Disaster Relief Medicaid Act

II 116TH CONGRESS 1ST SESSION S. 1754 To provide Medicaid assistance to individuals and families affected by a disaster or emergency, and for other purposes. IN THE SENATE OF THE UNITED STATES JUNE 10, 2019 Mr. CASEY (for himself, Mr. BROWN, Mr. BLUMENTHAL, Ms. HARRIS, and Mrs. GILLIBRAND) introduced the following bill; which was read twice and referred to the Committee on Finance A BILL To provide Medicaid assistance to individuals and families affected by a disaster or emergency, and for other purposes. Be it enacted by the Senate and House of Representa- 1 tives of the United States of America in Congress assembled, 2 SECTION 1. SHORT TITLE. 3 This Act may be cited as the ‘‘Disaster Relief Med- 4 icaid Act’’. 5 SEC. 2. MEDICAID RELIEF FOR DISASTER SURVIVORS. 6 Title XIX of the Social Security Act (42 U.S.C. 1396 7 et seq.) is amended— 8 (1) in section 1902(a)— 9 VerDate Sep 11 2014 20:35 Jun 11, 2019 Jkt 089200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\S1754.IS S1754 pamtmann on DSKBFK8HB2PROD with BILLS 2 •S 1754 IS (A) in paragraph (85), by striking ‘‘; and’’ 1 and inserting a semicolon; 2 (B) in paragraph (86), by striking the pe- 3 riod at the end and inserting ‘‘; and’’; and 4 (C) by inserting after paragraph (86) the 5 following new paragraph: 6 ‘‘(87) beginning January 1, 2020, provide for 7 making medical assistance available to relief-eligible 8 survivors of disasters during relief coverage periods 9 in accordance with section 1947.’’; and 10 (2) by adding at the end the following new sec- 11 tion: 12 ‘‘SEC. 1947. DISASTER RELIEF MEDICAID FOR SURVIVORS 13 OF MAJOR DISASTERS. 14 ‘‘(a) IN GENERAL.—Notwithstanding any other pro- 15 vision of this title, a State plan shall provide medical as- 16 sistance to a relief-eligible survivor of a disaster in accord- 17 ance with this section. 18 ‘‘(b) DEFINITIONS.—In this section: 19 ‘‘(1) DISASTER.—The term ‘disaster’ means a 20 major disaster— 21 ‘‘(A) that is declared on or after January 22 1, 2020, by the President in accordance with 23 section 401 of the Robert T. Stafford Disaster 24 VerDate Sep 11 2014 20:35 Jun 11, 2019 Jkt 089200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\S1754.IS S1754 pamtmann on DSKBFK8HB2PROD with BILLS 3 •S 1754 IS Relief and Emergency Assistance Act (42 1 U.S.C. 5170); and 2 ‘‘(B) which the President has determined 3 warrants individual and public assistance from 4 the Federal Government under such Act. 5 ‘‘(2) DIRECT IMPACT AREA.— 6 ‘‘(A) IN GENERAL.—The term ‘direct im- 7 pact area’ means, with respect to a disaster, the 8 geographic area in which the disaster exists. 9 ‘‘(B) WEBSITE POSTING OF DIRECT IM- 10 PACT AREAS.—As soon as practicable after a 11 disaster is declared (as described in paragraph 12 (1)(A)), the Secretary shall post on the website 13 of the Centers for Medicare & Medicaid Serv- 14 ices a list of the areas identified as the direct 15 impact areas of the disaster. 16 ‘‘(3) HOME STATE.—The term ‘home State’ 17 means, with respect to a survivor of a disaster, the 18 State in which the survivor was a resident during 19 the 7-day period preceding the date on which the 20 disaster is declared (as described in paragraph 21 (1)(A)). 22 ‘‘(4) RELIEF COVERAGE PERIOD.—The term 23 ‘relief coverage period’ means, with respect to a dis- 24 aster, the period that begins on the date the disaster 25 VerDate Sep 11 2014 20:35 Jun 11, 2019 Jkt 089200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\S1754.IS S1754 pamtmann on DSKBFK8HB2PROD with BILLS 4 •S 1754 IS is declared (as described in paragraph (1)(A)) and 1 ends on the day that is 2 years after such date. 2 ‘‘(5) RELIEF-ELIGIBLE SURVIVOR.— 3 ‘‘(A) IN GENERAL.—The term ‘relief-eligi- 4 ble survivor’ means an individual who is a sur- 5 vivor of a disaster whose family income does not 6 exceed the higher of— 7 ‘‘(i) 133 percent (or, in the case of a 8 survivor who is a pregnant woman, a child, 9 or a recipient of benefits under title II on 10 the basis of a disability, 200 percent) of 11 the poverty line; or 12 ‘‘(ii) the income eligibility standard 13 that would otherwise apply to the survivor 14 under the State plan or waiver of the sur- 15 vivor’s host State. 16 ‘‘(B) DISREGARD OF UNEMPLOYMENT IN- 17 COME.—For purposes of this section, and not- 18 withstanding section 1902(e)(14)(B), the in- 19 come of a survivor of a disaster shall not in- 20 clude any amount received during the relief cov- 21 erage period of the disaster under a law of the 22 United States or a State which is in the nature 23 of unemployment compensation. 24 ‘‘(6) SURVIVOR.— 25 VerDate Sep 11 2014 20:35 Jun 11, 2019 Jkt 089200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\S1754.IS S1754 pamtmann on DSKBFK8HB2PROD with BILLS 5 •S 1754 IS ‘‘(A) IN GENERAL.—The term ‘survivor’ 1 means, with respect to a disaster, an individual 2 who is described in subparagraph (B) or (C). 3 ‘‘(B) RESIDENTS AND EVACUEES OF DI- 4 RECT IMPACT AREAS.—An individual described 5 in this subparagraph is an individual who, on 6 any day during the 7-day period preceding the 7 date on which a disaster is declared (as de- 8 scribed in paragraph (1)(A)), has a primary 9 residence in the disaster’s direct impact area. 10 ‘‘(C) INDIVIDUALS WHO LOST EMPLOY- 11 MENT.—An individual described in this sub- 12 paragraph is an individual— 13 ‘‘(i) whose worksite, on any day dur- 14 ing the 7-day period preceding the date on 15 which a disaster is declared (as so de- 16 scribed), was located in the disaster’s di- 17 rect impact area; 18 ‘‘(ii) who was employed by an em- 19 ployer that— 20 ‘‘(I) conducted an active trade or 21 business in such area on any day dur- 22 ing such 7-day period; and 23 ‘‘(II) was unable to operate such 24 trade or business as a result of the 25 VerDate Sep 11 2014 20:35 Jun 11, 2019 Jkt 089200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\S1754.IS S1754 pamtmann on DSKBFK8HB2PROD with BILLS 6 •S 1754 IS disaster on any day during the disas- 1 ter’s relief coverage period; and 2 ‘‘(iii) whose employment with such 3 employer was terminated. 4 ‘‘(D) TREATMENT OF HOMELESS PER- 5 SONS.—For purposes of subparagraph (B), in 6 the case of an individual who was homeless on 7 any day during the 7-day period preceding the 8 date on which a disaster is declared (as so de- 9 scribed), the individual’s ‘residence’ during such 10 period shall be determined as it would otherwise 11 be determined for purposes of this title. 12 ‘‘(E) EFFECT OF CONCURRENT ELIGI- 13 BILITY FOR MEDICAID.—An individual’s eligi- 14 bility for medical assistance under a State plan 15 (or waiver of such plan) on a basis other than 16 under this section shall not prevent the indi- 17 vidual from being treated as a survivor under 18 this section, and the rights afforded to an indi- 19 vidual who is eligible for or enrolled under a 20 State plan (or waiver) shall not be affected by 21 the individual’s receipt of medical assistance as 22 a relief-eligible survivor of a disaster in accord- 23 ance with this section. 24 ‘‘(c) ELIGIBILITY.— 25 VerDate Sep 11 2014 20:35 Jun 11, 2019 Jkt 089200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\S1754.IS S1754 pamtmann on DSKBFK8HB2PROD with BILLS 7 •S 1754 IS ‘‘(1) SIMPLIFIED APPLICATION.— 1 ‘‘(A) IN GENERAL.—For purposes of deter- 2 mining eligibility for medical assistance under 3 this section, each State shall use a simplified, 4 1-page application form (as developed by the 5 Secretary in consultation with the National As- 6 sociation of State Medicaid Directors), which 7 shall— 8 ‘‘(i) require an applicant for medical 9 assistance in accordance with this section 10 as a survivor of a disaster to— 11 ‘‘(I) provide the applicant’s ex- 12 pected address for the duration of the 13 relief coverage period of the disaster; 14 and 15 ‘‘(II) agree to update the infor- 16 mation described in subclause (I) if it 17 changes during such period; 18 ‘‘(ii) provide notice of the penalties for 19 making a fraudulent application described 20 in subsection (h); 21 ‘‘(iii) require the applicant to assign 22 to the State any rights of the applicant (or 23 any other individual who is a relief-eligible 24 survivor and on whose behalf the applicant 25 VerDate Sep 11 2014 20:35 Jun 11, 2019 Jkt 089200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\S1754.IS S1754 pamtmann on DSKBFK8HB2PROD with BILLS 8 •S 1754 IS has the legal authority to execute an as- 1 signment of such rights) in accordance 2 with the requirements of section 1912; 3 ‘‘(iv) require the applicant to list any 4 health insurance coverage in which the ap- 5 plicant was enrolled immediately prior to 6 submitting the application for medical as- 7 sistance under this section; and 8 ‘‘(v) require the applicant to self-at- 9 test that the applicant— 10 ‘‘(I) is a relief-eligible survivor of 11 the disaster; and 12 ‘‘(II) if applicable, requires home 13 and community-based services. 14 ‘‘(B) NO DOCUMENTATION REQUIRE- 15 MENT.—A State shall not require an applicant 16 for medical assistance as a survivor of a dis- 17 aster under this section to provide any docu- 18 mentation or other evidence— 19 ‘‘(i) of the applicant’s status as a re- 20 lief-eligible survivor; and 21 ‘‘(ii) if applicable, that the applicant 22 requires home and community-based serv- 23 ices. 24 VerDate Sep 11 2014 20:35 Jun 11, 2019 Jkt 089200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\S1754.IS S1754 pamtmann on DSKBFK8HB2PROD with BILLS 9 •S 1754 IS ‘‘(C) PRESUMPTIVE ELIGIBILITY.—If an 1 applicant submits a completed application to a 2 provider or facility described in section 3 1902(a)(55) (or any other provider or facility 4 participating in the State plan or under a waiv- 5 er of such plan that is qualified to make pre- 6 sumptive eligibility determinations under such 7 plan or waiver) and it appears to the provider 8 or facility that the applicant is a relief-eligible 9 survivor of a disaster who is eligible for medical 10 assistance under the plan based on the informa- 11 tion in the application, the applicant will be 12 deemed to be a relief-eligible survivor for med- 13 ical assistance under such plan in accordance 14 with this section. 15 ‘‘(D) CONTINUOUS ELIGIBILITY.—An ap- 16 plicant who is determined to be a relief-eligible 17 survivor of a disaster shall be eligible for med- 18 ical assistance under this section, without the 19 need for any redetermination of eligibility, for 20 the duration of the relief coverage period of the 21 disaster. 22 ‘‘(E) TIMELY PROCESSING OF APPLICA- 23 TIONS.—Each State shall establish such proc- 24 esses as are necessary to ensure that applica- 25 VerDate Sep 11 2014 20:35 Jun 11, 2019 Jkt 089200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\S1754.IS S1754 pamtmann on DSKBFK8HB2PROD with BILLS 10 •S 1754 IS tions for medical assistance under this section 1 are processed in a timely manner. 2 ‘‘(2) ISSUANCE OF DISASTER RELIEF MEDICAID 3 ELIGIBILITY CARD.—A State shall issue a disaster 4 relief Medicaid eligibility card to each applicant who 5 is determined to be a relief-eligible survivor of a dis- 6 aster and eligible for medical assistance under this 7 section, which shall be valid for the duration of the 8 relief coverage period of the disaster. 9 ‘‘(3) VERIFICATION OF STATUS AS A RELIEF- 10 ELIGIBLE SURVIVOR.— 11 ‘‘(A) IN GENERAL.—The State shall make 12 a good faith effort to verify the status of an in- 13 dividual who is enrolled in the State plan as a 14 relief-eligible survivor of a disaster in accord- 15 ance with this section. Such effort shall not 16 delay the determination of the eligibility of the 17 individual for medical assistance under this sec- 18 tion. 19 ‘‘(B) EVIDENCE OF VERIFICATION.—A 20 State may satisfy the verification requirement 21 under subparagraph (A) with respect to an in- 22 dividual by showing that the State obtained in- 23 formation from the Social Security Administra- 24 tion, the Internal Revenue Service, or, if appli- 25 VerDate Sep 11 2014 20:35 Jun 11, 2019 Jkt 089200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6201 E:\BILLS\S1754.IS S1754 pamtmann on DSKBFK8HB2PROD with BILLS 11 •S 1754 IS cable, the State Medicaid agency of the home 1 State of the individual. 2 ‘‘(4) DETERMINATION BY EXPRESS LANE AGEN- 3 CY.—Any determination or redetermination of eligi- 4 bility or verification of status made under this sec- 5 tion shall be made by an Express Lane agency (as 6 defined in section 1902(e)(13)(F)). 7 ‘‘(d) TERMINATION OF ELIGIBILITY.— 8 ‘‘(1) IN GENERAL.—Except as provided in para- 9 graph (4), no medical assistance shall be provided 10 under this section to a relief-eligible survivor of a 11 disaster after the end of the relief coverage period 12 of the disaster. 13 ‘‘(2) NOTICE OF TERMINATION OF ELIGIBILITY; 14 ASSISTANCE IN APPLYING FOR REGULAR MED- 15 ICAID.— 16 ‘‘(A) IN GENERAL.—No later than 2 17 months before the end of a relief coverage pe- 18 riod of a disaster, a State shall provide each re- 19 lief-eligible survivor of the disaster who is re- 20 ceiving medical assistance under the State plan 21 in accordance with this section with written no- 22 tice that includes— 23 ‘‘(i) the date after which, subject to 24 the exception described in paragraph (4), 25 VerDate Sep 11 2014 20:35 Jun 11, 2019 Jkt 089200 PO 00000 Frm 00011 Fmt 6652 Sfmt 6201 E:\BILLS\S1754.IS S1754 pamtmann on DSKBFK8HB2PROD with BILLS 12 •S 1754 IS the survivor will no longer be eligible for 1 such assistance; 2 ‘‘(ii) information regarding eligibility 3 (other than under this section) for medical 4 assistance under the State plan (or waiver 5 of such plan); and 6 ‘‘(iii) an application for such assist- 7 ance and information regarding how to 8 submit a completed application and how to 9 obtain assistance with completing such ap- 10 plication. 11 ‘‘(B) ASSISTANCE IN APPLYING FOR MED- 12 ICAID.—Before the end of the relief coverage 13 period of a disaster, the State shall— 14 ‘‘(i) provide any relief-eligible survivor 15 of the disaster who is receiving medical as- 16 sistance under the State plan assistance 17 with applying for medical assistance under 18 the State plan (or waiver ) for periods be- 19 ginning after the end of such relief cov- 20 erage period; and 21 ‘‘(ii) ensure that such assistance is 22 easily accessible to such survivors. 23 ‘‘(3) PRESUMPTIVE ELIGIBILITY PERIOD FOR 24 PENDING APPLICATIONS.—In the case of a relief-eli- 25 VerDate Sep 11 2014 20:35 Jun 11, 2019 Jkt 089200 PO 00000 Frm 00012 Fmt 6652 Sfmt 6201 E:\BILLS\S1754.IS S1754 pamtmann on DSKBFK8HB2PROD with BILLS 13 •S 1754 IS gible survivor of a disaster who, on the date that the 1 relief coverage period of the disaster ends, has an 2 application pending for medical assistance under the 3 State plan (or waiver of such plan) for per [Text truncated for display. 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