[Congressional Bills 109th Congress]
[From the U.S. Government Publishing Office]
[H.R. 3698 Introduced in House (IH)]


109th CONGRESS
  1st Session
                                H. R. 3698

To provide temporary Medicaid disaster relief in response to Hurricane 
                    Katrina, and for other purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                           September 8, 2005

  Mr. Dingell (for himself, Mr. Jefferson, Mr. Davis of Alabama, Mr. 
Thompson of Mississippi, Ms. Pelosi, Mrs. Capps, Mr. Brown of Ohio, Mr. 
    Waxman, Mr. Stark, Mr. Rangel, Mr. Gene Green of Texas, and Mr. 
  Melancon) introduced the following bill; which was referred to the 
 Committee on Energy and Commerce, and in addition to the Committee on 
   Ways and Means, for a period to be subsequently determined by the 
  Speaker, in each case for consideration of such provisions as fall 
           within the jurisdiction of the committee concerned

_______________________________________________________________________

                                 A BILL


 
To provide temporary Medicaid disaster relief in response to Hurricane 
                    Katrina, and for other purposes.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION. 1. SHORT TITLE; PURPOSE.

    (a) Short Title.--This Act may be cited as the ``Temporary Medicaid 
Disaster Relief Act of 2005''.
    (b) Purpose.--The purpose of this Act is to ensure all those 
affected by Hurricane Katrina have access to health coverage and 
medical care through the medicaid program and to authorize temporary 
changes in such program to guarantee and expedite that coverage and 
access to care.

SEC. 2. DISASTER RELIEF PERIOD.

    For purposes of this Act, the term ``disaster relief period'' means 
the period beginning on August 29, 2005, and ending on September 30, 
2006.

SEC. 3. TEMPORARY MEDICAID COVERAGE FOR KATRINA SURVIVORS.

    (a) Definitions.--In this Act:
            (1) Katrina survivor.--
                    (A) In general.--The term ``Katrina Survivor'' 
                means an individual who is described in subparagraph 
                (B) or (C).
                    (B) Residents of disaster localities.--
                            (i) In general.--An individual who, on any 
                        day during the week preceding the declaration 
                        of a public health emergency on August 29, 
                        2005, had a residence in--
                                    (I) a parish in the State of 
                                Louisiana that is among the parishes 
                                that the Federal Emergency Management 
                                Agency of the Emergency Preparedness 
                                and Response Directorate of the 
                                Department of Homeland Security 
                                declared on September 4, 2005, to be 
                                Federal Disaster Parishes; or
                                    (II) a county in the State of 
                                Alabama or Mississippi that is among 
                                the counties such Agency declared 
                                Federal Disaster Counties on September 
                                4, 2005.
                            (ii) Authority to rely on website posted 
                        designations.--The Secretary of Health and 
                        Human Services shall post on the Internet 
                        website for the Centers for Medicare & Medicaid 
                        Services a list of parishes and counties 
                        identified as Federal Disaster Parishes or 
                        Counties. Any State which provides medical 
                        assistance to Katrina Survivors on the basis of 
                        such posting and in accordance with this Act 
                        shall be held harmless if it is subsequently 
                        determined that the provision of such 
                        assistance was in error.
                    (C) Individuals who lost employment.--An individual 
                who, on any day during the week preceding the 
                declaration of a public health emergency on August 29, 
                2005, had a residence in a direct impact State and lost 
                their employment since Hurricane Katrina.
                    (D) Construction.--A Katrina Survivor shall be 
                treated as being ``from'' the State of residence 
                described in subparagraph (B)(i) or (C), as the case 
                may be.
                    (E) Treatment of current medicaid beneficiaries.--
                Nothing in this Act shall be construed as preventing an 
                individual who is otherwise entitled to medical 
                assistance under title XIX of the Social Security Act 
                from being treated as a Katrina Survivor under this 
                Act.
                    (F) Treatment of homeless persons.--For purposes of 
                this Act, in the case of an individual who was homeless 
                on any day during the week described in subparagraph 
                (B)(i), the individual's ``residence'' shall be deemed 
                to be the place of residence as otherwise determined 
                for such an individual under title XIX of the Social 
                Security Act.
            (2) Direct impact state.--The term ``direct impact State'' 
        means the State of Louisiana, Alabama, and Mississippi.
    (b) Rules for Providing Temporary Medical Assistance to Katrina 
Survivors.--During the disaster relief period, any State may provide 
medical assistance to Katrina Survivors under a State medicaid plan 
established under title XIX of the Social Security Act in accordance 
with the following:
            (1) Uniform eligibility rules.--
                    (A) No income, resources, residency, or categorical 
                eligibility requirements.--Such assistance shall be 
                provided without application of any income or resources 
                test, State residency, or categorical eligibility 
                requirements.
                    (B) Streamlined eligibility procedures.--The State 
                shall use the following streamlined procedures in 
                processing applications and determining eligibility for 
                medical assistance for Katrina Survivors:
                            (i) A common 1-page application form 
                        developed by the Secretary of Health and Human 
                        Services in consultation with the National 
                        Association of State Medicaid Directors. Such 
                        form shall include notice regarding the 
                        penalties for making a fraudulent application 
                        under paragraph (4) and shall require the 
                        applicant to assign to the State any rights of 
                        the applicant (or any other person who is a 
                        Katrina Survivor and on whose behalf the 
                        applicant has the legal authority to execute an 
                        assignment of such rights) under any group 
                        health plan or other third-party coverage for 
                        health care.
                            (ii) Self-attestation by the applicant that 
                        the applicant is a Katrina Survivor.
                            (iii) No requirement for documentation 
                        evidencing the basis on which the applicant 
                        qualifies to be a Katrina Survivor.
                            (iv) Issuance of a Medicaid eligibility 
                        card to an applicant who completes such 
                        application, including the self-attestation 
                        required under clause (ii). Such card shall be 
                        valid during the disaster relief period.
                            (v) If an applicant completes the 
                        application and presents it to a provider or 
                        facility participating in the State medicaid 
                        plan that is qualified to make presumptive 
                        eligibility determinations under such plan 
                        (which at a minimum shall consist of facilities 
                        identified in section 1902(a)(55) of the Social 
                        Security Act (42 U.S.C. 1396a(a)(55)) and it 
                        appears to the provider that the applicant is a 
                        Katrina Survivor based on the information in 
                        the application, the applicant will be deemed 
                        to be a Katrina Survivor eligible for medical 
                        assistance in accordance with this section, 
                        subject to paragraph (3).
                            (vi) Continuous eligibility, without the 
                        need for any redetermination of eligibility, 
                        for the duration of the disaster relief period.
                    (C) Determination of eligibility for coverage after 
                the termination of the disaster relief period.--In the 
                case of a Katrina Survivor who is receiving medical 
                assistance from a State, prior to the termination of 
                the disaster relief period, the State providing such 
                assistance shall determine whether the Katrina Survivor 
                is eligible for continued medical assistance under the 
                State's eligibility rules otherwise applicable under 
                the State medicaid plan. If a State determines that the 
                individual is so eligible, the State shall provide the 
                individual with written notice of the determination and 
                provide the individual with continued coverage for such 
                medical assistance for so long as the individual 
                remains eligible under such otherwise applicable 
                eligibility rules. If a State determines that the 
                individual is not so eligible, the State shall provide 
                the individual with written notice of the 
                determination, including the reasons for such 
                determination.
            (2) Scope of coverage same as categorically needy.--The 
        State shall treat Katrina Survivors as individuals eligible for 
        medical assistance under the State plan under title XIX of the 
        Social Security Act on the basis of section 1902(a)(10)(A)(i) 
        of the Social Security Act (42 U.S.C. 1396a(a)(10)(A)(i)), with 
        coverage for such assistance retroactive to August 29, 2005.
            (3) Verification of status as a katrina survivor.--
                    (A) In general.--The State shall make a good faith 
                effort to verify the status of a Katrina Survivor 
                enrolled in the State Medicaid plan under the 
                provisions of this section after the determination of 
                the eligibility of the Survivor for medical assistance 
                under such plan.
                    (B) Evidence of verification.--A State may satisfy 
                the verification requirement under subparagraph (A) 
                with respect to a Katrina Survivor by showing that the 
                State providing medical assistance obtained information 
                from the Social Security Administration, the Internal 
                Revenue Service, or the State Medicaid Agency of the 
                direct impact State.
                    (C) Disallowance of payments for failure to make 
                good faith effort.--If, with respect to the status of a 
                Katrina Survivor enrolled in a State Medicaid plan, the 
                State fails to make the good faith effort required 
                under subparagraph (A), and the Secretary determines 
                that the individual so enrolled is not a Katrina 
                Survivor, the Secretary shall disallow all Federal 
                payments made to the State that are directly 
                attributable to medical assistance provided or 
                administrative costs incurred with respect to the 
                individual during the disaster relief period.
            (4) Penalty for fraudulent applications.--
                    (A) Individual liable for costs.--If a State, as 
                the result of verification activities conducted under 
                paragraph (3), determines after a fair hearing that an 
                individual has knowingly made a false self-attestation 
                described in paragraph (1)(B)(ii), the State may, 
                subject to subparagraph (B), seek recovery from the 
                individual for the full amount of the cost of medical 
                assistance provided to the individual under this 
                section.
                    (B) Exception.--The Secretary shall exempt a State 
                from seeking recovery under subparagraph (A) if the 
                Secretary determines that it would not be cost-
                effective for the State to do so.
                    (C) Reimbursement to the federal government.--Any 
                amounts recovered by a State in accordance with this 
                paragraph shall be returned to the Federal government, 
                except that a State's administrative costs attributable 
                to obtaining such recovery shall be reimbursed by the 
                Federal government in accordance with section 4(a)(2).
            (5) Exemption from error rate penalties.--All payments 
        attributable to providing medical assistance to Katrina 
        Survivors in accordance with this section shall be disregarded 
        for purposes of section 1903(u) of the Social Security Act.

SEC. 4. TEMPORARY DISASTER RELIEF FOR STATES UNDER MEDICAID.

    (a) Increase in Federal Matching Rate.--
            (1) 100 percent fmap for medical assistance.--
        Notwithstanding section 1905(b) of the Social Security Act (42 
        U.S.C. 1396d(b)), the Federal medical assistance percentage for 
        providing medical assistance under a State medicaid plan under 
        title XIX of such Act to Katrina Survivors or, in the case of a 
        direct impact State, to any individual who is provided medical 
        assistance under the State medicaid plan during the disaster 
        relief period, shall be 100 percent.
            (2) 100 percent federal match for certain administrative 
        costs.--Notwithstanding paragraph (7) of section 1903(a) of 
        such Act (42 U.S.C. 1396b(a)), or any other paragraph of such 
        section, the Federal matching rate for costs directly 
        attributable to all administrative activities that relate to 
        the enrollment of Katrina Survivors under section 3 in a State 
        medicaid plan, verification of the status of such Survivors, 
        processing of claims for payment for medical assistance 
        provided to such Survivors under such section, and recovery 
        costs under section 3(b)(4)(C), shall be 100 percent. The 
        Secretary shall issue guidance not later 30 days after the date 
        of enactment of this Act on the implementation of this 
        paragraph.
    (b) Limitation on Reduction of FMAP for Fiscal Year 2006 for Any 
State.--If the Federal medical assistance percentage (as defined in 
section 1905(b) of the Social Security Act) determined for a State for 
fiscal year 2006 is less than the Federal medical assistance percentage 
determined for the State for fiscal year 2005, the Federal medical 
assistance percentage for the State for fiscal year 2005 shall apply to 
the State for fiscal year 2006 only for purposes of title XIX of the 
Social Security Act.
    (c) Temporary Suspension of Medicare ``Clawback'' and Postponement 
of Cut-Off of Medicaid Prescription Drug Funding in Affected States.--
            (1) Suspension in application of ``clawback''.--Section 
        1935(c) of the Social Security Act (42 U.S.C. 1396u-5(c)) shall 
        not apply, subject to paragraph (3), before January 2007 to a 
        direct impact State or to a State that experiences a 
        significant influx of Katrina Survivors.
            (2) Continuation of medicaid drug coverage for dual 
        eligibles.--Section 1935(d)(1) of such Act shall also not 
        apply, subject to paragraph (3), before January 2007 to a part 
        D eligible individual who is a Katrina Survivor.
            (3) Termination of application of subsection.--Paragraphs 
        (1) and (2) shall no longer apply to a State or a Katrina 
        Survivor, respectively, if the Secretary determines, after 
        consultation with the State, that enrollment of all part D 
        eligible individuals in the State under part D of title XVIII 
        of the Social Security Act who are described in section 
        1935(c)(6)(A)(ii) of such Act can be achieved without a 
        discontinuation in prescription drug coverage for any such 
        individual.
            (4) Definition.--For purposes of this subsection, the term 
        ``State that experiences a significant influx of Katrina 
        Survivors'' means those States, including Arkansas, Florida, 
        Oklahoma, and Texas, that the Secretary of Health and Human 
        Services identifies as having a significant in-migration of 
        Katrina Survivors.

SEC. 5. ACCOMMODATION OF SPECIAL NEEDS OF KATRINA SURVIVORS UNDER 
              MEDICARE PROGRAM.

    (a) Exclusion of Disaster Relief Period in Computing Part B Late 
Enrollment Penalty.--In applying the first sentence of section 1839(b) 
of the Social Security Act (42 U.S.C. 1395r(b)) in the case of a 
Katrina Survivor, there shall not be taken into account any month any 
part of which is within the disaster relief period or within the 2-
month period following the end of such disaster relief period.
    (b) Part D.--
            (1) Extension of initial enrollment period.--In the case of 
        a Katrina Survivor, the initial enrollment period under section 
        1860D-1(b)(2) of the Social Security Act (42 U.S.C. 1395w-
        101(b)(2)) shall in no case end before May 15, 2007.
            (2) Flexibility in documentation for low-income 
        subsidies.--For purposes of carrying out section 1860D-14 of 
        the Social Security Act (42 U.S.C. 1395w-114), with respect to 
        Katrina Survivors, the Secretary of Health and Human Services 
        shall establish documentation rules for Katrina Survivors which 
        take into account the loss and unavailability of documents due 
        to Hurricane Katrina.
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