[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.
                                 <all>