CMS to Grant Exceptions to ASCs Affected by Irma (Updated 12/11/17)

Updated: December 11, 2017

Surgery centers located in the path of Irma will be exempt from quality reporting requirements

Due to the devastating impact of Hurricane Irma, the Centers for Medicare & Medicaid Services (CMS) will grant exceptions for Medicare quality reporting requirements to ASCs located in areas affected by the storm.

ASCs will get exceptions without having to submit an extraordinary circumstances exception (ECE) request if they are located in one of the Florida counties, Georgia counties, South Carolina counties/Indian reservations, Puerto Rico municipios or U.S. Virgin Islands county-equivalents listed below, all of which have been designated by the Federal Emergency Management Agency (FEMA) as a major disaster locality. The scope and duration of the exception under the Medicare quality reporting program for ASCs is described below. All of the exceptions, however, will be granted to assist these providers while they direct their resources toward caring for their patients and repairing structural damages to facilities.

NOTE: Since the last communication, released on October 30, 2017, FEMA has designated 31 counties/Indian reservations in the state of South Carolina as disaster areas: Abbeville, Aiken, Calhoun, Catawba Indian Reservation, Cherokee, Chester, Chesterfield, Clarendon, Darlington, Dillon, Fairfield, Florence, Greenville, Greenwood, Horry, Kershaw, Lancaster, Laurens, Lee, Lexington, Marion, Marlboro, Newberry, Orangeburg, Richland, Saluda, Spartanburg, Sumter, Union, Williamsburg and York, as well as eight additional municipios in Puerto Rico: Bayamon, Comerio, Dorado, Guarbo, Hatillo, Naguabo, Salinas and Yauco. ASCs located within these FEMA-designated counties/Indian reservations and municipios have been granted exceptions in addition to ASCs located in the counties, Indian reservations, municipios, and county-equivalents previously identified.

The affected counties, Indian reservations, municipios and county-equivalents designated by FEMA as of the date of this communication are as follows:

Florida Counties

Georgia Counties

South Carolina Counties/Indian Reservation

Puerto Rico Municipios

U.S. Virgin Islands County-Equivalents

All 67 counties in Florida are within the FEMA-designated areas.

All 159 counties in Georgia are within the FEMA-designated areas.

All 46 counties in South Carolina, as well as the Catawba Indian Reservation, are within FEMA-designated areas Adjuntas
Aguas Buenas
Las Piedras
San Juan
Vega Baja
St. Croix (Island)
St. John (Island)
St. Thomas (Island)

ASCs located in the counties, Indian reservations, municipios and county-equivalents described above will get an exception for the following reporting requirements under the Ambulatory Surgical Center Quality Reporting (ASCQR) Program:

  • Data collection and submission requirements that apply for the remainder of Calendar Year (CY) 2017 and the 2017/2018 Influenza Season that relate to CY 2019 payment determinations. These exemptions apply to all data submitted via the QualityNet Secure Portal and the National Healthcare Safety Network (NHSN) web-based measure collection tools that are due May 15, 2018, including claims-based measures calculated from submitted Quality Data Codes (QDCs). This exemption does not apply to claims-based measures that do not utilize QDCs for calculation purposes.

Circumstances Under Which an Exception Due to Hurricane Irma Must Be Requested to Be Considered by CMS

ASCs located outside of the counties, Indian reservations, municipios and county-equivalents listed above are not covered by this communication, but may request an exception to the reporting requirements using the applicable ECE procedure. If FEMA expands the current disaster declaration for Hurricane Irma to include additional counties, Indian reservations, municipios or county-equivalents, CMS will update this communication to expand the list of providers eligible to receive an exception without submitting a request.  In addition, CMS will continue to monitor the situation and adjust exempted reporting periods and submission deadlines accordingly.

ASCs in counties outside of the designated areas may submit ECE requests based on individual circumstances by one of the following methods:

  • Secure File Transfer via QualityNet Secure Portal, “WAIVER EXCEPTION WITHHOLDING” group,
  • E-mail to,
  • Secure fax to 877.789.4443 or
  • Mail to HSAG, Attention: Quality Reporting Support Contractor, 3000 Bayport Drive, Suite 300, Tampa, FL 33607.

Additional information about the ECE Request process and form can be found here. The National Support Team for the ASCQR Program is available to answer questions or supply any additional information you may need. Please contact the team at or or call toll-free at (866) 800-8756.

For further assistance regarding the information contained in this message, please contact the Health Services Advisory Group (HSAG) (formerly FMQAI) online or via phone 866.800.8756 Monday through Friday, 7 am to 6 pm EST.