II 

109TH CONGRESS 

1ST SESSION S. 1769 

To provide relief to individuals and businesses affected by Hurricane Katrina 

related to healthcare and health insurance coverage, and for other purposes. 

IN THE SENATE OF THE UNITED STATES 

SEPTEMBER 26, 2005 

Mr. ENZI (for himself, Mr. KENNEDY, Mr. ALEXANDER, Mr. DODD, Mr. 

BURR, Ms. MIKULSKI, Mr. DEWINE, and Mrs. CLINTON) introduced the 

following bill; which was read twice and referred to the Committee on 

Health, Education, Labor, and Pensions 

A BILL 

To provide relief to individuals and businesses affected by 

Hurricane Katrina related to healthcare and health insurance coverage, and for other purposes. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Public Health and 

5 Health Insurance Emergency Response Act of 2005’’. 
2 

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1 TITLE I—CLARIFICATION OF A 

2 PUBLIC HEALTH EMERGENCY 

3 SEC. 101. MODIFICATION TO THE DEFINITION OF PUBLIC 

4 HEALTH EMERGENCY. 

5 Section 319 of the Public Health Service Act (42 

6 U.S.C. 247d) is amended— 

7 (1) in subsection (a), by inserting before the 

8 last sentence, the following: ‘‘Any determination 

9 under this section shall specify the geographic area 

10 with respect to which such determination applies.’’; 

11 and 

12 (2) by striking subsection (d) and inserting the 

13 following: 

14 ‘‘(d) STATUTORY WAIVER.— 

15 ‘‘(1) IN GENERAL.—Notwithstanding any other 

16 provision of this Act, if the Secretary declares a pub17 lic health emergency pursuant to subsection (a), the 

18 Secretary may waive the following statutory require19 ments: 

20 ‘‘(A) REPORTING OR ADMINISTRATIVE RE21 QUIREMENTS.—In any case in which the Sec22 retary determines that, wholly or partially as a 

23 result of a public health emergency that has 

24 been determined pursuant to subsection (a), in25 dividuals or public or private entities are unable 
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1 to comply with deadlines for the submission to 

2 the Secretary of data, reports, or other mate3 rials, or for the completion of other administra4 tive tasks required under any law administered 

5 by the Secretary, the Secretary may grant such 

6 extensions of such deadlines as the cir7 cumstances may reasonably require, and may 

8 waive, wholly or partially, any sanctions other9 wise applicable to such failure to comply. 

10 ‘‘(B) VACCINATIONS.—With respect to sec11 tion 317 of this Act and section 1928 of the So12 cial Security Act, the Secretary may waive re13 quirements related to the eligibility of adults 

14 and children for participation in the program 

15 for those in an area with respect to which the 

16 Secretary has declared a public health emer17 gency during the period of such declaration. 

18 ‘‘(C) EXTENSION OF AVAILABILITY OF

19 FUNDS.—If, as a result of a public health emer20 gency declared pursuant to subsection (a), the 

21 Secretary determines that the Secretary is un22 able to obligate funds for a particular fiscal 

23 year, such funds shall remain available for an 

24 additional 180 days. 
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1 ‘‘(D) MATCHING REQUIREMENTS.—In any 

2 case in which the Secretary determines that an 

3 entity in an area with respect to which the Sec4 retary has declared a public health emergency 

5 pursuant to subsection (a) is unable to provide 

6 funds required as a condition of Federal match7 ing under any provision of the Public Health 

8 Service Act, the Secretary may grant a waiver 

9 of such funding requirement for the fiscal years 

10 covered by such emergency declaration. To the 

11 extent that additional amounts have been ap12 propriated for programs that have received a 

13 waiver under this subparagraph as a result of 

14 Hurricane Katrina, the Secretary may make 

15 such additional amounts available to entities on 

16 a pro rata basis. 

17 ‘‘(E) MOBILIZING RESOURCES TO PROVIDE

18 ACCESS.—If the Secretary declares a public 

19 health emergency pursuant to subsection (a) 

20 with respect to an area, the Secretary may 

21 deem such area as a health professional short22 age area (as defined under section 332(a)), a 

23 medically underserved population (as defined 

24 under section 330(b)(3)), or a medically under-
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1 served area or community during the period of 

2 such declaration. 

3 ‘‘(e) LICENSING AND LIABILITY PROVISIONS.—If the 

4 Secretary declares a public health emergency pursuant to 

5 subsection (a) with respect to an area, the Secretary may 

6 waive the application of licensing requirements applicable 

7 to physicians and other health care professionals who are 

8 volunteering to provide medical services (within their 

9 scope of practice) within such area as part of a coordi10 nated emergency response if such physicians or health 

11 care professionals have equivalent licensing in good stand12 ing in another State and are not affirmatively excluded 

13 from practice in that State or in any State a part of which 

14 is included in the designated public health emergency area. 

15 A physician or other health care professional described in 

16 section 2811(d)(1) shall be covered by the provisions of 

17 section 2811(d)(2), including with respect to liability. 

18 ‘‘(f) FDA WAIVER AUTHORITY.—If the Secretary de19 clares a public health emergency pursuant to subsection 

20 (a) with respect to an area, the Secretary may— 

21 ‘‘(1) waive the requirements in the second sen22 tence of section 304(h)(1)(B) of the Federal Food, 

23 Drug, and Cosmetic Act; 
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1 ‘‘(2) waive the requirement of section 304(h)(2) 

2 of such Act that limits the administrative detention 

3 of foods to not more than 30 days; and 

4 ‘‘(3) waive the requirement of section 

5 304(h)(4)(A) of such Act relating to the timing of 

6 an opportunity for an informal hearing upon the ap7 peal of a detention order. 

8 Under paragraph (1), the Secretary may not waive the re9 quirements of sections 1.392 or 1.393 of title 21, Code 

10 of Federal Regulations, or any successor regulations 

11 thereto. 

12 ‘‘(g) REPORT.—Not later than 2 days after granting 

13 any waiver under subsection (d), (e), or (f), the Secretary 

14 shall notify the appropriate committees of Congress of 

15 such action. The Secretary shall publish in the Federal 

16 Register a notice of such waiver in a timely manner. Such 

17 notification shall include, if applicable— 

18 ‘‘(1) the specific provisions of law to be waived 

19 or modified; 

20 ‘‘(2) the rationale for such waiver or modifica21 tion; 

22 ‘‘(3) the geographic area in which the waiver or 

23 modification will apply; and 
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1 ‘‘(4) the period of time, not to exceed the period 

2 of the emergency, for which the waiver or modifica3 tion will be in effect. 

4 ‘‘(h) AUTHORITY FOR RETROACTIVE APPLICA5 TION.—A waiver or modification described in subsections 

6 (d), (e), and (f), at the discretion of the Secretary, may 

7 be made retroactive to the beginning of the emergency pe8 riod or any subsequent date in such period as specified 

9 by the Secretary.’’. 

10 SEC. 102. SENSE OF CONGRESS CONCERNING THE HURRI11 CANE KATRINA-RELATED PUBLIC HEALTH 

12 EMERGENCY. 

13 It is the sense of Congress that— 

14 (1) with respect to the public health emergency 

15 declared under section 319 of the Public Health 

16 Service Act (42 U.S.C. 247d) resulting from Hurri17 cane Katrina, the Secretary of Health and Human 

18 Services, in coordination with other Federal entities 

19 (including the Federal Emergency Management As20 sociation, the Department of Defense, the Depart21 ment of Veterans’ Affairs, Environmental Protection 

22 Agency, and the National Disaster Medical System), 

23 State and local governments, and public and private 

24 sector entities, where appropriate, should ensure the 

25 following: 
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1 (A) grants and funding should be provided 

2 to address ongoing emergency responses and re3 covery; 

4 (B) the provision of health services includ5 ing medical specialty services, health-related so6 cial services including protection and advocacy 

7 services, other appropriate human services, and 

8 appropriate auxiliary services to respond to the 

9 needs of the survivors of the public health 

10 emergency; 

11 (C) clinicians deployed as part of the emer12 gency response efforts who are licensed and cer13 tified within their respective State and in good 

14 standing within their State should be afforded 

15 appropriate liability protections; 

16 (D) clinicians deployed as part of the 

17 emergency response who are licensed or other18 wise certified in their respective State and in 

19 good standing within their State should not 

20 need to fulfill additional licensure or certifi21 cation requirements in areas declared to be part 

22 of a public health emergency; 

23 (E) individuals within the public health 

24 emergency areas should be able to access qual25 ity mental health and substance abuse services 
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1 including services to reduce and identify indi2 viduals at risk of suicide and post-traumatic 

3 stress disorder and provide appropriate inter4 ventions; 

5 (F) environmental teams should be de6 ployed to provide assessments and environ7 mental controls for areas within the public 

8 health emergency; 

9 (G) social services, including protection 

10 and advocacy services and access to domestic vi11 olence shelters, should be extended to those 

12 within the public health emergency areas; 

13 (H) communication resources should be 

14 available to those displaced by the hurricane in15 cluding access to 2–1–1 call centers; 

16 (I) support services including supports, 

17 equipment, supplies, medications, and other 

18 types of assistance (such as those provided 

19 through the Developmental Disabilities Assist20 ance and Bill of Rights Act of 2000) should be 

21 available to vulnerable populations including the 

22 elderly and individuals with disabilities; 

23 (J) real time electronic surveillance, diag24 nosis, and treatment of epidemic, re-emerging, 

25 and emerging diseases, including a functioning 
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1 diagnostic laboratory, should be provided for 

2 those dislocated as a result of Hurricane 

3 Katrina and first-responders; 

4 (K) funding should be provided to help 

5 healthcare facilities, medical research facilities, 

6 community health centers, and other essential 

7 public health and health care infrastructure 

8 components to assist them in the ongoing re9 sponse efforts, to clean up their facilities, or to 

10 rebuild; 

11 (L) coordination and minimizing the dupli12 cation of Federal, State, and local response and 

13 recovery efforts; 

14 (M) funding should be provided to ensure 

15 that the Strategic National Stockpile is able to 

16 provide and appropriately deploy the necessary 

17 drugs, vaccines, and other biological products, 

18 medical devices, and other supplies needed to 

19 address acute exacerbations of chronic illness as 

20 well as acute injuries and illness resulting from 

21 Hurricane Katrina; 

22 (N) funding should be provided to the Cen23 ters for Disease Control and Prevention and the 

24 National Institutes of Health to pay for needed 

25 communications, including public service an-
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1 nouncements on radio and television, to provide 

2 for additional personnel, and to provide needed 

3 health and safety training and resources to af4 fected workers and employers; 

5 (O) none of the funds provided by the Sec6 retary of Health and Human Services in re7 sponse to Hurricane Katrina should made avail8 able to entities that have been indicted for 

9 abandoning patients during the disaster period; 

10 and 

11 (P) the Department of Health and Human 

12 Services should conduct an effective ongoing 

13 program to monitor the health of survivors of 

14 Hurricane Katrina and of workers and volun15 teers involved in rescue, response, and rebuild16 ing efforts due to Hurricane Katrina, and that 

17 such a program should include screening for 

18 health conditions (including mental health con19 ditions) and appropriate referrals; and 

20 (2) the current public health emergency de21 clared by Secretary Leavitt relating to Hurricane 

22 Katrina under such section 319 should be extended 

23 beyond 90 days. 
12 

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1 TITLE II—HEALTHCARE 

2 RESPONSE 

3 SEC. 201. ASSISTANCE TO STATES IN A PUBLIC HEALTH 

4 EMERGENCY. 

5 Section 311(c)(2) of the Public Health Service Act 

6 (42 U.S.C. 243(c)(2)) is amended— 

7 (1) by striking ‘‘(2) The’’ and inserting the fol8 lowing: 

9 ‘‘(2)(A) Except as provided in subparagraph (B), 

10 the’’; and 

11 (2) by adding at the end the following: 

12 ‘‘(B) If the Secretary declares a public health emer13 gency under section 319, the 6 month period described 

14 in the first sentence of subparagraph (A) may be extended 

15 for a period of not to exceed 18 months with respect to 

16 assistance to geographic areas that are the subject of such 

17 declaration.’’. 

18 SEC. 202. STRENGTHENING THE HEALTHCARE SAFETY NET. 

19 Notwithstanding any other provision of law, the Sec20 retary of Health and Human Services may temporarily 

21 provide (for the period for which a determination of public 

22 health emergency is in effect under section 319 of the 

23 Public Health Service Act (42 U.S.C. 247d)) with respect 

24 to Hurricane Katrina that any health center or facility 

25 providing primary and preventive care that— 
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1 (1) is located in an area to which such deter2 mination applies, and 

3 (2) treats individuals displaced by Hurricane 

4 Katrina; 

5 shall receive reimbursement for such treatment from Fed6 eral health programs at the same rate at which a Feder7 ally qualified health center (as defined in section 

8 1905(l)(2)(B) of the Social Security Act (42 U.S.C. 

9 1596d(l)(2)(B))) would receive such reimbursement and 

10 shall be eligible to receive funds under section 330 of the 

11 Public Health Service Act (42 U.S.C. 245b) with respect 

12 to services furnished to individuals displaced by Hurricane 

13 Katrina if additional funds are made available under such 

14 section for Hurricane Katrina response efforts. 

15 SEC. 203. MENTAL HEALTH NEEDS. 

16 (a) ENSURING FUNDING FOR MENTAL HEALTH IN

17 TIMES OF NATIONAL CRISIS.—Section 501(m) of the 

18 Public Health Service Act (42 U.S.C. 290aa(m)) is 

19 amended by adding at the end the following: 

20 ‘‘(4) EXISTING FUNDING.—For purposes of car21 rying out this subsection, amounts appropriated 

22 under this title for emergency response, as provided 

23 for in this section, for fiscal years 2005 and 2006 

24 shall remain available until expended or until a pub-
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1 lic health emergency as declared by the Secretary no 

2 longer exists.’’. 

3 (b) STRENGTHENING ACCESS TO MENTAL HEALTH

4 SERVICES IN AN EMERGENCY.—Section 520F of the Pub5 lic Health Service Act (42 U.S.C. 290bb–37) is amend6 ed— 

7 (1) by striking subsection (b) and inserting the 

8 following: 

9 ‘‘(b) HEALTH CENTER.—In this section, the term 

10 ‘health center’ has the meaning given such term in section 

11 330, and includes community health centers and commu12 nity mental health centers.’’; 

13 (2) in subsection (c), by adding at the end the 

14 following: ‘‘With respect to a declaration of a public 

15 health emergency under section 319, the Secretary 

16 shall, in awarding such grants, ensure that priority 

17 is given to States and localities that are most af18 fected by such emergency.’’; 

19 (3) in subsection (e)(2)— 

20 (A) in clause (i), by striking ‘‘individuals’’ 

21 and all that follows through the semicolon and 

22 inserting ‘‘individuals, including children, who 

23 may be in need of emergency mental health 

24 services, including individuals at risk of devel-
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1 oping a mental illness, including Post Trau2 matic Stress Disorder;’’; and 

3 (B) in clause (iii), by inserting ‘‘or at risk 

4 of developing’’ after ‘‘individual with’’; and 

5 (4) in subsection (g), by striking ‘‘2003’’ and 

6 inserting ‘‘2006’’. 

7 SEC. 204. ASSISTANCE FOR INDIVIDUALS WITH DISABIL8 ITIES. 

9 (a) ASSESSMENT AND RESPONSE.— 

10 (1) DEFINITIONS.— 

11 (A) EMERGENCY SHELTER.—The term 

12 ‘‘emergency shelter’’ means an emergency shel13 ter for persons described in subparagraph 

14 (C)(ii). 

15 (B) INDIVIDUAL WITH A DISABILITY.—The 

16 term ‘‘individual with a disability’’ has the 

17 meaning given the term in section 3 of the 

18 Americans with Disabilities Act of 1990 (42 

19 U.S.C. 12102). 

20 (C) INDIVIDUAL AFFECTED BY HURRICANE

21 KATRINA.—The term ‘‘individual with a dis22 ability affected by Hurricane Katrina’’ means a 

23 person who is— 
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1 (i) an individual with a disability, or 

2 a family member of an individual with a 

3 disability; and 

4 (ii) a person who resided on August 

5 22, 2005, in an area in which the Presi6 dent has declared that a major disaster ex7 ists, in accordance with section 401 of the 

8 Robert T. Stafford Disaster Relief and 

9 Emergency Assistance Act (42 U.S.C. 

10 5170), related to Hurricane Katrina. 

11 (2) ASSISTANCE.—An entity that receives fi12 nancial assistance under title I of the Developmental 

13 Disabilities Assistance and Bill of Rights Act of 

14 2000 (42 U.S.C. 15001 et seq.) may use a portion 

15 of such financial assistance to— 

16 (A) determine the location and status of 

17 individuals affected by Hurricane Katrina, who 

18 are transferred from emergency shelters to 

19 long-term care facilities (including nursing 

20 homes and group homes), intermediate care fa21 cilities for individuals with mental retardation, 

22 hospitals, correctional institutions, and other 

23 similar locations; and 

24 (B) assess and respond to the needs of in25 dividuals affected by Hurricane Katrina to en-
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1 sure that the individuals receive necessary serv2 ices, supports, and other types of assistance. 

3 (b) OVERSIGHT AND DISASTER ASSISTANCE.—Sub4 title C of title I of the Developmental Disabilities Assist5 ance and Bill of Rights Act of 2000 (42 U.S.C. 15041 

6 et seq.) is amended by inserting after section 144 the fol7 lowing: 

8 ‘‘SEC. 144A. OVERSIGHT AND DISASTER ASSISTANCE. 

9 ‘‘(a) DEFINITIONS.—In this section: 

10 ‘‘(1) EMERGENCY SHELTER.—The term ‘emer11 gency shelter’ means an emergency shelter for per12 sons described in paragraph (3)(B). 

13 ‘‘(2) INDIVIDUAL WITH A DISABILITY.—The 

14 term ‘individual with a disability’ has the meaning 

15 given the term in section 3 of the Americans with 

16 Disabilities Act of 1990 (42 U.S.C. 12102). 

17 ‘‘(3) INDIVIDUAL AFFECTED BY A MAJOR DIS18 ASTER.—The term ‘individual affected by a major 

19 disaster’ means a person who is— 

20 ‘‘(A) an individual with a disability; and 

21 ‘‘(B) a person who resided in an area in 

22 which the Secretary has declared a public 

23 health emergency under section 319 of the Pub24 lic Health Service Act, 7 days before the dec25 laration. 
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1 ‘‘(4) PUBLIC HEALTH EMERGENCY.—The term 

2 ‘public health emergency’ means a public health 

3 emergency as designated under section 319 of the 

4 Public Health Service Act. 

5 ‘‘(b) OVERSIGHT.— 

6 ‘‘(1) GRANTS.— 

7 ‘‘(A) IN GENERAL.—In a case in which the 

8 Secretary of Health and Human Services has 

9 declared that a public health emergency exists 

10 for a geographic area, and as a result individ11 uals affected by a major disaster are placed in 

12 an emergency shelter in a State, the Secretary 

13 may make a grant to the system for that State. 

14 ‘‘(B) USE OF FUNDS.—A system that re15 ceives a grant under subparagraph (A) shall use 

16 the funds made available through the grant 

17 to— 

18 ‘‘(i) establish a registry to identify 

19 and maintain information about such indi20 viduals who are in such emergency shelter; 

21 ‘‘(ii) track the transfers of such indi22 viduals from such emergency shelter to 

23 community and non-community settings; 

24 and 
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1 ‘‘(iii) provide oversight at such emer2 gency shelter to assure that such individ3 uals are receiving necessary services, sup4 ports, and other types of assistance. 

5 ‘‘(2) COORDINATION.—In carrying out activities 

6 under paragraph (1), the system shall coordinate the 

7 activities with the Under Secretary for Emergency 

8 Preparedness and Response in the Department of 

9 Homeland Security, and with any nonprofit agency 

10 (such as the American Red Cross) providing assist11 ance through an emergency shelter described in 

12 paragraph (1). 

13 ‘‘(c) ACCESS.—As soon as practicable after the Sec14 retary of Health and Human Services has declared a pub15 lic health emergency for an area, and as a result individ16 uals affected by the emergency are placed in an emergency 

17 shelter in a State, the Commissioner of the Administration 

18 on Developmental Disabilities shall notify each emergency 

19 shelter in the State receiving such individuals that staff 

20 of the system for the State shall have authority to enter 

21 the shelter, and shall have access to the individuals af22 fected by the emergency residing in that shelter, to provide 

23 information related to services, supports, and other types 

24 of assistance for, and to protect the human, service, and 
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1 legal rights of, individuals affected by the emergency resid2 ing in that shelter. 

3 ‘‘(d) AUTHORIZATION OF APPROPRIATIONS.—There 

4 are authorized to be appropriated to carry out subsection 

5 (b) $2,000,000 for fiscal year 2006 and such sums as may 

6 be necessary for fiscal year 2007.’’. 

7 SEC. 205. LIABILITY AND LICENSURE AWARENESS PRO8 MOTION FOR HEALTH VOLUNTEERS. 

9 (a) IN GENERAL.—The Secretary of Health and 

10 Human Services shall utilize the Internet and other appro11 priate means to disseminate to the public information on 

12 health professional liability coverage and licensure require13 ments for intermittent disaster response personnel (as de14 scribed in section 2811(d)(1) of the Public Health Service 

15 Act (42 U.S.C. 300hh–11(d)(1))) in areas in which a pub16 lic health emergency have been declared under section 319 

17 of such Act (42 U.S.C. 247d). 

18 (b) TYPE OF INFORMATION.—The information to be 

19 provided under subsection (a) shall, in the case of a State 

20 where health professional licensure requirements have 

21 been waived, include— 

22 (1) whether and how intermittent disaster re23 sponse personnel may be able to receive certain li24 ability protections as described in section 2811(d)(2) 
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1 of the Public Health Service Act (42 U.S.C. 300hh– 

2 (d)(2)), or under applicable provisions of State law; 

3 (2) the possible limitations of such coverage 

4 and protections; and 

5 (3) other information needed to enable health 

6 professionals to make an informed decision about 

7 providing volunteer health services. 

8 TITLE III—RESEARCH AND 

9 REPORTS 

10 SEC. 301. MONITORING THE HEALTHCARE, MENTAL 

11 HEALTH, AND PUBLIC HEALTH RESPONSE. 

12 (a) IN GENERAL.—The Secretary of Health and 

13 Human Services, acting through a public service non-prof14 it research and analysis firm, shall provide for an imme15 diate and independent review (through the immediate col16 lection of data and conduct of analyses) of the lessons 

17 learned from the Federal, State and local public health, 

18 mental health, and medical care planning, preparedness, 

19 and response to Hurricane Katrina. 

20 (b) PURPOSE.—The purpose of the study under sub21 section (a) is to collect available relevant data, through 

22 site visits, reviews of medical and epidemiological records, 

23 interviews with individuals residing in an area in which 

24 a public health emergency has been declared under section 

25 319 of the Public Health Service Act as a result of Hurri-
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1 cane Katrina, and interviews with Federal, State, and 

2 local public health, mental health services, and medical of3 ficials. Such interviews shall be conducted in a manner 

4 that, to the extent practicable, does not interfere with the 

5 delivery of patient care and services. 

6 (c) REPORT.—Not later than 120 days after the date 

7 of enactment of this Act, the Secretary of Health and 

8 Human Services shall submit to the Committee on Health, 

9 Education, Labor, and Pensions of the Senate and the 

10 Committee on Emergency and Commerce of the House of 

11 Representatives, a report concerning the lessons learned 

12 (as described in subsection (a)). 

13 (d) AUTHORIZATION OF APPROPRIATIONS.—There 

14 are authorized to be appropriated $2,000,000 to carry out 

15 this section. 

16 SEC. 302. REPORT ON REGULATORY REQUIREMENTS AND 

17 FUNDING FORMULAS. 

18 (a) IN GENERAL.—Not later than 120 days after the 

19 date of enactment of this Act, the Secretary of Health and 

20 Human Services shall submit to Congress a report on the 

21 specific regulatory requirements and funding formulas 

22 under the Public Health Service Act (42 U.S.C. 201 et 

23 seq.) that would assist the Secretary in responding to a 

24 public health emergency (as declared under section 319 

25 of such Act (42 U.S.C. 247d)). 
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1 (b) AUTHORIZATION OF APPROPRIATIONS.—There 

2 are authorized to be appropriated such sums as may be 

3 necessary to carry out this section. 

4 SEC. 303. DEPARTMENT OF HEALTH AND HUMAN SERVICES 

5 INSPECTOR GENERAL AUDIT AND REPORT. 

6 (a) IN GENERAL.—The Inspector General of the De7 partment of Health and Human Services (referred to in 

8 this section as the ‘‘Inspector General’’) shall conduct an 

9 audit and investigation of each program carried out by 

10 the Department of Health and Human Services that in11 cludes response and recovery activities related to Hurri12 cane Katrina. 

13 (b) WEEKLY REPORT.—Not less frequently than once 

14 a week, the Inspector General shall provide a report to 

15 the Committee on Health, Education, Labor, and Pen16 sions of the Senate and the Committee on Energy and 

17 Commerce of the House of Representatives listing the au18 dits and investigations initiated pursuant to subsection 

19 (a). 

20 (c) STATUS REPORT.—Not later than 6 months after 

21 the date of enactment of this section, and biannually 

22 thereafter until the audits and investigations described in 

23 subsection (a) are complete, the Inspector General shall 

24 report to the Committee on Health, Education, Labor, and 

25 Pensions of the Senate and the Committee on Energy and 
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1 Commerce of the House of Representatives on the full sta2 tus of the activities of the Inspector General under this 

3 section. 

4 (d) COOPERATIVE VENTURES.—In carrying out this 

5 section, the Inspector General is encouraged to enter into 

6 cooperative ventures with Inspectors General of other Fed7 eral agencies. 

8 TITLE IV—HEALTH INSURANCE 

9 COVERAGE 

10 SEC. 401. TEMPORARY EMERGENCY HEALTH COVERAGE 

11 ASSISTANCE FOR BUSINESS AND INDIVID12 UALS. 

13 (a) IN GENERAL.—The Secretary of Health and 

14 Human Services (referred to in this section as the ‘‘Sec15 retary’’), in consultation with the insurance commissioners 

16 of those States contained in whole or in part in the Hurri17 cane Katrina disaster area, shall establish a program to 

18 provide emergency health coverage continuation relief 

19 through the provision of direct payments of health insur20 ance premiums or continuation assistance on behalf of eli21 gible businesses and their employees and purchasers of in22 dividual health insurance coverage. 

23 (b) DEFINITIONS.—In this section: 

24 (1) ELIGIBLE INDIVIDUALS.—The term ‘‘eligi25 ble individual’’ means an individual (and the family 
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1 dependents of such individual as may be covered 

2 under the health insurance coverage in which such 

3 individual is enrolled)— 

4 (A) who is a citizen, national, or qualified 

5 alien as defined in section 431(b) of the Per6 sonal Responsibility and Work Opportunity 

7 Reconciliation Act of 1996 (8 U.S.C. 1641(b)); 

8 (B) whose permanent residence as of Au9 gust 29, 2005 was located in a Hurricane 

10 Katrina disaster area; 

11 (C) who was covered under individual 

12 (non-group) health insurance coverage, includ13 ing a policy operated pursuant to a qualified 

14 high risk pool (as defined in section 2744 of the 

15 Public Health Service Act (42 U.S.C. 300gg– 

16 44)), on August 29, 2005; and 

17 (D) whose ability to continue such cov18 erage was severely impaired as a result of hur19 ricane-related disruption in a Hurricane 

20 Katrina disaster area. 

21 (2) ELIGIBLE BUSINESSES.—The term ‘‘eligible 

22 business’’ means a corporation, sole proprietorship, 

23 or partnership that employs not more than 50 em24 ployees and that— 
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1 (A) operated as of August 29, 2005 in a 

2 Hurricane Katrina disaster area; 

3 (B) offered coverage under a group health 

4 plan (as defined in section 733(a)(1) of the 

5 Employee Retirement Income Security Act of 

6 1974 (29 U.S.C. 1191b(a)(1))) on August 29, 

7 2005 to employees in a Hurricane Katrina dis8 aster area; and 

9 (C) had its ability to continue coverage 

10 under such plan severely impaired as a result of 

11 disruption of the sponsor’s business activity in 

12 the Hurricane Katrina disaster area. 

13 (3) CONTINUATION ASSISTANCE.—The term 

14 ‘‘continuation assistance’’ means, in the case of an 

15 eligible business that offers health insurance cov16 erage under a self-insured arrangement, assistance 

17 in paying administrative services fees, claims costs, 

18 stop-loss premiums, and any amounts required to be 

19 paid by employees to participate in the arrangement. 

20 (4) HURRICANE KATRINA DISASTER AREA.— 

21 The term ‘‘Hurricane Katrina disaster area’’ means 

22 a parish in the State of Louisiana, a county in the 

23 State of Mississippi, or a county in the State of Ala24 bama, for which a major disaster has been declared 

25 in accordance with section 401 of the Robert T. 
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1 Stafford Disaster Relief and Emergency Assistance 

2 Act (42 U.S.C. 5170) as a result of Hurricane 

3 Katrina and which the President has determined, 

4 before September 11, 2005, warrants both individual 

5 and public assistance from the Federal Government 

6 under such Act. 

7 (c) HEALTH COVERAGE CONTINUATION RELIEF.— 

8 (1) IN GENERAL.—The Secretary shall design 

9 and implement the program under subsection (a) in 

10 a manner that enables eligible individuals and eligi11 ble businesses to be eligible for direct premium reim12 bursement or continuation assistance to be paid by 

13 the Secretary on behalf of such individual or busi14 ness directly to the health insurance issuer or ad15 ministrative services provider involved. In the case of 

16 an eligible business, premium reimbursement shall 

17 include the premium shares of both the employer 

18 and employees, as applicable. 

19 (2) LIMITATION.—Subject to paragraph (3), in 

20 no case shall the value of the assistance provided 

21 under the program under this section, with respect 

22 to an individual or business, exceed 100 percent of 

23 the applicable premium for coverage or continuation 

24 assistance for the period of coverage involved, in25 cluding, with respect to employer coverage, the em-
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1 ployer and employees’ share of premiums, if applica2 ble. 

3 (3) ENROLLMENT.— 

4 (A) IN GENERAL.—The Secretary shall es5 tablish an expedited process for the enrollment 

6 of eligible individuals and eligible businesses in 

7 the program under this section. 

8 (B) DUTY OF SECRETARY UPON RECEIPT

9 OF NOTICE.—The Secretary, upon receipt of a 

10 notice under subsection (f)(2), shall enroll the 

11 eligible individual or eligible business involved 

12 in the program under this section. 

13 (C) DUTY OF ISSUER.—A group health 

14 plan, or health insurance insurer with respect 

15 to such a plan, shall make a reasonable effort 

16 to notify an eligible individual or eligible busi17 ness— 

18 (i) of the automatic enrollment of 

19 such individual or business in the program 

20 under subparagraph (B); 

21 (ii) that, if it is later determined that 

22 the means of support of such individual, or 

23 the ability of such business to continue 

24 health insurance coverage, was not severely 

25 disrupted (as determined subject to a ran-
29 

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1 domized retrospective audit process), such 

2 individual or business may be required at 

3 a later date to repay the program for the 

4 amount of premiums or continuation as5 sistance paid on its behalf; and 

6 (iii) that such individual or business 

7 may elect to decline enrollment, or cancel 

8 enrollment, in the program by notifying 

9 the health insurance issuer or administra10 tive service provider involved. 

11 (d) RETROSPECTIVE AUDIT AUTHORITY.— 

12 (1) IN GENERAL.—The Secretary shall provide 

13 for the application of a randomized retrospective au14 diting process to the program under this section by 

15 a date that is not earlier than November 1, 2005. 

16 (2) REPAYMENT OF FUNDS.—If the Secretary 

17 determines, pursuant to the audit process under 

18 paragraph (1), that an individual or business that 

19 was enrolled in the program under this section did 

20 not meet the disruption or other eligibility require21 ments provided for in paragraph (1) or (2) of sub22 section (b), the Secretary shall seek the repayment 

23 of funds paid on behalf of such individual or busi24 ness. Such repayments shall be made with no inter25 est or late penalty to accrue prior to the commence-
30 

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1 ment of a repayment period which shall begin not 

2 earlier than the date that is 3 months after the date 

3 on which a determination and notice of non-eligi4 bility is provided. 

5 (3) NO DOUBLE PAYMENTS.—The Secretary 

6 shall take appropriate actions to ensure that health 

7 insurance issuers do not retain double payments in 

8 instances where businesses or individuals pay pre9 miums for any period for which payments have al10 ready been made under the program under this sec11 tion. 

12 (e) EMERGENCY PERIOD.—Payments under the pro13 gram under this section shall be made only for premiums 

14 due during the period beginning on August 29, 2005 and 

15 expiring 3 months after such date. Prior to the expiration 

16 of such period, the Secretary may make recommendations 

17 to Congress regarding any reasonably determined need to 

18 extend such emergency period. 

19 (f) NON-CANCELLATION OF HEALTH INSURANCE

20 COVERAGE.— 

21 (1) IN GENERAL.—During the 3-month emer22 gency period described in subsection (e), health in23 surance issuers that accept payments under the pro24 gram under this section shall be prohibited from 

25 canceling or terminating health insurance coverage 
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1 or, in the case of administrative services providers, 

2 refusing to process claims under a self-insured ar3 rangement. Such health insurance issuers and ad4 ministrative service providers shall be prohibited 

5 during such period from increasing any amounts due 

6 pursuant to such coverage or arrangements that 

7 were not previously scheduled pursuant to a contract 

8 prior to August 29, 2005. 

9 (2) NOTIFICATION.—To be eligible to receive 

10 payments under ths program under this section, a 

11 health insurance issuer or administrative services 

12 provider shall notify the Secretary— 

13 (A) not earlier than 31 days following the 

14 nonpayment of a scheduled premium payment 

15 from an individual or business policyholder in a 

16 Hurricane Katrina disaster area, of the fact of 

17 such nonpayment (or nonreimbursement of 

18 claims under a self-insured arrangement); or 

19 (B) following a communication to the 

20 health insurance insurer or administrative serv21 ice provider by an individual or business reason22 ably indicating eligibility for assistance under 

23 such program, of the fact of such communica24 tion. 
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1 (g) EXPEDITED RULEMAKING.—The Secretary shall 

2 utilize expedited rulemaking procedures to carry out this 

3 section. 

4 (h) AUTHORIZATION OF APPROPRIATIONS.—There is 

5 authorized to be appropriated to carry out this section 

6 $1,000,000,000 for fiscal year 2006. 

7 SEC. 402. AUTHORITY TO POSTPONE CERTAIN DEADLINES 

8 RELATED TO INDIVIDUAL HEALTH COV9 ERAGE BY REASON OF PRESIDENTIALLY DE10 CLARED DISASTER OR TERRORISTIC OR 

11 MILITARY ACTION. 

12 (a) IN GENERAL.—Title XXVII of the Public Health 

13 Service Act (42 U.S.C. 300gg et seq.) is amended by add14 ing at the end the following: 

15 ‘‘SEC. 2793. AUTHORITY TO POSTPONE CERTAIN DEAD16 LINES BY REASON OF PRESIDENTIALLY DE17 CLARED DISASTER OR TERRORISTIC OR 

18 MILITARY ACTION. 

19 ‘‘In the case of a plan offered through the individual 

20 market, or any health insurance issuer, participant, bene21 ficiary, or other person with respect to such plan, affected 

22 by a Presidentially declared disaster (as defined in section 

23 1033(h)(3) of the Internal Revenue Code of 1986) or a 

24 terroristic or military action (as defined in section 

25 692(c)(2) of such Code), the Secretary may, notwith-
33 

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1 standing any other provision of law, prescribe, by notice 

2 or otherwise, a period of up to 1 year which may be dis3 regarded in determining the date by which any action is 

4 required or permitted to be completed under this title. No 

5 plan shall be treated as failing to be operated in accord6 ance with the terms of the plan solely as a result of dis7 regarding any period by reason of the preceding sen8 tence.’’. 

9 (b) APPLICATION OF AMENDMENT.—The Secretary 

10 of Health and Human Services shall implement the 

11 amendment made by subsection (a) in the same manner 

12 in which the Secretary of Labor implements section 518 

13 of the Employee Retirement Income Security Act of 1974 

14 (29 U.S.C. 1148) with respect to group health plans. 

15 TITLE V—EMERGENCY 

16 DESIGNATION 

17 SEC. 501. EMERGENCY DESIGNATION. 

18 Any amount provided under this Act is designated as 

19 an emergency requirement pursuant to section 402 of H. 

20 Con. Res. 95 (109th Congress). 

Æ