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U.S. Department of Health and Human Services

Participating in NDMS

The NDMS is a partnership between the Departments of Health and Human Services (HHS), Defense (DOD), Homeland Security (DHS), and Veterans Affairs (VA). It began in the 1980s as a mechanism for DOD to bring back mass casualties from a large scale conflict and as a way to respond to a large civilian disaster. Over the years, the domestic disaster mission has expanded and the military need had diminished.

Patient movement is managed by the DOD, and they provide medical evacuation services. VA and DOD regulate patient flow through over 60 Federal Coordinating Centers (FCCs) across the country. Definitive care is provided by a network of over 1900 civilian hospitals nationwide that have signed agreements with the NDMS to accept patients from the NDMS during a public health emergency. The NDMS is managed by HHS. Activation of the NDMS is by the HHS Secretary in response to a public health emergency.

Accredited hospitals, usually over 100 beds in size and located in large U.S. metropolitan areas, are encouraged to enter into a voluntary agreement with the NDMS. Hospitals agree to commit a number of their acute care beds, subject to availability, for NDMS patients in the event of a public health emergency.

Because this is a completely voluntary program, hospitals may, upon activation of the NDMS, provide more or fewer beds than the number committed in the agreement.  Hospitals who enter into an agreement with the NDMS qualify to be reimbursed at 110% of their Medicare rate for any NDMS patient cared for.

A copy of the Memorandum of Agreement (MOA) to participate in the NDMS that is executed between a hospital and the NDMS is provided below:

NDMS Seal 

  • This page last reviewed: December 16, 2020