMS indicated that under the new rules, CSAs will not be “excluded from obtaining hospital transfer contracts or hospital physicians that authorize privileges where possible,” but CMS believes that such agreements with hospitals should not be explicitly necessary for a CSA to participate in The Medicare and Medicaid programs. The CMS stressed the importance of communication between CETs and hospitals on possible patient transfers and will therefore require CSAs to regularly inform the local hospital in writing of their operations and the patient population. The Centers for Medicare – Medicaid Services (“CMS”) has issued a final rule that significantly reduces many supplier obligations, in response to an executive order from President Trump, who urged the Department of Health and Human Services (“HHS”) to limit regulatory constraints. In particular, the final rule ends the requirement to enter into written transfer agreements with local hospitals through ambulatory centres (ASCs), to remove rules that require CSAs to perform certain patient assessments prior to surgery, and to reduce emergency prevention requirements for CSAs and other providers.

The final rule is expected to come into effect on November 29, 2019. Hospitals should consider companies with organizations that can provide them with resources and services in the event of an emergency or disaster. Agreements are established between hospitals, other health care providers and/or emergency organizations to identify their agreements for cooperation, communication, response and assistance in the event of a public health disaster or emergency. Agreements relating to the incident command structure, patient and resource management, processes and policies regarding the requirement and sharing of personnel, equipment and consumables, as well as payment, are generally covered in a mutual assistance agreement in the field. A Memorandum of Understanding (MOU), also known as a Transfer Agreement, is a good faith agreement between institutions that, at the time of an emergency, must be used to facilitate the evacuation of residents/clients. It is recommended that institutions sign MOUs with up to 20 different buildings on site and outside the county. Consider evacuating nearly 100 residents, with other facilities with only 3-5 residents – or other facilities near you also affected and looking for beds.