The CMS Emergency Preparedness Rule Is On the Clock!

The CMS Emergency Preparedness Rule Is On the Clock!

On December 3, 2015, Dr. Nicole Lurie, Assistant Secretary for Preparedness and Response (ASPR) in the U.S. Department of Health and Human Services (HHS) stated that the Centers for Medicare and Medicaid Services (CMS) proposed emergency preparedness rule would ‘publish final’ within weeks. Now, understand that weeks could mean eight, twelve, twenty, forty-eight, or… That said, the only thing we know for sure is that – if it survives – the rule will not publish more than 55 weeks, three days from the day of Lurie’s public statement.

The proposed rule was published on December 27, 2013. The final rule is on the clock! 

 We’ll get back to the clock.

Dr. Lurie made her statement at the National Healthcare Coalition Preparedness Conference in San Diego. Given that her chair is one seat from HHS Secretary Sylvia Mathews Burwell – a direct appointee of the President – it is unlikely she would make such a bold statement to 1,100 healthcare preparedness professionals if she were not privy to some solid intelligence. Did I mention that CMS also resides in HHS under Secretary Burwell’s command? Just saying.

It’s been seven weeks since Dr. Lurie made her prediction and there is no sign of the rule. Understand that seven weeks in the federal government bureaucracy is the equivalent of four weeks in state government, one week in local government, and about two days for the average human. So, seven weeks is not unto itself a concern. But, the ticking clock in concert with rumors floating around Washington has stirred speculation that there may be a hiccup.

Dr. David Marcozzi, former Director of the National Healthcare Preparedness Program (NHPP), has been rumored to be leaving HHS. The speculation goes that he’s leaving out of frustration with the status of the proposed rule, that special interest gutted it. But, rumors are much like a game of Chinese Whispers, especially in Washington.

Marcozzi, was the change agent that shifted the Hospital Preparedness Program (HPP) paradigm from hospital facility preparedness to healthcare system preparedness. He was ASPR’s voice and public face for directing states to move HPP funding from individual facilities to healthcare coalitions, of which there are over 450 nationwide.

In 2014, Marcozzi left ASPR to take the position of Senior Advisor for Emergency Preparedness and Acute Care at CMS. He reportedly took the position to shepherd the proposed emergency preparedness rule through the comment and amendment process. He clearly understands how important it is to bring synergy between the NHPP and the emergency preparedness regulatory requirements overseen by CMS. In October of 2015, he transitioned back to ASPR as a Senior Advisor. Ideally, because his work was done at CMS and the rule was simply in the signature process.

We have learned that Marcozzi will soon transition out of government to take a position in academia at the University of Maryland. Maybe the rumors are just that, beltway rumors? Maybe a doctor with the credentials of Marcozzi got done what he saw needed to get done and is just ready to take on his next great challenge. Change agents are like that. Either way, he will be sorely missed in the healthcare preparedness arena.

 So, what about the clock?

With the grapevine amuck, we decided to go to the source and reach directly to CMS for comment. As expected, officials remain tight-lipped, declining to provide specificity. “This rule is currently in the rulemaking process,“ stated a CMS official. "Our goal is to publish the rule as soon as possible.“ Got it! But is there a statutory deadline that marks the end of the game? Is it publish final by a drop dead date, or the rule dies?

If so, can CMS spike the rule to stop the clock like a quarterback spikes a football? How much time is left in the game? “By statute the Agency (CMS) must publish final Medicare regulations within 3 years of the publication date of the proposed rule.  For Emergency Preparedness, our statutory deadline would be in December, 2016.”

More specifically, December 27, 2016. The rule is on the clock. Stay tuned to We’re on it!

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About Karl Schmitt

Karl Schmitt Photo Karl is the passionate Founder of He is on a mission to align the disaster preparedness programs of healthcare institutions with those of emergency management, public health, and others in the public, private, and not-for-profit sectors who care for the physical, mental, and spiritual health of people each day. Learn more about him here. He can be reached at






Karl Schmitt, MPA

Karl Schmitt, MPA

Karl is the Passionate Founder & CEO of bParati. He is on a mission to build a national network of effective, sustainable healthcare coalitions. More...

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