On June 16, 2008, HHS declared a public health emergency in response to flooding in Iowa and Indiana. This declaration allows CMS to waive certain documentation and other requirements to enable providers to care for Medicare beneficiaries who have been evacuated. Among other things, for institutional providers treating evacuated patients in flood areas, the CMS will waive certain critical access hospital patient limits, the skilled nursing facility (SNF) three-day prior hospitalization requirement and benefit limits; disregard evacuated patients in calculating the 25-day average length of stay for long-term care hospitals, and not count evacuated patients in determining compliance with the 60 percent inpatient rehabilitation facility rule. For patients in the community, CMS will allow evacuees to receive home health services in alternative sites, waive rules preventing early refills of Medicare Part D prescriptions, and work to assist beneficiaries replace DME. CMS also will waive certain Emergency Medical Treatment and Labor Act (EMTALA) rules, allow beneficiaries in health plans to go out of network, and make emergency arrangements for ESRD care. Details regarding the emergency policies are available here.