Coronavirus Relief for Seniors and People with Disabilities Act of 2020

I 116TH CONGRESS 2D SESSION H. R. 6305 To assist older Americans and people with disabilities affected by COVID– 19. IN THE HOUSE OF REPRESENTATIVES MARCH 19, 2020 Mrs. DINGELL (for herself, Ms. SCHAKOWSKY, Ms. MATSUI, Ms. PRESSLEY, Mr. DEUTCH, Ms. ROYBAL-ALLARD, and Mr. LAMB) introduced the fol- lowing bill; which was referred to the Committee on Appropriations, and in addition to the Committees on the Budget, and Energy and Commerce, 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 assist older Americans and people with disabilities affected by COVID–19. 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; TABLE OF CONTENTS. 3 (a) IN GENERAL.—This Act may be cited as the 4 ‘‘Coronavirus Relief for Seniors and People with Disabil- 5 ities Act of 2020’’. 6 (b) TABLE OF CONTENTS.—The table of contents for 7 this Act is as follows: 8 VerDate Sep 11 2014 22:34 Apr 15, 2020 Jkt 099200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\H6305.IH H6305 pbinns on DSKJLVW7X2PROD with BILLS 2 •HR 6305 IH Sec. 1. Short title; table of contents. TITLE I—SUPPLEMENTAL APPROPRIATIONS Sec. 101. Supplemental appropriations. TITLE II—MEDICAID Sec. 201. Expanded access to medical assistance for Medicare costs during the COVID-19 public health emergency. Sec. 202. Authority to award Medicaid HCBS grants to respond to the COVID–19 public health emergency. TITLE I—SUPPLEMENTAL 1 APPROPRIATIONS 2 SEC. 101. SUPPLEMENTAL APPROPRIATIONS. 3 The following sums are hereby appropriated, out of 4 any money in the Treasury not otherwise appropriated, 5 for the fiscal year ending September 30, 2020, and for 6 other purposes, namely: 7 DEPARTMENT OF HEALTH AND HUMAN 8 SERVICES 9 CENTERS FOR MEDICARE & MEDICAID SERVICES 10 SURVEY AND CERTIFICATION ACTIVITIES 11 For an additional amount for survey and certification 12 activities authorized under sections 1862(g) and 1864 of 13 the Social Security Act (42 U.S.C. 1395y(g), 1395aa) and 14 section 353 of the Public Health Service Act (42 U.S.C. 15 263a), $154,400,000, to remain available through Sep- 16 tember 30, 2021: Provided, That such amount is des- 17 ignated by the Congress as being for an emergency re- 18 quirement pursuant to section 251(b)(2)(A)(i) of the Bal- 19 anced Budget and Emergency Deficit Control Act of 1985. 20 VerDate Sep 11 2014 22:34 Apr 15, 2020 Jkt 099200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H6305.IH H6305 pbinns on DSKJLVW7X2PROD with BILLS 3 •HR 6305 IH TITLE II—MEDICAID 1 SEC. 201. EXPANDED ACCESS TO MEDICAL ASSISTANCE 2 FOR MEDICARE COSTS DURING THE COVID-19 3 PUBLIC HEALTH EMERGENCY. 4 (a) IN GENERAL.—Section 1902 of the Social Secu- 5 rity Act (42 U.S.C. 1396a) is amended— 6 (1) in subsection (a)(10)(E)— 7 (A) in clause (iii), by striking ‘‘; and’’ and 8 inserting a semicolon; 9 (B) in clause (iv), by striking the semi- 10 colon and inserting ‘‘; and’’; and 11 (C) by adding at the end the following new 12 clause: 13 ‘‘(v) during the period described in sub- 14 section (ss), for making medical assistance 15 available for medicare cost-sharing (as defined 16 in section 1905(p)(3)) for— 17 ‘‘(I) individuals who are described in 18 clause (ii), (iii), or (iv); and 19 ‘‘(II) individuals— 20 ‘‘(aa) who are not described in 21 clauses (i) through (iv) but who are 22 eligible for, or enrolled in, the low-in- 23 come subsidy program under section 24 1860D–14; and 25 VerDate Sep 11 2014 22:34 Apr 15, 2020 Jkt 099200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H6305.IH H6305 pbinns on DSKJLVW7X2PROD with BILLS 4 •HR 6305 IH ‘‘(bb) whose application for such 1 medical assistance is received by the 2 State (or automatically initiated pur- 3 suant to the transmittal of data under 4 section 1144(c)(3)(B)) before the end 5 of the emergency period defined in 6 section 1135(g)(1)(B).’’; and 7 (2) by adding at the end the following new sub- 8 section: 9 ‘‘(ss) COVID–19 EMERGENCY ASSISTANCE PE- 10 RIOD.—For purposes of subsection (a)(10)(E)(v), the pe- 11 riod described in this subsection is the period— 12 ‘‘(1) beginning with the date of enactment of 13 this subsection; and 14 ‘‘(2) ending with the last day of the 12th month 15 that begins after the emergency period defined in 16 section 1135(g)(1)(B).’’. 17 (b) TRANSMITTAL OF DATA TO STATES AND AUTO- 18 MATIC ENROLLMENT OF INDIVIDUALS.—Section 19 1144(c)(3) of the Social Security Act (42 U.S.C. 1320b– 20 14(c)(3)) is amended— 21 (1) by striking ‘‘Beginning on January 1, 22 2010’’ and inserting the following: 23 VerDate Sep 11 2014 22:34 Apr 15, 2020 Jkt 099200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H6305.IH H6305 pbinns on DSKJLVW7X2PROD with BILLS 5 •HR 6305 IH ‘‘(A) TRANSMITTAL OF LIS APPLICATIONS 1 TO STATES.—Beginning on January 1, 2010’’; 2 and 3 (2) by adding at the end the following new sub- 4 paragraph: 5 ‘‘(B) TRANSMITTAL OF LIS ENROLLMENT 6 INFORMATION TO STATES DURING THE COVID- 7 19 PUBLIC HEALTH EMERGENCY.—During the 8 period described in section 1902(ss), the Sec- 9 retary, in coordination with the Commissioner 10 of Social Security, shall electronically transmit 11 to the appropriate State Medicaid agency data 12 related to each individual who is enrolled in the 13 low-income subsidy program under section 14 1860D–14, and such transmittal shall initiate 15 an application of the individual for benefits 16 under the Medicare Savings Program with the 17 State Medicaid agency. In order to ensure that 18 such data transmittal provides effective assist- 19 ance for purposes of State adjudication of ap- 20 plications for benefits under the Medicare Sav- 21 ings Program, the Secretary shall consult with 22 the States regarding the content, form, fre- 23 quency, and manner in which data (on a uni- 24 VerDate Sep 11 2014 22:34 Apr 15, 2020 Jkt 099200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\H6305.IH H6305 pbinns on DSKJLVW7X2PROD with BILLS 6 •HR 6305 IH form basis for all States) shall be transmitted 1 under this subparagraph.’’. 2 (c) ADDITIONAL APPROPRIATION FOR ADMINISTRA- 3 TIVE COSTS FOR THE DEPARTMENT OF HEALTH AND 4 HUMAN SERVICES AND THE SOCIAL SECURITY ADMINIS- 5 TRATION.— 6 (1) IN GENERAL.—There are hereby appro- 7 priated to carry out the requirement of subpara- 8 graph (B) of section 1144(c)(3) of the Social Secu- 9 rity Act (42 U.S.C. 1320b–14(c)(3)), as added by 10 subsection (b), out of any funds in the Treasury not 11 otherwise appropriated— 12 (A) $1,000,000 to the Secretary of Health 13 and Human Services, to remain available until 14 expended; and 15 (B) $1,000,000 to the Commissioner of 16 Social Security, to remain available until ex- 17 pended. 18 (2) SUPPLEMENT NOT SUPPLANT.—Any 19 amounts appropriated pursuant to this subsection 20 shall be in addition to any other amounts otherwise 21 appropriated pursuant to any other provision of law. 22 (d) BUDGET NEUTRALITY WITH RESPECT TO MEDI- 23 CARE ADVANTAGE PAYMENTS.—The Secretary of Health 24 and Human Services shall assess the effect of the amend- 25 VerDate Sep 11 2014 22:34 Apr 15, 2020 Jkt 099200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\H6305.IH H6305 pbinns on DSKJLVW7X2PROD with BILLS 7 •HR 6305 IH ments made by subsection (a) on payments to Medicare 1 Advantage plans under part C of title XVIII of the Social 2 Security Act (42 U.S.C. 1395w–21 et seq.) and make nec- 3 essary adjustments to ensure that, during the COVID– 4 19 emergency assistance period described in subsection 5 (ss) of section 1902 of the Social Security Act (42 U.S.C. 6 1396a) (as added by subsection (a)), risk-adjusted pay- 7 ments under such part with respect to individuals newly 8 enrolled in the Medicare Savings Program (as defined in 9 section 1144 of the Social Security Act (42 U.S.C. 1320b– 10 14)) pursuant to such amendments do not exceed such 11 payments that would have been made under such part 12 with respect to such individuals if such subsection had not 13 been enacted. 14 (e) FEDERAL MEDICAL ASSISTANCE PERCENT- 15 AGE.—Section 1905 of the Social Security Act (42 U.S.C. 16 1396d) is amended— 17 (1) in subsection (b), by striking ‘‘and (ff)’’ and 18 inserting ‘‘(ff), and (gg)’’; and 19 (2) by adding at the end the following: 20 ‘‘(gg) INCREASED FMAP FOR ADDITIONAL EXPEND- 21 ITURES FOR MEDICARE COST-SHARING PROVIDED DUR- 22 ING THE COVID-19 PUBLIC HEALTH EMERGENCY.— 23 Notwithstanding subsection (b), the Federal medical as- 24 sistance percentage for a State shall be 100 percent— 25 VerDate Sep 11 2014 22:34 Apr 15, 2020 Jkt 099200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\H6305.IH H6305 pbinns on DSKJLVW7X2PROD with BILLS 8 •HR 6305 IH ‘‘(1) with respect to the additional amounts ex- 1 pended by the State for medical assistance provided 2 during the period described in section 1902(ss) 3 under the State plan under this title or a waiver of 4 such plan that are attributable to the requirements 5 imposed by section 1902(a)(10)(E)(v); 6 ‘‘(2) with respect to expenditures described in 7 section 1903(a)(7) that— 8 ‘‘(A) are made by the State during the pe- 9 riod described in section 1902(ss); and 10 ‘‘(B) the State demonstrates to the satis- 11 faction of the Secretary are attributable to ad- 12 ministrative costs related to meeting such re- 13 quirements; and 14 ‘‘(3) with respect to expenditures that are made 15 by the State to determine whether individuals who 16 are provided medical assistance for medicare cost- 17 sharing under section 1902(a)(10)(E)(v)(II) remain 18 eligible for such assistance after the period described 19 in section 1902(ss).’’. 20 SEC. 202. AUTHORITY TO AWARD MEDICAID HCBS GRANTS 21 TO RESPOND TO THE COVID–19 PUBLIC 22 HEALTH EMERGENCY. 23 (a) IN GENERAL.—The Secretary is authorized to 24 award grants to States in accordance with this section to 25 VerDate Sep 11 2014 22:34 Apr 15, 2020 Jkt 099200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\H6305.IH H6305 pbinns on DSKJLVW7X2PROD with BILLS 9 •HR 6305 IH enhance access to home and community-based services 1 during the COVID–19 public health emergency period. 2 (b) DEFINITIONS.—In this section: 3 (1) COVID–19 PUBLIC HEALTH EMERGENCY 4 PERIOD.—The term ‘‘COVID–19 public health emer- 5 gency period’’ means the portion of the emergency 6 period defined in paragraph (1)(B) of section 7 1135(g) of the Social Security Act (42 U.S.C. 8 1320b–5(g)) beginning on or after the date of the 9 enactment of this Act. 10 (2) ELIGIBLE INDIVIDUAL.—The term ‘‘eligible 11 individual’’ means an individual who is eligible for or 12 enrolled for medical assistance under a State Med- 13 icaid program. 14 (3) HOME AND COMMUNITY-BASED SERV- 15 ICES.—The term ‘‘home and community-based serv- 16 ices’’ means, with respect to a State Medicaid pro- 17 gram, home and community-based services (includ- 18 ing home health and personal care services) that are 19 provided under the State’s qualified HCBS program 20 or that could be provided under such a program but 21 are otherwise provided under the Medicaid program. 22 (4) INDIAN TRIBE.—The term ‘‘Indian tribe’’ 23 means an Indian tribe, a tribal organization, or an 24 urban Indian organization (as such terms are de- 25 VerDate Sep 11 2014 22:34 Apr 15, 2020 Jkt 099200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\H6305.IH H6305 pbinns on DSKJLVW7X2PROD with BILLS 10 •HR 6305 IH fined in section 4 of the Indian Health Care Im- 1 provement Act (25 U.S.C. 1603)), and includes a 2 tribal consortium of Indian tribes or tribal organiza- 3 tions (as so defined). 4 (5) MEDICAID PROGRAM.—The term ‘‘Medicaid 5 program’’ means, with respect to a State, the State 6 program under title XIX of the Social Security Act 7 (42 U.S.C. 1396 et seq.) (including any waiver or 8 demonstration under such title or under section 9 1115 of such Act (42 U.S.C. 1315) relating to such 10 title). 11 (6) SECRETARY.—The term ‘‘Secretary’’ means 12 the Secretary of Health and Human Services. 13 (7) STATE.—The term ‘‘State’’ has the mean- 14 ing given such term for purposes of title XIX of the 15 Social Security Act (42 U.S.C. 1396 et seq.). 16 (8) QUALIFIED HCBS PROGRAM.—The term 17 ‘‘qualified HCBS program’’ means a program pro- 18 viding home and community-based services operating 19 under a State Medicaid program, whether or not op- 20 erating under waiver authority. 21 (c) GRANTS TO STATES.— 22 (1) IN GENERAL.—During the COVID–19 pub- 23 lic health emergency period, the Secretary may 24 VerDate Sep 11 2014 22:34 Apr 15, 2020 Jkt 099200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6201 E:\BILLS\H6305.IH H6305 pbinns on DSKJLVW7X2PROD with BILLS 11 •HR 6305 IH award grants to States with applications meeting the 1 requirements of paragraph (2). 2 (2) APPLICATION REQUIREMENTS.—A State 3 seeking a grant under this section shall submit an 4 application to the Secretary at such time, in such 5 form and manner, and containing such information 6 as the Secretary shall require. 7 (3) LIMITATIONS.— 8 (A) TERMINATION OF AUTHORITY.—The 9 Secretary shall not award any grants under this 10 section with respect to a State that submits an 11 application after the date that is 60 days after 12 the end of the COVID–19 public health emer- 13 gency period. 14 (B) USE OF FUNDS.—A State to which a 15 grant is made under this section shall only use 16 grant funds in accordance with subsection (d). 17 (C) MAINTENANCE OF STATE EFFORT.— 18 Federal funds paid to a State pursuant to this 19 section must be used to supplement, but not 20 supplant, the level of State funds expended for 21 home and community-based services for eligible 22 individuals programs in effect for such individ- 23 uals at the time the grant is awarded under 24 this section. 25 VerDate Sep 11 2014 22:34 Apr 15, 2020 Jkt 099200 PO 00000 Frm 00011 Fmt 6652 Sfmt 6201 E:\BILLS\H6305.IH H6305 pbinns on DSKJLVW7X2PROD with BILLS 12 •HR 6305 IH (4) MONTHLY GRANT PAYMENT AMOUNTS.— 1 (A) IN GENERAL.—Subject to paragraph 2 (5), the Secretary shall pay to each State that 3 is awarded a grant under this section, for each 4 month during the State’s grant period (as de- 5 fined in subparagraph (C)), an amount equal to 6 15 percent of the amount determined for the 7 State under subparagraph (B). 8 (B) AVERAGE MONTHLY HCBS EXPENDI- 9 TURES.—The amount determined for a State 10 under this subparagraph is the amount equal 11 to— 12 (i) the sum of— 13 (I) the average annual amount of 14 State expenditures under title XIX of 15 the Social Security Act (42 U.S.C. 16 1396 et seq.) that are attributable to 17 providing medical assistance for home 18 and community-based services for the 19 3 most rec [Text truncated for display. 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