,,ii  #aaith ,,congress  #ast ,session  
,s4 #bjga  ,,in ,,the ,,senate ,,of     
,,the ,,united ,,states  ,june #ab1     
#bjbe,mr4 ,blumenthal 7for himself1 ,mr4
 ,schatz1 ,mr4 ,schiff1 ,mrs4           
,gillibrand1 ,mr4 ,fetterman1 ,ms4      
,duckworth1 ,mr4 ,lujn1 ,ms4 ,warren1   
and ,mr4 ,welch7 introduced the         
following bill2 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 emergency1 and
 for other purposes4  #a4 ,short title  
,this ,act may be cited as the ,disaster
 ,relief ,medicaid ,act4  #b4 ,medicaid 
relief for disaster survivors ,title    
,,xix of the ,social ,security ,act 7#db
 ,u4,s4,c4 #acif et seq47 is amended--  
7#a7 in section #aijb7;a7-- 7,a7 in     
paragraph 7#hf71 by striking 2 and and  
inserting a semicolon2  7,b7 in         
paragraph 7#hg71 by striking the period 
at the end and inserting 2 and2 and     
7,c7 by inserting after paragraph 7#hg7 

the following new paragraph3  7#hh7     
beginning ,january #a1 #bjbg1 provide   
for making medical assistance available 
to relief-eligible survivors of         
disasters during relief coverage periods
 in accordance with section #aidi4  2   
and  7#b7 by adding at the end the      
following new section3  #aidi4 ,disaster
 relief ,medicaid for survivors of major
 disasters  7a7 ,in general             
,notwithstanding any other provision of 
this title1 a ,state plan shall provide 
medical assistance to a relief-eligible 
survivor of a disaster in accordance    
with this section4  7b7 ,definitions ,in
 this section3 7#a7 ,disaster ,the term 
disaster means any of the following3    
7,a7 ,a major disaster that is declared 
on or after ,january #a1 #bjbg1 by the  
,president in accordance with section   
#dja of the ,robert ,t4 ,stafford       
,disaster ,relief and ,emergency        
,assistance ,act 7#db ,u4,s4,c4 #eagj7  
and which the ,president has determined 
warrants individual or public assistance

 from the ,federal ,government under    
such ,act4  7,b7 ,a national emergency  
declared by the ,president under the    
,national ,emergencies ,act 7#ej        
,u4,s4,c4 #afja et seq474  7,c7 ,a      
public health emergency declared by the 
,secretary pursuant to section #cai of  
the ,public ,health ,service ,act 7#db  
,u4,s4,c4 #bdg;d74  7#b7 ,direct impact 
area  7,a7 ,in general ,the term direct 
impact area means1 with respect to a    
disaster1 the geographic area in which  
the disaster exists4  7,b7 ,website     
posting of direct impact areas ,as soon 
as practicable after a disaster is      
declared 7as described in subparagraph  
7,a71 7,b71 or 7,c7 of paragraph 7#a71  
as applicable71 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 disaster4    
7#c7 ,home ,state ,the term home ,state 
means1 with respect to a survivor of a  

disaster1 the ,state in which the       
survivor was a resident 7as determined  
in accordance with section #dce4djc of  
title #db1 ,code of ,federal            
,regulations 7or any successor          
regulation77 on the date on which the   
disaster is declared 7as described in   
subparagraph 7,a71 7,b71 or 7,c7 of     
paragraph 7#a71 as applicable74  7#d7   
,relief coverage period ,the term relief
 coverage period means1 with respect to 
a disaster1 the period that begins on   
the date the disaster is declared 7as   
described in subparagraph 7,a71 7,b71 or
 7,c7 of paragraph 7#a71 as applicable7 
and ends on the day that is #b years    
after such date4  7#e7 ,relief-eligible 
survivor  7,a7 ,in general ,subject to  
subparagraph 7,c71 the term             
relief-eligible survivor means an       
individual who is a survivor of a       
disaster whose family income does not   
exceed the higher of-- 7i7 #acc percent 
7or1 in the case of a survivor who is a 
pregnant individual1 a child1 or a      

recipient of benefits under title ,,ii  
on the basis of a disability1 #bjj      
percent7 of the poverty line2 or  7ii7  
the income eligibility standard that    
would otherwise apply to the survivor   
under the ,state plan of the survivor's 
home ,state 7or a waiver of such plan74 
7,b7 ,disregard of unemployment income  
and ,,fema individual assistance grants 
,for purposes of this section1 and      
notwithstanding section                 
#aijb7;e77#ad77;,b71 the income of a    
survivor of a disaster shall not        
include-- 7i7 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          
compensation2 or  7ii7 any amount       
received during the relief coverage     
period of the disaster by the survivor  
7or the survivor's household7 as        
assistance under a program administered 
by the ,federal ,emergency ,management  
,agency4  7,c7 ,limitation to relief    

coverage period  7i7 ,in general ,except
 as provided in clauses 7ii7 and 7iii71 
for purposes of this section1 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       
disaster4  7ii7 ,continuous eligibility 
for disaster relief coverage for        
pregnant and postpartum individuals ,in 
the case of an individual who1 while    
pregnant1 receives medical assistance as
 a relief-eligible survivor of a        
disaster under a ,state plan 7or a      
waiver of such a plan7 in accordance    
with this section1 such individual shall
 continue to be eligible for medical    
assistance as a relief-eligible survivor
 through the end of the month in which  
the #fj-;day period 7beginning on the   
last day of the pregnancy7 7or1 if      
longer1 the period of postpartum        
continuous eligibility that otherwise   
applies to individuals who1 while       

pregnant1 are eligible for medical      
assistance under the ,state plan or     
waiver7 ends1 without regard to whether 
the pregnancy ends before or after the  
end of the relief coverage period of the
 disaster4  7iii7 ,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 7or a waiver of such
 a plan7 in accordance with this section
 has an application pending for medical 
assistance under the ,state plan 7or    
waiver7 under this title or for child   
health assistance or pregnancy-related  
assistance under a ,state plan under    
title ,,xxi 7or a waiver of such a plan7
 on the date that the relief coverage   
period of the disaster ends1 such       
individual shall continue to be eligible
 for medical assistance as a            
relief-eligible survivor through the    
earlier of-- 7,i7 the end of the month  
in which the #fj-;day period 7beginning 

on the last day of such relief coverage 
period7 ends2 and  7,,ii7 the date on   
which the individual's application for  
medical assistance1 child health        
assistance1 or pregnancy-related        
assistance 7as applicable7 is approved  
or denied4  7#f7 ,survivor  7,a7 ,in    
general ,the term survivor means1 with  
respect to a disaster1 an individual who
 is described in subparagraph 7,b7 or   
7,c74  7,b7 ,residents and evacuees of  
direct impact areas ,an individual      
described in this subparagraph is an    
individual who1 on the date on which a  
disaster is declared 7as described in   
subparagraph 7,a71 7,b71 or 7,c7 of     
paragraph 7#a71 as applicable71 has a   
primary residence in the disaster's     
direct impact area4  7,c7 ,individuals  
who lost employment ,an individual      
described in this subparagraph is an    
individual-- 7i7 whose worksite was     
located in the disaster's direct impact 
area2  7ii7 who was employed by an      
employer that-- 7,i7 conducted an active

 trade or business in such area on the  
date on which the disaster was declared 
7as so described72 and  7,,ii7 was      
unable to operate such trade or business
 as a result of the disaster on any day 
during the disaster's relief coverage   
period2 and  7iii7 whose employment with
 such employer was terminated4  7,d7    
,treatment of homeless persons ,in the  
case of an individual who is homeless   
7as such term is defined in section     
#ajc7;a7 of the ,mc,kinney-,vento       
,homeless ,assistance ,act 7#db         
,u4,s4,c4 #aacjb7;a777 on the date on   
which a disaster is declared 7as so     
described71 the individual's residency  
for purposes of subparagraph 7,b7 shall 
be determined in accordance with section
 #dce4djc of title #db1 ,code of        
,federal ,regulations 7or any successor 
regulation74  7,e7 ,effect of concurrent
 eligibility for ,medicaid or ,,chip ,an
 individual's eligibility for medical   
assistance under a ,state plan 7or      
waiver of such plan7 7or for child      

health assistance or pregnancy-related  
assistance under a ,state plan under    
title ,,xxi 7or a waiver of such a      
plan77 on a basis other than under this 
section shall not prevent the individual
 from being treated as a survivor under 
this section1 and the rights afforded to
 an individual who is eligible for or   
enrolled under a ,state plan 7or waiver7
 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 section4  7c7 ,eligibility    
7#a7 ,simplified application  7,a7 ,in  
general ,for purposes of determining    
eligibility for medical assistance under
 this section1 each ,state may accept a 
simplified1 streamlined application form
 7as developed by the ,secretary in     
consultation with the ,national         
,association of ,state ,medicaid        
,directors71 which shall-- 7i7 require  
an applicant for medical assistance in  
accordance with this section as a       

survivor of a disaster to-- 7,i7 provide
 the applicant's mailing address for the
 duration of the relief coverage period 
of the disaster2 and  7,,ii7 agree to   
update the information described in     
subclause 7,i7 if it changes during such
 period2  7ii7 provide notice of the    
penalties for making a fraudulent       
application described in subsection 7g72
  7iii7 require the applicant to assign 
to the ,state any rights of the         
applicant 7or 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 rights7 as described and in        
accordance with the requirements of     
section #aiab2  7iv7 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 section2 and  7v7 require the
 applicant to self-attest that the      
applicant-- 7,i7 is a relief-eligible   

survivor of the disaster2 and  7,,ii7 if
 applicable1 requires home and          
community-based services4  7,b7 ,no     
documentation requirement  7i7 ,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-- 7,i7 of the applicant's
 status as a relief-eligible survivor2  
and  7,,ii7 if applicable1 that the     
applicant requires home and             
community-based services4  7ii7 ,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 section1 or such an          
applicant's need for home and           
community-based services1 a ,state may  
use data relating to the applicant that 
is available to the ,state from         
electronic data sources4  7#b7          
,presumptive eligibility for            
relief-eligible survivors  7,a7 ,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 period4  7,b7   
,presumptive eligibility period defined 
,for purposes of this paragraph-- 7i7   
the term presumptive eligibility period 
means1 with respect to an individual1   
the period that-- 7,i7 begins with the  
date on which a qualified provider      
determines1 on the basis of preliminary 
information1 that the individual        
satisfies the criteria for eligibility  
for medical assistance as a             
relief-eligible survivor under this     
section2 and  7,,ii7 ends with 7and     
includes7 the earlier of-- 7aa7 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     
section2 or  7bb7 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 7aa71 such last day2
 and  7ii7 the term qualified provider  
has the meaning given such term in      
section #aibj4  7,c7 ,coordination      
between ,state agencies and qualified   
providers  7i7 ,provision of forms and  
information to qualified providers ,the 
,state agency shall provide qualified   
providers with-- 7,i7 such forms as are 
necessary for an individual to make     
application for medical assistance under
 the ,state plan as a relief-eligible   
survivor2 and  7,,ii7 information on how
 to assist individuals and their        
authorized representatives in completing
 and filing such forms4  7ii7 ,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-- 7,i7 notify the ,state  

agency of the determination within #e   
working days after the date on which    
determination is made2 and  7,,ii7      
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 
made4  7,d7 ,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 made1 which application
 may be the streamlined application     
described in paragraph 7#a74  7,e7      
,treatment as medical assistance        
,notwithstanding any other provision of 
this title1 items and services that     

are-- 7i7 furnished to an individual    
during a presumptive eligibility period 
under this paragraph by a provider that 
is eligible for payments under the      
,state plan2 and  7ii7 included in the  
care and services covered by the ,state 
plan2  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 section4  7#c7 ,continuous   
eligibility  7,a7 ,in general ,subject  
to subparagraph 7,b71 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 7or a  
waiver of such plan7 as such a survivor1
 without the need for any               
redetermination of eligibility1 for the 
duration of the relief coverage period  
of the disaster4  7,b7 ,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-- 7i7 the individual 7or the         
individual's authorized representative7 
requests a voluntary termination of     
eligibility2  7ii7 the individual ceases
 to be a resident of the ,state2  7iii7 
the ,state determines that eligibility  
was erroneously granted because of      
,state error or fraud1 abuse1 or perjury
 attributed to the individual 7or the   
individual's authorized representative72
 or  7iv7 the individual dies4  7#d7    
,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 section1 which    
shall be valid for the duration of the  
relief coverage period of the disaster4 
7#e7 ,verification of status as a       
relief-eligible survivor  7,a7 ,in      
general ,the ,state shall make a good   

faith effort to verify the status of an 
individual who is enrolled in the ,state
 plan 7or a waiver of such plan7 as a   
relief-eligible survivor of a disaster  
in accordance with this section4 ,such  
effort shall not delay the determination
 of the eligibility of the individual   
for medical assistance under this       
section1 and a ,state may enroll an     
individual in the ,state plan or waiver 
under this section pending such         
verification4  7,b7 ,evidence of        
verification ,a ,state may satisfy the  
verification requirement under          
subparagraph 7,a7 with respect to an    
individual by showing that the ,state   
obtained information from the ,social   
,security ,administration1 the ,internal
 ,revenue ,service1 or1 if applicable1  
the ,state ,medicaid agency of the home 
,state of the individual4  7#f7         
,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 7as defined in
 section #aijb7;e77#ac77;,f774  7d7     
,scope of coverage  7#a7 ,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 7or waiver of such plan7 as an    
individual described in clause 7i7 of   
section #aijb7;a77#aj77;,a71 except     
that1 in the case of such a survivor    
whose home ,state is not the ,state     
providing medical assistance to the     
individual1 the ,state shall also       
provide medical assistance for any item 
or service for which medical assistance 
is available to individuals described in
 clause 7i7 of section                  
#aijb7;a77#aj77;,a7 under the ,state    
plan 7or waiver7 of the survivor's home 
,state4  7#b7 ,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 7or waiver of such plan7 but
 which is available under the ,state    
plan 7or waiver7 of the survivor's home 
,state1 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 7or1 if no    
such payment rate applies under the plan
 or waiver of the home ,state1 the usual
 and customary prevailing rate for the  
item or service for the community in    
which it is provided74  7#c7            
,retroactive coverage  7,a7 ,in general 
,notwithstanding section #aije7;a71 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 7,b74  7,b7   
,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 #ij days    
after the end of the disaster's relief  
coverage period4  7#d7 ,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 disaster1 
the child shall be treated as having    
been born to a pregnant individual      
eligible for medical assistance under   
the ,state plan 7or waiver of such plan7
 and shall be eligible for medical      
assistance under such plan 7or waiver7  

in accordance with section              
#aijb7;e77#d74 ,notwithstanding         
subsection 7f71 the ,federal medical    
assistance percentage determined for a  
,state and fiscal year under section    
#aije7;b7 shall apply to medical        
assistance provided during the year to a
 child under the ,state plan 7or waiver7
 in accordance with the preceding       
sentence4  7#e7 ,option to provide      
extended mental health and care         
coordination benefits ,a ,state may     
provide1 without regard to any          
restrictions on amount1 duration1 scope1
 or comparability1 or other restrictions
 under this title or the ,state plan or 
waiver of such plan 7other than         
restrictions applicable to services     
provided in an institution for mental   
diseases71 medical assistance to        
relief-eligible survivors of a disaster 
under this section for extended mental  
health and care coordination services1  
which may include the following3 7,a7   
,screening1 assessment1 and diagnostic  

services 7including specialized         
assessments for individuals with        
cognitive impairments74  7,b7 ,coverage 
for a full range of mental health       
medications at the dosages and          
frequencies prescribed by health        
professionals for depression1           
post-traumatic stress disorder1 and     
other mental disorders4  7,c7 ,treatment
 of alcohol and substance abuse         
determined to result from circumstances 
related to the disaster4  7,d7          
,psychotherapy1 rehabilitation and other
 treatments administered by             
psychiatrists1 psychologists1 social    
workers1 or other qualified mental or   
behavioral health professionals for     
conditions exacerbated by1 or resulting 
from1 the disaster4  7,e7 ,peer support 
services related to the disaster4  7,f7 
,mobile crisis services to assist with  
crises related to the disaster4  7,g7   
,inpatient and outpatient mental health 
care4  7,h7 ,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 disaster4  7,i7 ,in      
connection with the provision of health 
and long-term care services1 arranging  
for1 7and when necessary1 enrollment in 
waiver programs or other specialized    
programs71 and coordination related to1 
primary and specialty medical care1     
which may include personal care         
services1 durable medical equipment and 
supplies1 assistive technology1 and     
transportation4  7#f7 ,option to provide
 home and community-based services  7,a7
 ,in general ,a ,state may provide      
medical assistance under this section   
for home and community-based services to
 a relief-eligible survivor of a        
disaster1 including any survivor who is 
an individual described in subparagraph 
7,b71 who self-attests that the survivor
 immediately requires such services1    
without regard to whether the survivor  
would require the level of care provided

 in a hospital1 nursing facility1 or    
intermediate care facility for the      
developmentally disabled4  7,b7         
,individuals described ,individuals     
described in this subparagraph are      
relief-eligible survivors of a disaster 
who-- 7i7 on any day during the week    
preceding the date on which the disaster
 is declared 7as described in           
subparagraph 7,a71 7,b71 or 7,c7 of     
subsection 7b77#a71 as applicable7--    
7,i7 had been receiving home and        
community-based services in a direct    
impact area under a waiver under section
 #aaae or section #aiae2  7,,ii7 had    
been receiving support services from a  
family caregiver who1 as a result of the
 disaster1 is no longer available to    
provide services2 or  7,,iii7 had been  
receiving personal care1 home health1 or
 rehabilitative services under a ,state 
plan under this title or under a waiver 
granted under sections #aaae or #aiae2  
or  7ii7 are disabled 7as determined in 
accordance with the ,state plan of the  

home ,state of the individual74  7,c7   
,waiver of restrictions ,with respect to
 the provision of home and              
community-based services under this     
paragraph1 the ,secretary-- 7i7 shall   
waive any limitations on-- 7,i7 the     
number of individuals who may receive   
home or community-based services under a
 waiver described in subparagraph       
7,b77i77,i72  7,,ii7 budget neutrality  
requirements applicable to such waiver2 
and  7,,iii7 populations eligible for   
services under such waiver2 and  7ii7   
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 paragraph4  7e7    
,state reports ,each ,state shall submit
 to the ,secretary an annual report that
 includes-- 7#a7 the number of survivors
 of a disaster who were determined by   
the ,state to be relief-eligible        
survivors of a disaster in the preceding
 year2 and  7#b7 the number of          

relief-eligible survivors of a disaster 
who were determined to be eligible for1 
and enrolled in1 the ,state plan 7or    
waiver of such plan7 or the ,state child
 health plan under title ,,xxi 7or      
waiver of such plan7 other than under   
this section4  7f7 #ajj percent ,federal
 matching payments  7#a7 ,in general    
,notwithstanding section #aije7;b71 the 
,federal medical assistance percentage  
shall be equal to #ajj percent with     
respect to amounts expended by a        
,state-- 7,a7 for medical assistance    
provided in accordance with this section
 to relief-eligible survivors of a      
disaster during the relief coverage     
period of the disaster and1 in the case 
of individuals described in clause 7ii7 
or 7iii7 of subsection 7b77#e77;,c71    
during the applicable periods described 
in such clauses2 and  7,b7 that are     
directly attributable to administrative 
activities related to the provision of  
medical assistance under this section1  
including costs attributable to         

obtaining recoveries under subsection   
7g74  7#b7 ,disregard of limits on      
payments to territories ,the limitations
 on payment under subsections 7f7 and   
7g7 of section #aajh shall not apply to 
,federal payments under this title that 
are based on the ,federal medical       
assistance percentage described in      
paragraph 7#a71 and such payments shall 
be disregarded in applying such         
subsections4  7g7 ,penalty for          
fraudulent applications  7#a7           
,individual liable for costs ,if a      
,state1 as the result of verification   
activities conducted by the ,state or   
otherwise1 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 section1 the ,state shall1   
subject to paragraph 7#b71 seek recovery
 from the individual for the full amount
 of the cost of medical assistance      
provided to the individual under this   

section4  7#b7 ,exception ,the          
,secretary shall exempt a ,state from   
the requirement to seek recovery from an
 individual under paragraph 7#a7 if the 
,secretary determines that it would not 
be cost-effective for the ,state to do  
so4  7#c7 ,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 amounts4    
7h7 ,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 #aijc7u74  4    
#c4 ,promoting effective and innovative 
,state responses to increased demand for
 medical assistance following a disaster
  7a7 ,guidance on increasing access to 

providers ,not later than ,january #a1  
#bjbg1 the ,secretary of ,health and    
,human ,services 7in this section       
referred to as the ,secretary7 shall    
issue 7and update as the ,secretary     
determines necessary7 guidance to ,state
 ,medicaid directors on best practices  
for-- 7#a7 expediting the approval of   
providers under a ,state ,medicaid plan 
under title ,,xix of the ,social        
,security ,act 7#db ,u4,s4,c4 #acif et  
seq471 or waiver of such plan1 after a  
disaster to meet increased demand for   
medical assistance under the plan or    
waiver from relief-eligible survivors   
7as defined in section #aidi7;b77#e7 of 
such ,act7 of disasters2 and  7#b7 using
 out-of-,state providers to provide care
 to relief-eligible survivors of a      
disaster under the plan or waiver4  7b7 
,technical assistance and support for   
innovative ,state strategies ,to respond
 to increased demand for medical        
assistance following a disasters  7#a7  
,in general ,the ,secretary shall       

provide technical assistance and support
 to ,states to develop or expand        
infrastructure1 strategies1 or          
innovations 7including through ,state   
,medicaid demonstration projects7 to    
provide medical assistance under a      
,state ,medicaid plan under title ,,xix 
of the ,social ,security ,act 7#db      
,u4,s4,c4 #acif et seq471 or a waiver of
 such a plan1 to relief-eligible        
survivors 7as defined in section        
#aidi7;b77#e7 of such ,act7 of          
disasters4  7#b7 ,report ,not later than
 #ahj days after the date of enactment  
of this ,act1 the ,secretary shall issue
 a report to ,congress detailing a plan 
of action to carry out the requirements 
of paragraph 7#a74  7c7 ,,hcbs emergency
 response corps grant program  7#a7 ,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 7#b7 to provide medical       

assistance for home and community-based 
services under a ,state ,medicaid plan  
under title ,,xix of the ,social        
,security ,act 7#db ,u4,s4,c4 #acif et  
seq47 to relief-eligible survivors 7as  
defined in section #aidi7;b77#e7 of such
 ,act7 of disasters4  7#b7 ,home and    
community-based services emergency      
response corps ,an ,,hcbs emergency     
response corps meets the requirements of
 this paragraph if it satisfies the     
following requirements3 7,a7 ,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 7as determined 
by the ,secretary74  7,b7 ,the corps is 
composed of representatives from each of
 the following3 7i7 ,voluntary          
organizations delivering assistance4    
7ii7 ,area agencies on aging 7as defined
 in section #ajb of the ,older          
,americans ,act of #aife 7#db ,u4,s4,c4 
#cjjb774  7iii7 ,the ,medicare program  
under title ,,xviii of the ,social      

,security ,act 7#db ,u4,s4,c4 #acie et  
seq474  7iv7 ,the ,state agency         
responsible for administering the ,state
 ,medicaid program under title ,,xix of 
the ,social ,security ,act 7#db         
,u4,s4,c4 #acif et seq474  7v7 ,state   
agencies serving older adults and people
 with disabilities4  7vi7 ,nonprofit    
service providers4  7vii7 ,individuals  
who are enrolled in the ,state ,medicaid
 program under title ,,xix of the       
,social ,security ,act 7#db ,u4,s4,c4   
#acif et seq47 or the ,children's       
,health ,insurance ,program under title 
,,xxi of the ,social ,security ,act 7#db
 ,u4,s4,c4 #acig;aa et seq474  7viii7   
,centers for independent living1 as     
described in part ,c of title ,,vii of  
the ,rehabilitation ,act of #aigc 7#bi  
,u4,s4,c4 #gif;f et seq474  7ix7 ,other 
organizations that address the needs of 
older adults and people with            
disabilities4  7,c7 ,the corps is led by
 a representative of a ,state or        
nonprofit agency serving older adults or

 people with disabilities4  7,d7 ,the   
corps operates under a plan to meet the 
acute and long-term services and support
 needs of relief-eligible survivors 7as 
defined in section #aidi7;b77#e7 of the 
,social ,security ,act7 of disasters1   
and is provided with the resources      
necessary to execute such plan4  7#c7   
,grants  7,a7 ,limitation ,the          
,secretary may award a grant under this 
subsection to up to #e ,states4  7,b7   
,term of grants ,grants under this      
subsection shall be made for a term of  
#b years4  7#d7 ,authorization ,there   
are authorized to be appropriated to    
carry out this subsection1 #aj1jjj1jjj  
for each of fiscal years #bjbg through  
#bjcb1 to remain available until        
expended4  #d4 ,targeted ,medicaid      
relief for direct impact areas  7a7 #ajj
 percent ,federal matching payments for 
medical assistance provided in a direct 
impact area  7#a7 ,in general ,section  
#aije of the ,social ,security ,act 7#db
 ,u4,s4,c4 #acif;d7 is amended-- 7,a7 in

 subsection 7b71 by striking and 7ii7   
and inserting 7ii71 and 7kk72 and  7,b7 
by adding at the end the following new  
subsection3  7kk7 #ajj percent ,,fmap   
for all medical assistance provided in  
disaster direct impact areas            
,notwithstanding subsection 7b71 the    
,federal medical assistance percentage  
for a ,state and fiscal year shall be   
equal to #ajj percent with respect to   
amounts expended by the ,state during   
the fiscal year for medical assistance  
for an individual who1 during the fiscal
 quarter in which the assistance is     
provided to the individual1 is a        
resident of a direct impact area of a   
disaster during the disaster's relief   
coverage period 7as such terms are      
defined in section #aidi74  4  7#b7     
,exclusion of enhanced payments from    
territorial caps ,notwithstanding any   
other provision of law1 for purposes of 
section #aajh of the ,social ,security  
,act 7#db ,u4,s4,c4 #acjh71 with respect
 to any additional amount paid to a     

territory as a result of the application
 of subsection 7kk7 of section #aije of 
the ,social ,security ,act 7#db         
,u4,s4,c4 #acif;d71 as added by         
paragraph 7#a7-- 7,a7 the limitation on 
payments to territories under           
subsections 7f7 and 7g7 of such section 
#aajh shall not apply to such additional
 amounts2 and  7,b7 such additional     
amounts shall be disregarded in applying
 such subsections4  7#c7 ,application to
 ,,chip  7,a7 ,in general ,section      
#baje7;c7 of the ,social ,security ,act 
7#db ,u4,s4,c4 #acig;ee7a77 is amended  
by adding at the end the following new  
paragraph3  7#ac7 #ajj percent match for
 assistance provided in disaster direct 
impact areas ,notwithstanding subsection
 7b71 the enhanced ,,fmap for a ,state1 
with respect to payments under          
subsection 7a7 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 who1 at the  
time the assistance is provided1 is a   
resident of a direct impact area of a   
disaster during the disaster's relief   
coverage period 7as such terms are      
defined in section #aidi7 shall be equal
 to #ajj percent4  4  7,b7 ,adjustment  
of ,,chip allotments ,section #bajd7m7  
of the ,social ,security ,act 7#db      
,u4,s4,c4 #acig;dd7m77 is amended-- 7i7 
in paragraph 7#b77;,b71 by striking and 
7#ab7 and inserting 7#ab71 and 7#ac72   
and  7ii7 by adding at the end the      
following new paragraph3  7#ac7         
,adjusting allotments to account for    
increased federal payments for          
assistance provided in disaster direct  
impact areas ,if a ,state 7including the
 ,district of ,columbia and each        
commonwealth and territory7 receives a  
payment for a fiscal year under         
subsection 7a7 of section #baje for     
expenditures that are subject to the    
enhanced ,,fmap specified under         

subsection 7c77#ac7 of such section--   
7,a7 the amount of the allotment        
determined for the ,state under this    
subsection for such fiscal year shall be
 increased by the product of-- 7i7 the  
amount of such expenditures that the    
,state is projected to make for such    
fiscal year2 and  7ii7 a percentage     
equal to #ajj percent reduced by a      
number of percentage points equal to the
 enhanced ,,fmap determined for the     
,state and fiscal year under subsection 
7b7 of section #baje2 and  7,b7 once    
actual expenditures for the fiscal year 
are available1 the amount of such       
allotment1 as increased under           
subparagraph 7,a71 shall be further     
increased or reduced1 as appropriate1 on
 the basis of the difference between--  
7i7 the amount of the increase          
determined under subparagraph 7,a72 and 
7ii7 the product of-- 7,i7 the actual   
amount of ,state expenditures that are  
subject to the enhanced ,,fmap specified
 under section #baje7;c77#ac72 and      

7,,ii7 the percentage determined for the
 ,state under subparagraph 7,a77ii74  4 
7b7 ,moratorium on redeterminations     
,during the relief coverage period 7as  
defined in paragraph 7#d7 of section    
#aidi7;b7 of the ,social ,security ,act1
 as added by section #b77 of a disaster1
 a ,state that contains a direct impact 
area 7as defined in paragraph 7#b7 of   
such section7 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 7#db  
,u4,s4,c4 #acif et seq41 #acig;aa7 with 
respect to individuals who reside in    
such area4  #e4 ,authority to waive     
requirements during national emergencies
 with respect to evacuees from an       
emergency area ,section #aace7;g77#a7 of
 the ,social ,security ,act 7#db        
,u4,s4,c4 #acbj;b-#e7;g77#a77 is        
amended-- 7#a7 in subparagraph 7,a71 by 
striking subparagraph 7,b7 and inserting
 subparagraphs 7,b7 and 7,c72 and  7#b7 

by adding at the end the following new  
subparagraph3  7,c7 ,additional areas   
,any geographical area in which the     
,secretary determines there are a       
significant number of evacuees from an  
area described in subparagraph 7,a7     
shall also be considered to be an       
emergency area for purposes of this     
section4  4  #f4 ,exclusion of disaster 
relief coverage period in computing     
,medicare part ,b late enrollment period
 ,section #ahci7;b7 of such ,act 7#db   
,u4,s4,c4 #acier7b77 is amended1 in the 
second sentence1 by inserting before the
 period at the end the following3 or1 in
 the case of an individual who is a     
survivor of a disaster 7as defined in   
paragraph 7#f7 of section #aidi7;b771   
any month any part of which is within   
the relief coverage period 7as defined  
in paragraph 7#d7 of such section7 of   
such disaster4  #g4 ,effective date  7a7
 ,in general ,subject to subsection 7b71
 this ,act and the amendments made by   
this ,act shall take effect on the date 

of enactment of this ,act4  7b7 ,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 7other than 
legislation appropriating funds7 in     
order for the plan to meet the          
additional requirement imposed by this  
section1 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 #ast day of the #ast calendar       
quarter beginning after the close of the
 #ast regular session of the ,state     
legislature that ends after the #a-year 
period beginning with the date of the   
enactment of this section4 ,for purposes
 of the preceding sentence1 in the case 
of a ,state that has a #b-year          
legislative session1 each year of the   
session is deemed to be a separate      

regular session of the ,state           
legislature4  #h4 ,impact evaluation and
 reporting  7a7 ,in general ,not later  
than #bd months after the date of       
enactment of this ,act1 the ,secretary  
of ,health and ,human ,services shall   
enter into a #e year agreement through a
 contract1 grant1 or cooperative        
agreement with an independent nonprofit 
entity experienced in conducting        
evaluations of program and systems      
change efforts to-- 7#a7 conduct a      
multi-year evaluation on the impact of  
this ,act1 with respect to              
relief-eligible survivors 7including    
people with disabilities and pregnant   
individuals72 and  7#b7 prepare the     
reports described in subsection 7c74    
7b7 ,evaluation ,in carrying out        
subsection 7a77#a71 the entity awarded a
 contract1 grant1 or cooperative        
agreement under this section shall      
evaluate at a minimum-- 7#a7 the        
availability of and access to ,medicaid 
services for relief-eligible survivors  

under the ,medicaid program nationally  
and in each ,state1 territory and tribal
 organization1 including scope and      
coverage of services1 provision of home 
and community-based services and        
extended mental health and care         
coordination services2 and provider     
capacity2  7#b7 the demographics of     
individuals receiving these benefits1   
including individuals with disabilities 
and pregnant individuals2 and  7#c7     
actions taken by ,states to comply with 
this ,act1 including coordination of    
efforts between states1 coordination    
between state agencies and qualified    
providers1 and activities of ,,hcbs     
emergency response corps 7as described  
in section #c7;c774  7c7 ,reports ,the  
,secretary of ,health and ,human        
,services shall submit to the ,committee
 on ,finance of the ,senate1 the        
,special ,committee on ,aging of the    
,senate1 the ,committee on ,energy and  
,commerce of the ,house of              
,representatives1 and the ,committee on 

,ways and ,means of the ,house of       
,representatives the following reports  
on the evaluation conducted under       
subsection 7a77#a73 7#a7 ,an interim    
report on the evaluation1 to be         
submitted not later than #c years after 
the evaluation commences4  7#b7 ,a      
follow-up report on such evaluation1 to 
be submitted not later than #bd months  
after the date on which the interim     
report is issued4