As of today, only the Federal Healthcare Sector, about 10% of healthcare capacity in the US, is mandated to prepare for All-Hazards events, while the remaining 90% private sector has been expected to prepare voluntarily to meet their roles and responsibilities. Unfortunately, as is evidenced by every major disaster since 9/11, the Public Health and Non-Federal Sector has failed to live up to its’ expectations according to the National Response Framework (NRF). The new proposed rule would help to bridge this gap in preparedness.

CMS-3178-P was slipped into the Federal Register on December 27^th, 2013, between Christmas and the New Year; strange timing given that CMS is currently overwhelmed with implementation ACA and ICD-10, both of which represent monumental efforts.

We see evidence that many in the industry are considering this a fait accompli and are making their preparations. Our experience shows this may be premature.  Our initial impression can be seen here in a response to a query on one forum:

The proposed CMS Rule 3178-P still has major hurdles, time will tell as to the potential for mandates. As you mentioned, NIMS (and National Response Framework (NRF)) are designed to allow coordinated and collaborative communication between and among all 18 DHS-identified economic sectors. The Public Health and Healthcare sector is and continues to be the weakest link in the Homeland Security chain. At this point, we are looking for expressed commitment from congressional committees who have jurisdiction over these areas and have yet to receive any assurances that there is strong advocacy for this rule. Monitoring feedback from the current 60 day comment period ending 2/25 will surface the levels of opposition and support. As seen in this post from 2008 when TJC first required then suspended EC and EM Standards, when there is significant push back from industry the current mechanisms to drive readiness have not been adequate despite hundreds of healthcare deaths attributable to natural disasters.