Update: Wildfire Emergency, Recovery Resources, Smoke Safety, and How to Help

Updated Sept. 1 – The WSMA offers an up-to-date, comprehensive overview of wildfire recovery resources for the physician community, including information about new regulatory flexibilities for health professionals in the affected areas, as well as resources available from the Centers for Medicare & Medicaid Services, the state Health Care Authority, the state Pharmacy Commission, how to donate to help the recovery, and tips on smoke safety.

Washington remains in a severe wildfire emergency. While the Spokane disaster is moving into a recovery and containment phase, several large fires continue to burn statewide. A federal public health emergency and a statewide emergency proclamation have been issued to allow for targeted resources and flexibilities.

While no injuries or fatalities have been confirmed, dangerous fire conditions persist across Eastern and North-Central Washington. Smoke has prompted air quality alerts across much of the state, and an emergency statewide burn ban remains in effect through Sept. 30.

Washington wildfire emergency: Health care takeaways

On Aug. 31, Governor Bob Ferguson amended his wildfire emergency proclamation to include five additional counties, and extend certain state protections and assistance for another 60 days. The amendment adds Benton, Columbia, Grant, Kittitas and Whitman counties, bringing the total number counties covered by the state of emergency to 12, along with three Tribal Nations. The governor’s emergency proclamation enables the Department of Health to grant extra time for physicians and practitioners to renew their licenses so they can continue providing care without worrying about having to file paperwork. Read the announcement to learn more.

On Aug. 21, the Washington State Health Care Authority, Department of Health, and Department of Social and Health Services issued a joint letter containing updated information for health care and long-term care providers and partners. The agencies advised that licensees with addresses in the impacted areas should be aware that renewal deadlines will be extended 30 days past the declared emergency with no late penalties.

Issued Aug. 10, Washington’s emergency proclamation temporarily relaxes several health care requirements to help maintain access to care during the wildfires.

• Physician and professional licensing: Health care professionals in designated areas may receive additional time to renew licenses. To apply, fill out a WMC license renewal, fee, and CME waiver.
• Medical assistants: Supervising physicians no longer need to be physically present, as long as they are immediately available.
• Hospital staffing: Hospitals can temporarily bypass certain clinical privilege documentation and verification requirements to add or retain health professionals more quickly.
• Alternative care sites: Hospitals and pharmacies may operate at alternative locations, supporting flexible care delivery and medication access.
• Long-term care: Adult family homes and assisted living facilities have temporary flexibility around admissions, capacity, and paperwork to accommodate displaced residents.
• Federal support: Issued Aug. 4, a county- and territory-specific federal Public Health Emergency provides additional flexibility, including faster medication and medical-supply refills, reduced administrative requirements, and use of alternative care settings. The declaration covers Chelan, Ferry, Okanogan, Spokane, Stevens and Yakima counties, as well as the Confederated Tribes and Bands of the Yakama Nation, Confederated Tribes of the Colville Reservation and the Spokane Tribe of Indians.

These measures are intended to reduce administrative barriers and help clinicians and facilities continue providing essential care to wildfire-affected communities.

CMS wildfire emergency resources

In response to the federal public health emergency issued Aug. 4, the Centers for Medicare & Medicaid Services has announced temporary resources and flexibilities for physicians, professionals, and organizations affected by the Washington wildfires near Spokane County, effective retroactively to Aug. 1. Organizations that need additional 1135 waivers or flexibilities can submit requests to CMS.

Key support includes:

• Hospitals and facilities: Waivers to help maintain operations and access to care during the emergency.
• Dialysis patients and facilities: Emergency support through the Kidney Community Emergency Response program and ESRD Network 16.
• Medicare beneficiaries: Replacement of damaged or lost durable medical equipment and supplies.
• Part D medications: Greater access to medications, including coverage of out-of-network refills and removal of “refill too soon” restrictions when appropriate.
• HIPAA and civil rights: Temporary HIPAA-enforcement flexibilities may apply during disaster protocols, while physicians and organizations should continue ensuring language access and accessibility.

CMS will continue coordinating with Washington and federal partners and encourages those affected in the health care community to use CMS emergency resources for additional guidance and assistance.

Health Care Authority response

The Washington State Health Care Authority has established a Wildfire Response Information page to help Apple Health and PEBB/SEBB clients navigate to any health care resources they may need from the state.

Supports for Apple Health (Medicaid) clients:

• HCA has been coordinating with MCOs and in-region providers who are impacted, to determine any opportunities to support communities.
• HCA has authorized pharmacies to furnish medications and supplies to Apple Health clients as needed, if any such products have been lost, destroyed, or have become inaccessible due to wildfire conditions. HCA has also communicated with pharmacies to guarantee payment on claims that meet our emergency fill policy.
• HCA is working with MCOs to waive prior authorization for durable medical equipment and necessary expedited services.
• All MCOs are reaching out to members and providers in the affected areas to support care coordination needs.

Tribal coordination:

• HCA’s Office of Tribal Affairs is actively tracking the impact of fires to Tribes in Colville, Yakima, and Spokane.
• HCA has reached out to Tribal elected officials and health leadership to ask for any emergent needs that HCA can help with and informing Tribes of updated processes for supporting prescriptions and other care needs.
• HCA is exploring utilization of grant contract funds to support emergency community needs.

Behavioral health support:

• HCA is actively coordinating with the Spokane Behavioral Health Administrative Services Organization to support the local crisis system and any challenges they may face.
• HCA has confirmed that the crisis system is still intact and supporting mobile crisis as calls come in, with the exception of level 2 and 3 evacuation zones.
• Opioid treatment professionals and organizations near the go-now area are authorizing take home doses for clients.

Supports for PEBB/SEBB enrollees:

• Alerts have gone out to consumers and health carrier contractors (Premera, UnitedHealthcare, and Kaiser Permanente) are updating websites with information on how to access care during a wildfire.
• Regence (UMP administrator) is providing assistance in navigating to appropriate sites of care when hospitals or clinics may be closed as a result of the disaster. Virtual care services are also a valuable resource and will be offered when appropriate.
• Importantly, under federal and state balance billing protections, all emergency services are covered at the in-network benefit level, even if the hospital is a non-contracted provider.

Pharmacy and medication

Apple Health Emergency Fill Policy 

In response to the wildfires occurring in Washington, the state Health Care Authority is authorizing Apple Health (Medicaid) fee-for-service pharmacies to furnish medications and supplies to clients as needed, if such products have been lost, destroyed, or have become inaccessible due to wildfire conditions.

The Pharmacy Quality Assurance Commission is aware of the devastating impacts of the wildfires in the Spokane area. As a reminder, WAC 246-945-332 states: “When the governor issues an emergency proclamation for an event which prevents continuity of health care for persons and animals because their prescribed medications are no longer available to them due to the emergency event, pharmacists and pharmacies may provide emergency prescription supplies for medications during the period of the proclaimed emergency” as provided in WAC 246-945-332.

On Aug. 1, 2026, Governor Ferguson declared a statewide state of emergency due to the wildfires in Washington state and extreme weather conditions. WAC 246-945-332 may be utilized during the declared state of emergency as outlined above.

• If a pharmacy claim rejects for refill-too-soon, pharmacies should resubmit the claim indicating the previous fill was lost, destroyed or inaccessible by entering a value of 5 in the Prior Authorization Type Code NCPDP field (461-EU).
• If the medication requires authorization and the dispensing pharmacists determines there is an urgent need, the pharmacy may dispense as an emergency fill.

Moda/ArrayRX (Pharmacy for UMP) has an alert on their website: ArrayRx UMP

• Members evacuating because of a natural disaster may receive an early prescription refill at a network pharmacy.
• Ardon (specialty drugs) is prepared to handle members affected by the Spokane wildfires on a case-by-case basis to ensure access to needed specialty medications. Ardon will work closely with members to identify available options and help coordinate access to their medication.
• Members will be reimbursed at the network rate when using a non-network pharmacy for emergency fills.

How you can help Spokane recovery efforts

Community organizations are mobilizing to support Spokane recovery efforts.

The Innovia Foundation’s Spokane Complex Wildfire Response Fund, the City of Spokane’s H.O.M.E. Starts Here Fund, and Catholic Charities Eastern Washington are accepting donations to assist affected individuals, families, nonprofits, and businesses.

Employers can also access the Greater Spokane Valley Chamber of Commerce’s Spokane County Wildfire Resources and the U.S. Chamber of Commerce’s Small Business Resilience Hub for recovery resources.

For patients: N95 masks, health tips during wildfire smoke episodes

Direct Relief has been shipping N95 respirators to local health organizations in Spokane County. In recent weeks, they’ve sent 2,200 N95 masks to the Community Health Association of Spokane and other partners. These may be available through local clinics or health centers that receive them.

In Chelan and Douglas counties, free N95 masks are available at participating local libraries while supplies last. Learn more and find a distribution location.

In response to the risk of wildfires and variable air quality in some regions, last week, the WSMA introduced a new social media video, 5 Health Tips During Wildfire Smoke Season, featuring Central Washington physician Bindu Nayak, MD. Find the video on Facebook, LinkedIn, X, and the WSMA website. If you use social media, please share, like, and comment, to help raise awareness.