The Centers for Medicare & Medicaid Services (CMS) has announced a range of regulatory flexibilities and additional resources in response to a Public Health Emergency (PHE) declared for the state of Hawaii because of mudslides, landslides, flooding, and storms that started on March 10, 2026, and continue to impact that region. The public health emergency declaration was signed on April 21, 2026, by Robert F. Kennedy, Jr., Secretary of the U.S. Department of Health and Human Services (HHS). CMS has been closely cooperating with state officials and federal partners in Hawaii to safeguard continuity of healthcare services and approach to care by the disaster-affected populations.
To support the healthcare delivery system, CMS is initiating additional regulatory flexibilities and activating blanket waivers to commence the period of disaster. These waivers are envisioned to decrease administrative hurdles for clinics, hospitals, and other providers that allow them to continue operations under emergency conditions.
Providers who need more modifications under the influence of the local impacts can file waiver requests using the CMS 1135 Waiver, flexibility request, and inquiry form. This is done to make sure that healthcare services are not interrupted in case of damage to infrastructure and other operational disruptions triggered by the disaster. For individuals impacted by the emergency, CMS is enabling access to health insurance coverage through a Special Enrollment Period (SEP) under the Health Insurance Marketplace.
FEMA-declared disaster residents who missed enrollment because of the incident can receive a 60-day special enrollment period upon the completion of the incident. To sign up or renew coverage and remain covered with necessary health insurance, they can contact the Marketplace Call Center for assistance.
CMS has also highlighted preparedness and continuity of coverage for Medicaid and the Children’s Health Insurance Program (CHIP). A disaster response toolkit has been issued to state agencies outlining authorities to sustain programs during the course of emergencies and drawing on available flexibilities. This toolkit helps ensure beneficiaries continue receiving services without interruption during crises.
Critical care services, specifically dialysis care, are being highlighted through the ESRD Network 17 and KCER program that assesses patient support, backup resources, and facility operations across Hawaii. Patients are advised to follow a three-day diet plan and keep emergency kits ready, and a special hotline is created to help dialysis patients to seek care during the displacement.
CMS is safeguarding continuity of care by permitting the replacement of damaged medical equipment and modifying Medicare Part D policies to enable access to medications, including waived refill limits and out-of-network fills. Temporary HIPAA flexibilities have been established to assist in emergency care, while CMS continues to provide guidance on protecting civil rights such as language access. CMS continues to collaborate with the federal partners and state of Hawaii to provide continuous care and sufficient support to affected populations in the recovery process.
Reference: Centers for Medicare & Medicaid Services. CMS announces resources, flexibilities to assist with public health emergency in state of Hawaii. 2026. CMS announces resources, flexibilities to assist with public health emergency in state of Hawaii
