As hospitals begin to recover from the effects of Hurricane Ike, CMS instituted a data submission waiver for IPPS hospitals located in Louisiana and Texas under its statutory authority pursuant to § 1886(b)(3)(A)(vii)(II) of the Social Security Act. IPPS hospitals are required to submit certain inpatient quality data to receive the full Medicare payment update. The waiver applies to clinical process measurements for the second quarter of 2008 and to HCAHPS data for the third quarter of 2008. CMS's rationale for the waivers recognized that hospitals' medical records were damaged or destroyed during the storm and that a hospital's ability to contact and survey patients may have been impaired as a result of the storm. Additionally, hospitals will not have to validate their first quarter 2008 clinical process measures. CMS notified hospitals and Quality Improvement Organizations of the inpatient waiver on Friday, and expects to issue similar information soon for the hospital outpatient reporting programs.