[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[S. 2071 Introduced in Senate (IS)]
<DOC>
119th CONGRESS
1st Session
S. 2071
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 12, 2025
Mr. Blumenthal (for himself, Mr. Schatz, Mr. Schiff, Mrs. Gillibrand,
Mr. Fetterman, Ms. Duckworth, Mr. Lujan, Ms. Warren, and Mr. Welch)
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 (86), by striking ``; and'' and
inserting a semicolon;
(B) in paragraph (87), by striking the period at
the end and inserting ``; and''; and
(C) by inserting after paragraph (87) the following
new paragraph:
``(88) beginning January 1, 2027, provide for making
medical assistance available to relief-eligible survivors of
disasters during relief coverage periods in accordance with
section 1949.''; and
(2) by adding at the end the following new section:
``SEC. 1949. 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 any of the
following:
``(A) A major disaster that is declared on or after
January 1, 2027, 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 which
the President has determined warrants individual or
public assistance from the Federal Government under
such Act.
``(B) A national emergency declared by the
President under the National Emergencies Act (50 U.S.C.
1601 et seq.).
``(C) A public health emergency declared by the
Secretary pursuant to section 319 of the Public Health
Service Act (42 U.S.C. 247d).
``(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 subparagraph (A), (B), or (C) of paragraph
(1), as applicable), the Secretary shall post on the
websites of the Centers for Medicare & Medicaid
Services and the Federal Emergency Management Agency 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 (as determined in accordance with
section 435.403 of title 42, Code of Federal Regulations (or
any successor regulation)) on the date on which the disaster is
declared (as described in subparagraph (A), (B), or (C) of
paragraph (1), as applicable).
``(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
subparagraph (A), (B), or (C) of paragraph (1), as applicable)
and ends on the day that is 2 years after such date.
``(5) Relief-eligible survivor.--
``(A) In general.--Subject to subparagraph (C), 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 individual, 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 of the survivor's home State (or a
waiver of such plan).
``(B) Disregard of unemployment income and fema
individual assistance grants.--For purposes of this
section, and notwithstanding section 1902(e)(14)(B),
the income of a survivor of a disaster shall not
include--
``(i) any amount received by the survivor
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; or
``(ii) any amount received during the
relief coverage period of the disaster by the
survivor (or the survivor's household) as
assistance under a program administered by the
Federal Emergency Management Agency.
``(C) Limitation to relief coverage period.--
``(i) In general.--Except as provided in
clauses (ii) and (iii), for purposes of this
section, an individual shall not be considered
to be a relief-eligible survivor on the basis
of the individual's status as a survivor of a
disaster after the end of the relief coverage
period of the disaster.
``(ii) Continuous eligibility for disaster
relief coverage for pregnant and postpartum
individuals.--In the case of an individual who,
while pregnant, receives medical assistance as
a relief-eligible survivor of a disaster under
a State plan (or a waiver of such a plan) in
accordance with this section, such individual
shall continue to be eligible for medical
assistance as a relief-eligible survivor
through the end of the month in which the 60-
day period (beginning on the last day of the
pregnancy) (or, if longer, the period of
postpartum continuous eligibility that
otherwise applies to individuals who, while
pregnant, are eligible for medical assistance
under the State plan or waiver) ends, without
regard to whether the pregnancy ends before or
after the end of the relief coverage period of
the disaster.
``(iii) Continuous eligibility for
individuals with pending applications.--If an
individual who receives medical assistance as a
relief-eligible survivor of a disaster under a
State plan (or a waiver of such a plan) in
accordance with this section has an application
pending for medical assistance under the State
plan (or waiver) under this title or for child
health assistance or pregnancy-related
assistance under a State plan under title XXI
(or a waiver of such a plan) on the date that
the relief coverage period of the disaster
ends, such individual shall continue to be
eligible for medical assistance as a relief-
eligible survivor through the earlier of--
``(I) the end of the month in which
the 60-day period (beginning on the
last day of such relief coverage
period) ends; and
``(II) the date on which the
individual's application for medical
assistance, child health assistance, or
pregnancy-related assistance (as
applicable) is approved or denied.
``(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 the date on which a disaster is
declared (as described in subparagraph (A), (B), or (C)
of paragraph (1), as applicable), 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 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 the date on
which the disaster was declared (as so
described); 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.--In the case
of an individual who is homeless (as such term is
defined in section 103(a) of the McKinney-Vento
Homeless Assistance Act (42 U.S.C. 11302(a))) on the
date on which a disaster is declared (as so described),
the individual's residency for purposes of subparagraph
(B) shall be determined in accordance with section
435.403 of title 42, Code of Federal Regulations (or
any successor regulation).
``(E) Effect of concurrent eligibility for medicaid
or chip.--An individual's eligibility for medical
assistance under a State plan (or waiver of such plan)
(or for child health assistance or pregnancy-related
assistance under a State plan under title XXI (or a
waiver of such a 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) under either
such title 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 may accept a simplified, streamlined
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
mailing 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 (g);
``(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) as described and 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.--
``(i) In general.--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.
``(ii) Use of available electronic data
sources.--In making determinations with respect
to the status of an applicant for medical
assistance as a survivor of a disaster under
this section, or such an applicant's need for
home and community-based services, a State may
use data relating to the applicant that is
available to the State from electronic data
sources.
``(2) Presumptive eligibility for relief-eligible
survivors.--
``(A) In general.--A State shall provide for making
medical assistance available to an individual as a
relief-eligible survivor under this section during a
presumptive eligibility period.
``(B) Presumptive eligibility period defined.--For
purposes of this paragraph--
``(i) the term `presumptive eligibility
period' means, with respect to an individual,
the period that--
``(I) begins with the date on which
a qualified provider determines, on the
basis of preliminary information, that
the individual satisfies the criteria
for eligibility for medical assistance
as a relief-eligible survivor under
this section; and
``(II) ends with (and includes) the
earlier of--
``(aa) the day on which a
determination is made with
respect to the eligibility of
the individual for medical
assistance as a relief-eligible
survivor under this section; or
``(bb) in the case of an
individual who does not file an
application by the last day of
the month following the month
during which the provider makes
the determination referred to
in item (aa), such last day;
and
``(ii) the term `qualified provider' has
the meaning given such term in section 1920.
``(C) Coordination between state agencies and
qualified providers.--
``(i) Provision of forms and information to
qualified providers.--The State agency shall
provide qualified providers with--
``(I) such forms as are necessary
for an individual to make application
for medical assistance under the State
plan as a relief-eligible survivor; and
``(II) information on how to assist
individuals and their authorized
representatives in completing and
filing such forms.
``(ii) Provision of notice of
determinations to state agencies.--A qualified
provider that determines under this
subparagraph that an individual is eligible for
medical assistance under a State plan as a
relief-eligible survivor under this section
shall--
``(I) notify the State agency of
the determination within 5 working days
after the date on which determination
is made; and
``(II) inform the individual at the
time the determination is made that the
individual is required to make
application for medical assistance
under the State plan by not later than
the last day of the month following the
month during which the determination is
made.
``(D) Application requirement.--An individual who
is determined by a qualified provider to be
presumptively eligible as a relief-eligible survivor
for medical assistance under a State plan shall make
application for medical assistance under such plan by
not later than the last day of the month following the
month during which the determination is made, which
application may be the streamlined application
described in paragraph (1).
``(E) Treatment as medical assistance.--
Notwithstanding any other provision of this title,
items and services that are--
``(i) furnished to an individual during a
presumptive eligibility period under this
paragraph by a provider that is eligible for
payments under the State plan; and
``(ii) included in the care and services
covered by the State plan;
shall be treated as medical assistance provided to a
relief-eligible survivor of a disaster during the
relief coverage period of the disaster under this
section.
``(3) Continuous eligibility.--
``(A) In general.--Subject to subparagraph (B), an
individual who is determined by a State to be a relief-
eligible survivor of a disaster shall remain eligible
for medical assistance under the State plan (or a
waiver of such plan) as such a survivor, without the
need for any redetermination of eligibility, for the
duration of the relief coverage period of the disaster.
``(B) Exceptions.--A State may terminate the
eligibility of an individual who is determined by a
State to be a relief-eligible survivor of a disaster
before the end of the relief coverage period of the
disaster if--
``(i) the individual (or the individual's
authorized representative) requests a voluntary
termination of eligibility;
``(ii) the individual ceases to be a
resident of the State;
``(iii) the State determines that
eligibility was erroneously granted because of
State error or fraud, abuse, or perjury
attributed to the individual (or the
individual's authorized representative); or
``(iv) the individual dies.
``(4) 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.
``(5) 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 (or a waiver of such
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,
and a State may enroll an individual in the State plan
or waiver under this section pending such verification.
``(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.
``(6) 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) 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 at least
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 under this section by a
State to a relief-eligible survivor of a disaster whose home
State is not the State providing such assistance for an item or
service which is not otherwise 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 least 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 relief-eligible survivors of a
disaster.--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 individual 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
(f), 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, social workers, or other qualified
mental or behavioral health professionals 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) Inpatient and outpatient mental health care.
``(H) Family counseling for families where a member
of the immediate family is a survivor of the disaster
or a 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 subparagraph (A), (B), or (C) of
subsection (b)(1), as applicable)--
``(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 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 in
accordance with the State plan of the home
State of the individual).
``(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.
``(e) State Reports.--Each State shall submit to the Secretary an
annual report that includes--
``(1) 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
``(2) 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.
``(f) 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 and, in the case of individuals described in
clause (ii) or (iii) of subsection (b)(5)(C), during
the applicable periods described in such clauses; and
``(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
(g).
``(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.
``(g) 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.
``(h) 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
January 1, 2027, 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
1949(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 1949(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
1949(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) Individuals who are enrolled in the
State Medicaid program under title XIX of the
Social Security Act (42 U.S.C. 1396 et seq.) or
the Children's Health Insurance Program under
title XXI of the Social Security Act (42 U.S.C.
1397aa et seq.).
(viii) Centers for independent living, as
described in part C of title VII of the
Rehabilitation Act of 1973 (29 U.S.C. 796f et
seq.).
(ix) 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
1949(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 2027 through 2032, 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 (ii)'' and
inserting ``(ii), and (kk)''; and
(B) by adding at the end the following new
subsection:
``(kk) 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 fiscal year for medical assistance for an individual who,
during the fiscal quarter in which 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 1949).''.
(2) Exclusion of enhanced payments from territorial caps.--
Notwithstanding any other provision of law, for purposes of
section 1108 of the Social Security Act (42 U.S.C. 1308), with
respect to any additional amount paid to a territory as a
result of the application of subsection (kk) of section 1905 of
the Social Security Act (42 U.S.C. 1396d), as added by
paragraph (1)--
(A) the limitation on payments to territories under
subsections (f) and (g) of such section 1108 shall not
apply to such additional amounts; and
(B) such additional amounts shall be disregarded in
applying such subsections.
(3) Application to chip.--
(A) In general.--Section 2105(c) of the Social
Security Act (42 U.S.C. 1397ee(a)) is amended by adding
at the end the following new paragraph:
``(13) 100 percent match for assistance provided in
disaster direct impact areas.--Notwithstanding subsection (b),
the enhanced FMAP for a State, with respect to payments under
subsection (a) for expenditures under the State plan for child
health assistance for targeted low-income children or
pregnancy-related assistance for individuals who are targeted
low-income women that is provided to such a child or individual
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 1949)
shall be equal to 100 percent.''.
(B) Adjustment of chip allotments.--Section 2104(m)
of the Social Security Act (42 U.S.C. 1397dd(m)) is
amended--
(i) in paragraph (2)(B), by striking `` and
(12)'' and inserting ``(12), and (13)''; and
(ii) by adding at the end the following new
paragraph:
``(13) Adjusting allotments to account for increased
federal payments for assistance provided in disaster direct
impact areas.--If a State (including the District of Columbia
and each commonwealth and territory) receives a payment for a
fiscal year under subsection (a) of section 2105 for
expenditures that are subject to the enhanced FMAP specified
under subsection (c)(13) of such section--
``(A) the amount of the allotment determined for
the State under this subsection for such fiscal year
shall be increased by the product of--
``(i) the amount of such expenditures that
the State is projected to make for such fiscal
year; and
``(ii) a percentage equal to 100 percent
reduced by a number of percentage points equal
to the enhanced FMAP determined for the State
and fiscal year under subsection (b) of section
2105; and
``(B) once actual expenditures for the fiscal year
are available, the amount of such allotment, as
increased under subparagraph (A), shall be further
increased or reduced, as appropriate, on the basis of
the difference between--
``(i) the amount of the increase determined
under subparagraph (A); and
``(ii) the product of--
``(I) the actual amount of State
expenditures that are subject to the
enhanced FMAP specified under section
2105(c)(13); and
``(II) the percentage determined
for the State under subparagraph
(A)(ii).''.
(b) Moratorium on Redeterminations.--During the relief coverage
period (as defined in paragraph (4) of section 1949(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) in subparagraph (A), by striking ``subparagraph (B)''
and inserting ``subparagraphs (B) and (C)''; and
(2) by adding at the end the following new subparagraph:
``(C) 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 1949(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.
SEC. 8. IMPACT EVALUATION AND REPORTING.
(a) In General.--Not later than 24 months after the date of
enactment of this Act, the Secretary of Health and Human Services shall
enter into a 5 year agreement through a contract, grant, or cooperative
agreement with an independent nonprofit entity experienced in
conducting evaluations of program and systems change efforts to--
(1) conduct a multi-year evaluation on the impact of this
Act, with respect to relief-eligible survivors (including
people with disabilities and pregnant individuals); and
(2) prepare the reports described in subsection (c).
(b) Evaluation.--In carrying out subsection (a)(1), the entity
awarded a contract, grant, or cooperative agreement under this section
shall evaluate at a minimum--
(1) the availability of and access to Medicaid services for
relief-eligible survivors under the Medicaid program nationally
and in each State, territory and tribal organization, including
scope and coverage of services, provision of home and
community-based services and extended mental health and care
coordination services; and provider capacity;
(2) the demographics of individuals receiving these
benefits, including individuals with disabilities and pregnant
individuals; and
(3) actions taken by States to comply with this Act,
including coordination of efforts between states, coordination
between state agencies and qualified providers, and activities
of HCBS emergency response corps (as described in section
3(c)).
(c) Reports.--The Secretary of Health and Human Services shall
submit to the Committee on Finance of the Senate, the Special Committee
on Aging of the Senate, the Committee on Energy and Commerce of the
House of Representatives, and the Committee on Ways and Means of the
House of Representatives the following reports on the evaluation
conducted under subsection (a)(1):
(1) An interim report on the evaluation, to be submitted
not later than 3 years after the evaluation commences.
(2) A follow-up report on such evaluation, to be submitted
not later than 24 months after the date on which the interim
report is issued.
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