[Congressional Bills 116th Congress]
[From the U.S. Government Publishing Office]
[S. 1754 Introduced in Senate (IS)]
<DOC>
116th CONGRESS
1st Session
S. 1754
To provide Medicaid assistance to individuals and families affected by
a disaster or emergency, and for other purposes.
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
June 10, 2019
Mr. Casey (for himself, Mr. Brown, Mr. Blumenthal, Ms. Harris, and Mrs.
Gillibrand) introduced the following bill; which was read twice and
referred to the Committee on Finance
_______________________________________________________________________
A BILL
To provide Medicaid assistance to individuals and families affected by
a disaster or emergency, 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.
This Act may be cited as the ``Disaster Relief Medicaid Act''.
SEC. 2. MEDICAID RELIEF FOR DISASTER SURVIVORS.
Title XIX of the Social Security Act (42 U.S.C. 1396 et seq.) is
amended--
(1) in section 1902(a)--
(A) in paragraph (85), by striking ``; and'' and
inserting a semicolon;
(B) in paragraph (86), by striking the period at
the end and inserting ``; and''; and
(C) by inserting after paragraph (86) the following
new paragraph:
``(87) beginning January 1, 2020, provide for making
medical assistance available to relief-eligible survivors of
disasters during relief coverage periods in accordance with
section 1947.''; and
(2) by adding at the end the following new section:
``SEC. 1947. DISASTER RELIEF MEDICAID FOR SURVIVORS OF MAJOR DISASTERS.
``(a) In General.--Notwithstanding any other provision of this
title, a State plan shall provide medical assistance to a relief-
eligible survivor of a disaster in accordance with this section.
``(b) Definitions.--In this section:
``(1) Disaster.--The term `disaster' means a major
disaster--
``(A) that is declared on or after January 1, 2020,
by the President in accordance with section 401 of the
Robert T. Stafford Disaster Relief and Emergency
Assistance Act (42 U.S.C. 5170); and
``(B) which the President has determined warrants
individual and public assistance from the Federal
Government under such Act.
``(2) Direct impact area.--
``(A) In general.--The term `direct impact area'
means, with respect to a disaster, the geographic area
in which the disaster exists.
``(B) Website posting of direct impact areas.--As
soon as practicable after a disaster is declared (as
described in paragraph (1)(A)), the Secretary shall
post on the website of the Centers for Medicare &
Medicaid Services a list of the areas identified as the
direct impact areas of the disaster.
``(3) Home state.--The term `home State' means, with
respect to a survivor of a disaster, the State in which the
survivor was a resident during the 7-day period preceding the
date on which the disaster is declared (as described in
paragraph (1)(A)).
``(4) Relief coverage period.--The term `relief coverage
period' means, with respect to a disaster, the period that
begins on the date the disaster is declared (as described in
paragraph (1)(A)) and ends on the day that is 2 years after
such date.
``(5) Relief-eligible survivor.--
``(A) In general.--The term `relief-eligible
survivor' means an individual who is a survivor of a
disaster whose family income does not exceed the higher
of--
``(i) 133 percent (or, in the case of a
survivor who is a pregnant woman, a child, or a
recipient of benefits under title II on the
basis of a disability, 200 percent) of the
poverty line; or
``(ii) the income eligibility standard that
would otherwise apply to the survivor under the
State plan or waiver of the survivor's host
State.
``(B) Disregard of unemployment income.--For
purposes of this section, and notwithstanding section
1902(e)(14)(B), the income of a survivor of a disaster
shall not include any amount received during the relief
coverage period of the disaster under a law of the
United States or a State which is in the nature of
unemployment compensation.
``(6) Survivor.--
``(A) In general.--The term `survivor' means, with
respect to a disaster, an individual who is described
in subparagraph (B) or (C).
``(B) Residents and evacuees of direct impact
areas.--An individual described in this subparagraph is
an individual who, on any day during the 7-day period
preceding the date on which a disaster is declared (as
described in paragraph (1)(A)), has a primary residence
in the disaster's direct impact area.
``(C) Individuals who lost employment.--An
individual described in this subparagraph is an
individual--
``(i) whose worksite, on any day during the
7-day period preceding the date on which a
disaster is declared (as so described), was
located in the disaster's direct impact area;
``(ii) who was employed by an employer
that--
``(I) conducted an active trade or
business in such area on any day during
such 7-day period; and
``(II) was unable to operate such
trade or business as a result of the
disaster on any day during the
disaster's relief coverage period; and
``(iii) whose employment with such employer
was terminated.
``(D) Treatment of homeless persons.--For purposes
of subparagraph (B), in the case of an individual who
was homeless on any day during the 7-day period
preceding the date on which a disaster is declared (as
so described), the individual's `residence' during such
period shall be determined as it would otherwise be
determined for purposes of this title.
``(E) Effect of concurrent eligibility for
medicaid.--An individual's eligibility for medical
assistance under a State plan (or waiver of such plan)
on a basis other than under this section shall not
prevent the individual from being treated as a survivor
under this section, and the rights afforded to an
individual who is eligible for or enrolled under a
State plan (or waiver) shall not be affected by the
individual's receipt of medical assistance as a relief-
eligible survivor of a disaster in accordance with this
section.
``(c) Eligibility.--
``(1) Simplified application.--
``(A) In general.--For purposes of determining
eligibility for medical assistance under this section,
each State shall use a simplified, 1-page application
form (as developed by the Secretary in consultation
with the National Association of State Medicaid
Directors), which shall--
``(i) require an applicant for medical
assistance in accordance with this section as a
survivor of a disaster to--
``(I) provide the applicant's
expected address for the duration of
the relief coverage period of the
disaster; and
``(II) agree to update the
information described in subclause (I)
if it changes during such period;
``(ii) provide notice of the penalties for
making a fraudulent application described in
subsection (h);
``(iii) require the applicant to assign to
the State any rights of the applicant (or any
other individual who is a relief-eligible
survivor and on whose behalf the applicant has
the legal authority to execute an assignment of
such rights) in accordance with the
requirements of section 1912;
``(iv) require the applicant to list any
health insurance coverage in which the
applicant was enrolled immediately prior to
submitting the application for medical
assistance under this section; and
``(v) require the applicant to self-attest
that the applicant--
``(I) is a relief-eligible survivor
of the disaster; and
``(II) if applicable, requires home
and community-based services.
``(B) No documentation requirement.--A State shall
not require an applicant for medical assistance as a
survivor of a disaster under this section to provide
any documentation or other evidence--
``(i) of the applicant's status as a
relief-eligible survivor; and
``(ii) if applicable, that the applicant
requires home and community-based services.
``(C) Presumptive eligibility.--If an applicant
submits a completed application to a provider or
facility described in section 1902(a)(55) (or any other
provider or facility participating in the State plan or
under a waiver of such plan that is qualified to make
presumptive eligibility determinations under such plan
or waiver) and it appears to the provider or facility
that the applicant is a relief-eligible survivor of a
disaster who is eligible for medical assistance under
the plan based on the information in the application,
the applicant will be deemed to be a relief-eligible
survivor for medical assistance under such plan in
accordance with this section.
``(D) Continuous eligibility.--An applicant who is
determined to be a relief-eligible survivor of a
disaster shall be eligible for medical assistance under
this section, without the need for any redetermination
of eligibility, for the duration of the relief coverage
period of the disaster.
``(E) Timely processing of applications.--Each
State shall establish such processes as are necessary
to ensure that applications for medical assistance
under this section are processed in a timely manner.
``(2) Issuance of disaster relief medicaid eligibility
card.--A State shall issue a disaster relief Medicaid
eligibility card to each applicant who is determined to be a
relief-eligible survivor of a disaster and eligible for medical
assistance under this section, which shall be valid for the
duration of the relief coverage period of the disaster.
``(3) Verification of status as a relief-eligible
survivor.--
``(A) In general.--The State shall make a good
faith effort to verify the status of an individual who
is enrolled in the State plan as a relief-eligible
survivor of a disaster in accordance with this section.
Such effort shall not delay the determination of the
eligibility of the individual for medical assistance
under this section.
``(B) Evidence of verification.--A State may
satisfy the verification requirement under subparagraph
(A) with respect to an individual by showing that the
State obtained information from the Social Security
Administration, the Internal Revenue Service, or, if
applicable, the State Medicaid agency of the home State
of the individual.
``(4) Determination by express lane agency.--Any
determination or redetermination of eligibility or verification
of status made under this section shall be made by an Express
Lane agency (as defined in section 1902(e)(13)(F)).
``(d) Termination of Eligibility.--
``(1) In general.--Except as provided in paragraph (4), no
medical assistance shall be provided under this section to a
relief-eligible survivor of a disaster after the end of the
relief coverage period of the disaster.
``(2) Notice of termination of eligibility; assistance in
applying for regular medicaid.--
``(A) In general.--No later than 2 months before
the end of a relief coverage period of a disaster, a
State shall provide each relief-eligible survivor of
the disaster who is receiving medical assistance under
the State plan in accordance with this section with
written notice that includes--
``(i) the date after which, subject to the
exception described in paragraph (4), the
survivor will no longer be eligible for such
assistance;
``(ii) information regarding eligibility
(other than under this section) for medical
assistance under the State plan (or waiver of
such plan); and
``(iii) an application for such assistance
and information regarding how to submit a
completed application and how to obtain
assistance with completing such application.
``(B) Assistance in applying for medicaid.--Before
the end of the relief coverage period of a disaster,
the State shall--
``(i) provide any relief-eligible survivor
of the disaster who is receiving medical
assistance under the State plan assistance with
applying for medical assistance under the State
plan (or waiver ) for periods beginning after
the end of such relief coverage period; and
``(ii) ensure that such assistance is
easily accessible to such survivors.
``(3) Presumptive eligibility period for pending
applications.--In the case of a relief-eligible survivor of a
disaster who, on the date that the relief coverage period of
the disaster ends, has an application pending for medical
assistance under the State plan (or waiver of such plan) for
periods beginning after such relief coverage period, such
survivor shall be deemed to be eligible for medical assistance
under such plan or waiver for 60 days after such date. Medical
assistance provided to such an individual during such 60-day
period shall not be treated as medical assistance provided
under this section and the Federal medical assistance
percentage described in subsection (f) shall not apply to
amounts expended on such assistance.
``(4) Pregnant women.--In the case of a relief-eligible
survivor of a disaster who, while pregnant, receives medical
assistance under the State plan in accordance with this
section, such survivor shall continue to be eligible for such
assistance through the end of the month in which the 60-day
period (beginning on the last day of her pregnancy) ends,
without regard to whether the pregnancy ends before or after
the end of the relief coverage period of the disaster and
without requiring the survivor to reapply for such assistance.
``(e) Scope of Coverage.--
``(1) In general.--A State providing medical assistance to
a relief-eligible survivor of a disaster in accordance with
this section shall provide medical assistance that is equal in
amount and scope to the medical assistance that would otherwise
be made available to such survivor if the survivor were
enrolled in the State plan (or waiver of such plan) as an
individual described in clause (i) of section 1902(a)(10)(A),
except that, in the case of such a survivor whose home State is
not the State providing medical assistance to the individual,
the State shall also provide medical assistance for any item or
service for which medical assistance is available to
individuals described in clause (i) of section 1902(a)(10)(A)
under the State plan (or waiver) of the survivor's home State.
``(2) Provider payment rates for home state services.--In
the case of medical assistance provided by a State to a relief-
eligible survivor of a disaster in accordance with this section
for an item or service which is not available under the State
plan (or waiver of such plan) but which is available under the
State plan (or waiver) of the survivor's home State, the State
shall pay the provider of such item or service at the same rate
that the home State would pay for the item or service if it
were provided under the plan or waiver of the home State (or,
if no such payment rate applies under the plan or waiver of the
home State, the usual and customary prevailing rate for the
item or service for the community in which it is provided).
``(3) Retroactive coverage.--
``(A) In general.--Notwithstanding section 1905(a),
a State shall provide medical assistance for items and
services furnished in the State beginning with the
first day of the relief coverage period of a disaster
to any relief-eligible survivor of the disaster who
submits an application for such assistance before the
deadline described in subparagraph (B).
``(B) Application deadline.--The deadline for a
relief-eligible survivor of a disaster to submit an
application for medical assistance in accordance with
this section is the date that is 90 days after the end
of the disaster's relief coverage period.
``(4) Children born to pregnant women.--In the case of a
child born to a relief-eligible survivor of a disaster who is
provided medical assistance in accordance with this section
during the relief coverage period of the disaster, the child
shall be treated as having been born to a pregnant woman
eligible for medical assistance under the State plan (or waiver
of such plan) and shall be eligible for medical assistance
under such plan (or waiver) in accordance with section
1902(e)(4). Notwithstanding subsection (g), the Federal medical
assistance percentage determined for a State and fiscal year
under section 1905(b) shall apply to medical assistance
provided during the year to a child under the State plan (or
waiver) in accordance with the preceding sentence.
``(5) Option to provide extended mental health and care
coordination benefits.--A State may provide, without regard to
any restrictions on amount, duration, scope, or comparability,
or other restrictions under this title or the State plan or
waiver of such plan (other than restrictions applicable to
services provided in an institution for mental diseases),
medical assistance to relief-eligible survivors of a disaster
under this section for extended mental health and care
coordination services, which may include the following:
``(A) Screening, assessment, and diagnostic
services (including specialized assessments for
individuals with cognitive impairments).
``(B) Coverage for a full range of mental health
medications at the dosages and frequencies prescribed
by health professionals for depression, post-traumatic
stress disorder, and other mental disorders.
``(C) Treatment of alcohol and substance abuse
determined to result from circumstances related to the
disaster.
``(D) Psychotherapy, rehabilitation and other
treatments administered by psychiatrists,
psychologists, or social workers for conditions
exacerbated by, or resulting from, the disaster.
``(E) Peer support services related to the
disaster.
``(F) Mobile crisis services to assist with crises
related to the disaster.
``(G) In-patient mental health care in a general
hospital.
``(H) Family counseling for families where a member
of the immediate family is a survivor of the disaster
or first responder to the disaster or includes an
individual who has died as a result of the disaster.
``(I) In connection with the provision of health
and long-term care services, arranging for, (and when
necessary, enrollment in waiver programs or other
specialized programs), and coordination related to,
primary and specialty medical care, which may include
personal care services, durable medical equipment and
supplies, assistive technology, and transportation.
``(6) Option to provide home and community-based
services.--
``(A) In general.--A State may provide medical
assistance under this section for home and community-
based services to a relief-eligible survivor of a
disaster, including any survivor who is an individual
described in subparagraph (B), who self-attests that
the survivor immediately requires such services,
without regard to whether the survivor would require
the level of care provided in a hospital, nursing
facility, or intermediate care facility for the
developmentally disabled.
``(B) Individuals described.--Individuals described
in this subparagraph are relief-eligible survivors of a
disaster who--
``(i) on any day during the week preceding
the date on which the disaster is declared (as
described in subsection (b)(1)(A))--
``(I) had been receiving home and
community-based services in a direct
impact area under a waiver under
section 1115 or section 1915;
``(II) had been receiving support
services from a primary family
caregiver who, as a result of the
disaster, is no longer available to
provide services; or
``(III) had been receiving personal
care, home health, or rehabilitative
services under a State plan under this
title or under a waiver granted under
sections 1115 or 1915; or
``(ii) are disabled (as determined under
the State plan).
``(C) Waiver of restrictions.--With respect to the
provision of home and community-based services under
this paragraph, the Secretary--
``(i) shall waive any limitations on--
``(I) the number of individuals who
may receive home or community-based
services under a waiver described in
subparagraph (B)(i)(I);
``(II) budget neutrality
requirements applicable to such waiver;
and
``(III) populations eligible for
services under such waiver; and
``(ii) may waive any other restriction
applicable under such a waiver that would
prevent a State from providing home and
community-based services in accordance with
this paragraph.
``(f) State Reports.--Each State shall submit to the Secretary an
annual report that includes--
``(1) information on how the State is satisfying the
requirements of subsection (d)(2) (relating to providing notice
of termination of medical assistance under this section and
assistance in applying for medical assistance other than under
this section);
``(2) the number of survivors of a disaster who were
determined by the State to be relief-eligible survivors of a
disaster in the preceding year; and
``(3) the number of relief-eligible survivors of a disaster
who were determined to be eligible for, and enrolled in, the
State plan (or waiver of such plan) or the State child health
plan under title XXI (or waiver of such plan) other than under
this section.
``(g) 100 Percent Federal Matching Payments.--
``(1) In general.--Notwithstanding section 1905(b), the
Federal medical assistance percentage shall be equal to 100
percent with respect to amounts expended by a State--
``(A) for medical assistance provided in accordance
with this section to relief-eligible survivors of a
disaster during the relief coverage period of the
disaster;
``(B) that are directly attributable to
administrative activities related to the provision of
medical assistance under this section, including costs
attributable to obtaining recoveries under subsection
(h);
``(C) that are directly attributable to providing
application assistance in accordance with subsection
(d)(2)(B); and
``(D) for medical assistance provided to relief-
eligible survivors of a disaster after the end of the
relief coverage period of the disaster in accordance
with subsection (d)(4).
``(2) Disregard of limits on payments to territories.--The
limitations on payment under subsections (f) and (g) of section
1108 shall not apply to Federal payments under this title that
are based on the Federal medical assistance percentage
described in paragraph (1), and such payments shall be
disregarded in applying such subsections.
``(h) Penalty for Fraudulent Applications.--
``(1) Individual liable for costs.--If a State, as the
result of verification activities conducted by the State or
otherwise, determines after a fair hearing that an individual
has knowingly made a false attestation in an application for
medical assistance as a relief-eligible survivor of a disaster
under this section, the State shall, subject to paragraph (2),
seek recovery from the individual for the full amount of the
cost of medical assistance provided to the individual under
this section.
``(2) Exception.--The Secretary shall exempt a State from
the requirement to seek recovery from an individual under
paragraph (1) if the Secretary determines that it would not be
cost-effective for the State to do so.
``(3) Reimbursement to the federal government.--Amounts
expended by a State for medical assistance provided to an
individual under this section that are subsequently recovered
by the State under this subsection shall be treated as an
overpayment under this title to the extent that payments were
made to the State for such amounts.
``(i) Exemption From Error Rate Penalties.--All payments
attributable to providing medical assistance to relief-eligible
survivors of disasters in accordance with this section shall be
disregarded for purposes of section 1903(u).''.
SEC. 3. PROMOTING EFFECTIVE AND INNOVATIVE STATE RESPONSES TO INCREASED
DEMAND FOR MEDICAL ASSISTANCE FOLLOWING A DISASTER.
(a) Guidance on Increasing Access to Providers.--Not later than
October 1, 2020, the Secretary of Health and Human Services (in this
section referred to as the ``Secretary'') shall issue (and update as
the Secretary determines necessary) guidance to State Medicaid
directors on best practices for--
(1) expediting the approval of providers under a State
Medicaid plan under title XIX of the Social Security Act (42
U.S.C. 1396 et seq.), or waiver of such plan, after a disaster
to meet increased demand for medical assistance under the plan
or waiver from relief-eligible survivors (as defined in section
1947(b)(5) of such Act) of disasters; and
(2) using out-of-State providers to provide care to relief-
eligible survivors of a disaster under the plan or waiver.
(b) Technical Assistance and Support for Innovative State
Strategies to Respond to Increased Demand for Medical Assistance
Following a Disasters.--
(1) In general.--The Secretary shall provide technical
assistance and support to States to develop or expand
infrastructure, strategies, or innovations (including through
State Medicaid demonstration projects) to provide medical
assistance under a State Medicaid plan under title XIX of the
Social Security Act (42 U.S.C. 1396 et seq.), or a waiver of
such a plan, to relief-eligible survivors (as defined in
section 1947(b)(5) of such Act) of disasters.
(2) Report.--Not later than 180 days after the date of
enactment of this Act, the Secretary shall issue a report to
Congress detailing a plan of action to carry out the
requirements of paragraph (1).
(c) HCBS Emergency Response Corps Grant Program.--
(1) In general.--The Secretary shall award grants under
this subsection to States for the purpose of establishing or
operating HCBS emergency response corps that meet the
requirements of paragraph (2) to provide medical assistance for
home and community-based services under a State Medicaid plan
under title XIX of the Social Security Act (42 U.S.C. 1396 et
seq.) to relief-eligible survivors (as defined in section
1947(b)(5) of such Act) of disasters.
(2) Home and community-based services emergency response
corps.--An HCBS emergency response corps meets the requirements
of this paragraph if it satisfies the following requirements:
(A) The corps serves a State with a history of
hosting individuals who are forced to relocate to the
State from another State due to a disaster (as
determined by the Secretary).
(B) The corps is composed of representatives from
each of the following:
(i) Voluntary organizations delivering
assistance.
(ii) Area agencies on aging (as defined in
section 102 of the Older Americans Act of 1965
(42 U.S.C. 3002)).
(iii) The Medicare program under title
XVIII of the Social Security Act (42 U.S.C.
1395 et seq.).
(iv) The State agency responsible for
administering the State Medicaid program under
title XIX of the Social Security Act (42 U.S.C.
1396 et seq.).
(v) State agencies serving older adults and
people with disabilities.
(vi) Nonprofit service providers.
(vii) Other organizations that address the
needs of older adults and people with
disabilities.
(C) The corps is led by a representative of a State
or nonprofit agency serving older adults or people with
disabilities.
(D) The corps operates under a plan to meet the
acute and long-term services and support needs of
relief-eligible survivors (as defined in section
1947(b)(5) of the Social Security Act) of disasters,
and is provided with the resources necessary to execute
such plan.
(3) Grants.--
(A) Limitation.--The Secretary may award a grant
under this subsection to up to 5 States.
(B) Term of grants.--Grants under this subsection
shall be made for a term of 2 years.
(4) Authorization.--There are authorized to be appropriated
to carry out this subsection, $10,000,000 for each of fiscal
years 2020 through 2025, to remain available until expended.
SEC. 4. TARGETED MEDICAID RELIEF FOR DIRECT IMPACT AREAS.
(a) 100 Percent Federal Matching Payments for Medical Assistance
Provided in a Direct Impact Area.--
(1) In general.--Section 1905 of the Social Security Act
(42 U.S.C. 1396d) is amended--
(A) in subsection (b), by striking ``and (aa)'' and
inserting ``(aa), and (ff)''; and
(B) by adding at the end the following new
subsection:
``(ff) 100 Percent FMAP for All Medical Assistance Provided in
Disaster Direct Impact Areas.--Notwithstanding subsection (b), the
Federal medical assistance percentage for a State and fiscal year shall
be equal to 100 percent with respect to amounts expended by the State
during the year for medical assistance for an individual who, at the
time the assistance is provided to the individual, is a resident of a
direct impact area of a disaster during the disaster's relief coverage
period (as such terms are defined in section 1947).''.
(2) Application to chip.--Section 2105(a) of the Social
Security Act (42 U.S.C. 1397ee(a)) is amended by adding at the
end the following new paragraph:
``(5) 100 percent match for all child health assistance
provided in disaster direct impact areas.--Notwithstanding
paragraph (1), the Secretary shall pay to each State with a
plan approved under this title, from its allotment under
section 2104, an amount for each quarter equal to 100 percent
of expenditures in the quarter for child health assistance
under the plan for targeted low-income children or pregnancy-
related assistance for targeted low-income women that is
provided to such a child or woman who, at the time the
assistance is provided, is a resident of a direct impact area
of a disaster during the disaster's relief coverage period (as
such terms are defined in section 1947).''.
(b) Moratorium on Redeterminations.--During the relief coverage
period (as defined in paragraph (4) of section 1947(b) of the Social
Security Act, as added by section 2)) of a disaster, a State that
contains a direct impact area (as defined in paragraph (2) of such
section) of the disaster shall not be required to conduct eligibility
redeterminations under the State's plans or waivers of such plans under
title XIX or XXI of such Act (42 U.S.C. 1396 et seq., 1397aa) with
respect to individuals who reside in such area.
SEC. 5. AUTHORITY TO WAIVE REQUIREMENTS DURING NATIONAL EMERGENCIES
WITH RESPECT TO EVACUEES FROM AN EMERGENCY AREA.
Section 1135(g)(1) of the Social Security Act (42 U.S.C. 1320b-
5(g)(1)) is amended--
(1) by redesignating subparagraphs (A) and (B) as clauses
(i) and (ii), respectively;
(2) by striking ``An `emergency area''' and inserting the
following:
``(A) In general.--An emergency area''; and
(3) by adding at the end the following new subparagraph:
``(B) Additional areas.--Any geographical area in which the
Secretary determines there are a significant number of evacuees
from an area described in subparagraph (A) shall also be
considered to be an `emergency area' for purposes of this
section.''.
SEC. 6. EXCLUSION OF DISASTER RELIEF COVERAGE PERIOD IN COMPUTING
MEDICARE PART B LATE ENROLLMENT PERIOD.
Section 1839(b) of such Act (42 U.S.C. 1395r(b)) is amended, in the
second sentence, by inserting before the period at the end the
following: ``or, in the case of an individual who is a survivor of a
disaster (as defined in paragraph (6) of section 1947(b)), any month
any part of which is within the relief coverage period (as defined in
paragraph (4) of such section) of such disaster''.
SEC. 7. EFFECTIVE DATE.
(a) In General.--Subject to subsection (b), this Act and the
amendments made by this Act shall take effect on the date of enactment
of this Act.
(b) Delay Permitted if State Legislation Required.--In the case of
a State plan approved under title XIX of the Social Security Act which
the Secretary of Health and Human Services determines requires State
legislation (other than legislation appropriating funds) in order for
the plan to meet the additional requirement imposed by this section,
the State plan shall not be regarded as failing to comply with the
requirements of such title solely on the basis of the failure of the
plan to meet such additional requirement before the 1st day of the 1st
calendar quarter beginning after the close of the 1st regular session
of the State legislature that ends after the 1-year period beginning
with the date of the enactment of this section. For purposes of the
preceding sentence, in the case of a State that has a 2-year
legislative session, each year of the session is deemed to be a
separate regular session of the State legislature.
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