Temporary Medicaid Disaster Relief Act of 2005 - States that the purpose of this Act is to: (1) ensure all those affected by Hurricane Katrina have access to health coverage and medical care through the Medicaid program; and (2) authorize temporary changes in such program to guarantee and expedite that coverage and access to care.
Provides that during the disaster relief period from August 29, 2005, to September 30, 2006, any state may provide temporary medical assistance to Katrina Survivors under a state Medicaid plan established under title XIX of the Social Security Act.
Sets at 100% the federal medical assistance percentage (FMAP) for providing medical assistance under a state Medicaid plan to Katrina Survivors, or in the case of a direct impact state, to any individual who is provided medical assistance under the state Medicaid plan during the disaster relief period.
Provides that if the FMAP determined for a state for FY2006 is less than the FMAP determined for FY2005, the FY2005 FMAP shall apply to the state for FY2006 only for Medicaid purposes.
Continues Medicaid drug coverage for dual eligibles.
Excludes the disaster relief period in computing part B late enrollment penalty.
Provides that, in the case of a Katrina Survivor, the initial enrollment period under part D (Voluntary Prescription Drug Benefit Program) shall in no case end before May 15, 2007.
Directs the Secretary of Health and Human Services to establish documentation rules for Katrina Surivors, with respect to premium and cost-sharing subsidies for low-income individuals, which take into account the loss and unavailability of documents due to Hurricane Katrina.
[Congressional Bills 109th Congress]
[From the U.S. Government Publishing Office]
[H.R. 3698 Introduced in House (IH)]
109th CONGRESS
1st Session
H. R. 3698
To provide temporary Medicaid disaster relief in response to Hurricane
Katrina, and for other purposes.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
September 8, 2005
Mr. Dingell (for himself, Mr. Jefferson, Mr. Davis of Alabama, Mr.
Thompson of Mississippi, Ms. Pelosi, Mrs. Capps, Mr. Brown of Ohio, Mr.
Waxman, Mr. Stark, Mr. Rangel, Mr. Gene Green of Texas, and Mr.
Melancon) introduced the following bill; which was referred to the
Committee on Energy and Commerce, and in addition to the Committee on
Ways and Means, for a period to be subsequently determined by the
Speaker, in each case for consideration of such provisions as fall
within the jurisdiction of the committee concerned
_______________________________________________________________________
A BILL
To provide temporary Medicaid disaster relief in response to Hurricane
Katrina, and for other purposes.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION. 1. SHORT TITLE; PURPOSE.
(a) Short Title.--This Act may be cited as the ``Temporary Medicaid
Disaster Relief Act of 2005''.
(b) Purpose.--The purpose of this Act is to ensure all those
affected by Hurricane Katrina have access to health coverage and
medical care through the medicaid program and to authorize temporary
changes in such program to guarantee and expedite that coverage and
access to care.
SEC. 2. DISASTER RELIEF PERIOD.
For purposes of this Act, the term ``disaster relief period'' means
the period beginning on August 29, 2005, and ending on September 30,
2006.
SEC. 3. TEMPORARY MEDICAID COVERAGE FOR KATRINA SURVIVORS.
(a) Definitions.--In this Act:
(1) Katrina survivor.--
(A) In general.--The term ``Katrina Survivor''
means an individual who is described in subparagraph
(B) or (C).
(B) Residents of disaster localities.--
(i) In general.--An individual who, on any
day during the week preceding the declaration
of a public health emergency on August 29,
2005, had a residence in--
(I) a parish in the State of
Louisiana that is among the parishes
that the Federal Emergency Management
Agency of the Emergency Preparedness
and Response Directorate of the
Department of Homeland Security
declared on September 4, 2005, to be
Federal Disaster Parishes; or
(II) a county in the State of
Alabama or Mississippi that is among
the counties such Agency declared
Federal Disaster Counties on September
4, 2005.
(ii) Authority to rely on website posted
designations.--The Secretary of Health and
Human Services shall post on the Internet
website for the Centers for Medicare & Medicaid
Services a list of parishes and counties
identified as Federal Disaster Parishes or
Counties. Any State which provides medical
assistance to Katrina Survivors on the basis of
such posting and in accordance with this Act
shall be held harmless if it is subsequently
determined that the provision of such
assistance was in error.
(C) Individuals who lost employment.--An individual
who, on any day during the week preceding the
declaration of a public health emergency on August 29,
2005, had a residence in a direct impact State and lost
their employment since Hurricane Katrina.
(D) Construction.--A Katrina Survivor shall be
treated as being ``from'' the State of residence
described in subparagraph (B)(i) or (C), as the case
may be.
(E) Treatment of current medicaid beneficiaries.--
Nothing in this Act shall be construed as preventing an
individual who is otherwise entitled to medical
assistance under title XIX of the Social Security Act
from being treated as a Katrina Survivor under this
Act.
(F) Treatment of homeless persons.--For purposes of
this Act, in the case of an individual who was homeless
on any day during the week described in subparagraph
(B)(i), the individual's ``residence'' shall be deemed
to be the place of residence as otherwise determined
for such an individual under title XIX of the Social
Security Act.
(2) Direct impact state.--The term ``direct impact State''
means the State of Louisiana, Alabama, and Mississippi.
(b) Rules for Providing Temporary Medical Assistance to Katrina
Survivors.--During the disaster relief period, any State may provide
medical assistance to Katrina Survivors under a State medicaid plan
established under title XIX of the Social Security Act in accordance
with the following:
(1) Uniform eligibility rules.--
(A) No income, resources, residency, or categorical
eligibility requirements.--Such assistance shall be
provided without application of any income or resources
test, State residency, or categorical eligibility
requirements.
(B) Streamlined eligibility procedures.--The State
shall use the following streamlined procedures in
processing applications and determining eligibility for
medical assistance for Katrina Survivors:
(i) A common 1-page application form
developed by the Secretary of Health and Human
Services in consultation with the National
Association of State Medicaid Directors. Such
form shall include notice regarding the
penalties for making a fraudulent application
under paragraph (4) and shall require the
applicant to assign to the State any rights of
the applicant (or any other person who is a
Katrina Survivor and on whose behalf the
applicant has the legal authority to execute an
assignment of such rights) under any group
health plan or other third-party coverage for
health care.
(ii) Self-attestation by the applicant that
the applicant is a Katrina Survivor.
(iii) No requirement for documentation
evidencing the basis on which the applicant
qualifies to be a Katrina Survivor.
(iv) Issuance of a Medicaid eligibility
card to an applicant who completes such
application, including the self-attestation
required under clause (ii). Such card shall be
valid during the disaster relief period.
(v) If an applicant completes the
application and presents it to a provider or
facility participating in the State medicaid
plan that is qualified to make presumptive
eligibility determinations under such plan
(which at a minimum shall consist of facilities
identified in section 1902(a)(55) of the Social
Security Act (42 U.S.C. 1396a(a)(55)) and it
appears to the provider that the applicant is a
Katrina Survivor based on the information in
the application, the applicant will be deemed
to be a Katrina Survivor eligible for medical
assistance in accordance with this section,
subject to paragraph (3).
(vi) Continuous eligibility, without the
need for any redetermination of eligibility,
for the duration of the disaster relief period.
(C) Determination of eligibility for coverage after
the termination of the disaster relief period.--In the
case of a Katrina Survivor who is receiving medical
assistance from a State, prior to the termination of
the disaster relief period, the State providing such
assistance shall determine whether the Katrina Survivor
is eligible for continued medical assistance under the
State's eligibility rules otherwise applicable under
the State medicaid plan. If a State determines that the
individual is so eligible, the State shall provide the
individual with written notice of the determination and
provide the individual with continued coverage for such
medical assistance for so long as the individual
remains eligible under such otherwise applicable
eligibility rules. If a State determines that the
individual is not so eligible, the State shall provide
the individual with written notice of the
determination, including the reasons for such
determination.
(2) Scope of coverage same as categorically needy.--The
State shall treat Katrina Survivors as individuals eligible for
medical assistance under the State plan under title XIX of the
Social Security Act on the basis of section 1902(a)(10)(A)(i)
of the Social Security Act (42 U.S.C. 1396a(a)(10)(A)(i)), with
coverage for such assistance retroactive to August 29, 2005.
(3) Verification of status as a katrina survivor.--
(A) In general.--The State shall make a good faith
effort to verify the status of a Katrina Survivor
enrolled in the State Medicaid plan under the
provisions of this section after the determination of
the eligibility of the Survivor for medical assistance
under such plan.
(B) Evidence of verification.--A State may satisfy
the verification requirement under subparagraph (A)
with respect to a Katrina Survivor by showing that the
State providing medical assistance obtained information
from the Social Security Administration, the Internal
Revenue Service, or the State Medicaid Agency of the
direct impact State.
(C) Disallowance of payments for failure to make
good faith effort.--If, with respect to the status of a
Katrina Survivor enrolled in a State Medicaid plan, the
State fails to make the good faith effort required
under subparagraph (A), and the Secretary determines
that the individual so enrolled is not a Katrina
Survivor, the Secretary shall disallow all Federal
payments made to the State that are directly
attributable to medical assistance provided or
administrative costs incurred with respect to the
individual during the disaster relief period.
(4) Penalty for fraudulent applications.--
(A) Individual liable for costs.--If a State, as
the result of verification activities conducted under
paragraph (3), determines after a fair hearing that an
individual has knowingly made a false self-attestation
described in paragraph (1)(B)(ii), the State may,
subject to subparagraph (B), seek recovery from the
individual for the full amount of the cost of medical
assistance provided to the individual under this
section.
(B) Exception.--The Secretary shall exempt a State
from seeking recovery under subparagraph (A) if the
Secretary determines that it would not be cost-
effective for the State to do so.
(C) Reimbursement to the federal government.--Any
amounts recovered by a State in accordance with this
paragraph shall be returned to the Federal government,
except that a State's administrative costs attributable
to obtaining such recovery shall be reimbursed by the
Federal government in accordance with section 4(a)(2).
(5) Exemption from error rate penalties.--All payments
attributable to providing medical assistance to Katrina
Survivors in accordance with this section shall be disregarded
for purposes of section 1903(u) of the Social Security Act.
SEC. 4. TEMPORARY DISASTER RELIEF FOR STATES UNDER MEDICAID.
(a) Increase in Federal Matching Rate.--
(1) 100 percent fmap for medical assistance.--
Notwithstanding section 1905(b) of the Social Security Act (42
U.S.C. 1396d(b)), the Federal medical assistance percentage for
providing medical assistance under a State medicaid plan under
title XIX of such Act to Katrina Survivors or, in the case of a
direct impact State, to any individual who is provided medical
assistance under the State medicaid plan during the disaster
relief period, shall be 100 percent.
(2) 100 percent federal match for certain administrative
costs.--Notwithstanding paragraph (7) of section 1903(a) of
such Act (42 U.S.C. 1396b(a)), or any other paragraph of such
section, the Federal matching rate for costs directly
attributable to all administrative activities that relate to
the enrollment of Katrina Survivors under section 3 in a State
medicaid plan, verification of the status of such Survivors,
processing of claims for payment for medical assistance
provided to such Survivors under such section, and recovery
costs under section 3(b)(4)(C), shall be 100 percent. The
Secretary shall issue guidance not later 30 days after the date
of enactment of this Act on the implementation of this
paragraph.
(b) Limitation on Reduction of FMAP for Fiscal Year 2006 for Any
State.--If the Federal medical assistance percentage (as defined in
section 1905(b) of the Social Security Act) determined for a State for
fiscal year 2006 is less than the Federal medical assistance percentage
determined for the State for fiscal year 2005, the Federal medical
assistance percentage for the State for fiscal year 2005 shall apply to
the State for fiscal year 2006 only for purposes of title XIX of the
Social Security Act.
(c) Temporary Suspension of Medicare ``Clawback'' and Postponement
of Cut-Off of Medicaid Prescription Drug Funding in Affected States.--
(1) Suspension in application of ``clawback''.--Section
1935(c) of the Social Security Act (42 U.S.C. 1396u-5(c)) shall
not apply, subject to paragraph (3), before January 2007 to a
direct impact State or to a State that experiences a
significant influx of Katrina Survivors.
(2) Continuation of medicaid drug coverage for dual
eligibles.--Section 1935(d)(1) of such Act shall also not
apply, subject to paragraph (3), before January 2007 to a part
D eligible individual who is a Katrina Survivor.
(3) Termination of application of subsection.--Paragraphs
(1) and (2) shall no longer apply to a State or a Katrina
Survivor, respectively, if the Secretary determines, after
consultation with the State, that enrollment of all part D
eligible individuals in the State under part D of title XVIII
of the Social Security Act who are described in section
1935(c)(6)(A)(ii) of such Act can be achieved without a
discontinuation in prescription drug coverage for any such
individual.
(4) Definition.--For purposes of this subsection, the term
``State that experiences a significant influx of Katrina
Survivors'' means those States, including Arkansas, Florida,
Oklahoma, and Texas, that the Secretary of Health and Human
Services identifies as having a significant in-migration of
Katrina Survivors.
SEC. 5. ACCOMMODATION OF SPECIAL NEEDS OF KATRINA SURVIVORS UNDER
MEDICARE PROGRAM.
(a) Exclusion of Disaster Relief Period in Computing Part B Late
Enrollment Penalty.--In applying the first sentence of section 1839(b)
of the Social Security Act (42 U.S.C. 1395r(b)) in the case of a
Katrina Survivor, there shall not be taken into account any month any
part of which is within the disaster relief period or within the 2-
month period following the end of such disaster relief period.
(b) Part D.--
(1) Extension of initial enrollment period.--In the case of
a Katrina Survivor, the initial enrollment period under section
1860D-1(b)(2) of the Social Security Act (42 U.S.C. 1395w-
101(b)(2)) shall in no case end before May 15, 2007.
(2) Flexibility in documentation for low-income
subsidies.--For purposes of carrying out section 1860D-14 of
the Social Security Act (42 U.S.C. 1395w-114), with respect to
Katrina Survivors, the Secretary of Health and Human Services
shall establish documentation rules for Katrina Survivors which
take into account the loss and unavailability of documents due
to Hurricane Katrina.
<all>
Introduced in House
Introduced in House
Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
Referred to the Subcommittee on Health.
Referred to the Subcommittee on Health.
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