S.Amdt. 2025

1. Adds TITLE __. TEMPORARY MEDICAID DISASTER RELIEF wherever appropriate

   Adds a title

   Inserted: TITLE __. TEMPORARY MEDICAID DISASTER RELIEF

   Inserted: SEC. __01. SHORT TITLE OF TITLE; PURPOSE.

   Inserted: (a) Short Title of Title.--This title may be cited as the "Temporary Medicaid Disaster Relief Act of 2005".

   Inserted: (b) Purpose.--The purpose of this title 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.

   Inserted: SEC. __02. DISASTER RELIEF PERIOD.

   Inserted: (a) In General.--For purposes of this title, the term "disaster relief period" means the period beginning on August 29, 2005, and, subject to subsection (b), ending on February 28, 2006.

   Inserted: (b) Presidential Authority To Extend Disaster Relief Period.--

   Inserted: (1) In general.--The President shall extend the application of section __03 and paragraphs (1) and (2) of section __04(a) until September 30, 2006, unless the President determines that all Katrina Survivors would have sufficient access to health care without such an extension. In the case of such an extension, the reference to "February 28, 2006" in subsection (a) shall be considered to be a reference to "September 30, 2006".

   Inserted: (2) Notice to congress.--The President shall notify the Majority and Minority Leaders of the Senate, the Speaker of the House of Representatives, the Minority Leader of the House of Representatives, and the Chairs and Ranking Members of the Committee on Finance of the Senate and the Committees on Energy and Commerce and Ways and Means of the House of Representatives at least 30 days prior to--

   Inserted: (A) extending the application of such sections; or

   Inserted: (B) if the President determines not to extend the application of such sections, February 28, 2006.

   Inserted: SEC. __03. TEMPORARY MEDICAID COVERAGE FOR KATRINA SURVIVORS.

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   Inserted: (a) Definitions.--In this title:

   Inserted: (1) Katrina survivor.--

   Inserted: (A) In general.--The term "Katrina Survivor" means an individual who is described in subparagraph (B) or (C).

   Inserted: (B) Residents of disaster localities.--

   Inserted: (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--

   Inserted: (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

   Inserted: (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.

   Inserted: (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 title shall be held harmless if it is subsequently determined that the provision of such assistance was in error.

   Inserted: (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.

   Inserted: (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.

   Inserted: (E) Treatment of current medicaid beneficiaries.--Nothing in this title 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 title.

   Inserted: (F) Treatment of homeless persons.--For purposes of this title, 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.

   Inserted: (2) Direct impact state.--The term "direct impact State" means the State of Louisiana, Alabama, and Mississippi.

   Inserted: (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:

   Inserted: (1) Uniform eligibility rules.--

   Inserted: (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.

   Inserted: (B) Streamlined eligibility procedures.--The State shall use the following streamlined procedures in processing applications and determining eligibility for medical assistance for Katrina Survivors:

   Inserted: (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.

   Inserted: (ii) Self-attestation by the applicant that the applicant is a Katrina Survivor.

   Inserted: (iii) No requirement for documentation evidencing the basis on which the applicant qualifies to be a Katrina Survivor.

   Inserted: (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.

   Inserted: (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).

   Inserted: (vi) Continuous eligibility, without the need for any redetermination of eligibility, for the duration of the disaster relief period.

   Inserted: (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.

   Inserted: (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.

   Inserted: (3) Verification of status as a katrina survivor.--

   Inserted: (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.

   Inserted: (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 for the direct impact State.

   Inserted: (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.

   Inserted: (4) Penalty for fraudulent applications.--

   Inserted: (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.

   Inserted: (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.

   Inserted: (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 __04(a)(2).

   Inserted: (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.

   Inserted: SEC. __04. TEMPORARY DISASTER RELIEF FOR STATES UNDER MEDICAID.

   Inserted: (a) Increase in Federal Matching Rate.--

   Inserted: (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.

   Inserted: (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 __03 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 __03(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.

   Inserted: (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.

   Inserted: (c) Temporary Suspension of Medicare "Clawback" and Postponement of Cut-Off of Medicaid Prescription Drug Funding in Affected States.--

   Inserted: (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.

   Inserted: (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.

   Inserted: (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.

   Inserted: (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.

   Inserted: SEC. __05. ACCOMMODATION OF SPECIAL NEEDS OF KATRINA SURVIVORS UNDER MEDICARE PROGRAM..

   Inserted: (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.

   Inserted: (b) Part D.--

   Inserted: (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.

   Inserted: (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.

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