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In a major disaster, health care institutions face many issues, including disaster readiness, privacy concerns, and insurance coverage considerations. Superstorm Sandy offers a few lessons with respect to various health law requirements, and also sends a reminder to health care institutions of the need to carefully review their property insurance policies before faced with a claim.

Disaster readiness and privacy issues

Some facilities, like New York University Langone Medical Center, met Sandys challenges admirably, conducting an orderly and safe evacuation of patients when emergency power failed, and notifying family members of the new locations of the relocated patients.

Other facilities were less prepared, failing to prepare patient health information for evacuation and stock sufficient medicine and flashlights (in violation of state regulations). These failures resulted in patients being transferred without their health care information, and relatives unable to find out where their loved ones had been sent.

In a disaster, it is important to be clear about what the federal Health Insurance Portability and Accountability Act (HIPAA) permits with respect to sharing patient health information. Following Hurricane Katrina in 2005, the United States Department of Health and Human Services Office for Civil Rights issued a bulletin that provides guidance on how HIPAA allows patient information to be shared to assist in disaster relief efforts, and to assist patients in receiving the care they need. For example, a facilitys patient directory information can be shared for these purposes.

In addition, HIPAA business associates, subject to their contractual agreements, can help facilitate appropriate information sharing. The Office for Civil Rights of the U.S. Department of Health and Human Services (also known as the HIPPA Police) has indicated that it will consider emergency circumstances when it assesses whether there has been a failure to meet HIPAA requirements and how quickly any failure must be cured.

Disaster readiness will also be under the microscope in the coming months. In light of the power failures at hospitals affected by Sandy, the Centers for Medicare and Medicaid Services are reviewing whether requirements for backup power should be updated.

Currently, Medicare Conditions of Participation (COPs) for hospitals require that the hospital meet the applicable provisions of the 2000 edition of the Life Safety Code, which references National Fire Protection Association (NFPA) standards, specifically NFPA 99. Emergency power and lighting are required in critical areas such as operating, recovery, intensive care and emergency rooms and stairwells. In other areas not serviced by emergency supply sources, battery lamps and flashlights must be available. Although NFPA updates its standards every three years, the COPs still reference the version that was in place in 2000.

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Health care institutions should learn lessons from Superstorm Sandy fallout