I 
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 Representa-
tives 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 pro-
gram 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
LOCAL-
ITIES.— 
(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 Lou-
isiana that is among the parishes that 
the Federal Emergency Management 
Agency of the Emergency Prepared-
ness and Response Directorate of the 
Department of Homeland Security de-
clared on September 4, 2005, to be 
Federal Disaster Parishes; or 
(II) a county in the State of Ala-
bama 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 par-
ishes 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 as-
sistance was in error. 
(C) INDIVIDUALS
WHO
LOST
EMPLOY-
MENT.—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
PER-
SONS.—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 other-
wise 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, Ala-
bama, and Mississippi.
(b) RULES FOR PROVIDING TEMPORARY MEDICAL 
ASSISTANCE TO KATRINA SURVIVORS.—During the dis-
aster relief period, any State may provide medical assist-
ance 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
REQUIRE-
MENTS.—Such assistance shall be provided 
without application of any income or resources 
test, State residency, or categorical eligibility 
requirements. 
(B) STREAMLINED
ELIGIBILITY
PROCE-
DURES.—The State shall use the following 
streamlined procedures in processing applica-
tions and determining eligibility for medical as-
sistance 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 Di-
rectors. Such form shall include notice re-
garding the penalties for making a fraudu-
lent 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 documenta-
tion evidencing the basis on which the ap-
plicant 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 ap-
plication 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 facili-
ties identified in section 1902(a)(55) of the
Social 
Security 
Act 
(42 
U.S.C. 
1396a(a)(55)) and it appears to the pro-
vider that the applicant is a Katrina Sur-
vivor based on the information in the ap-
plication, 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 pe-
riod. 
(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 as-
sistance 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 med-
ical 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 indi-
vidual with written notice of the determination
and provide the individual with continued cov-
erage for such medical assistance for so long as 
the individual remains eligible under such oth-
erwise applicable eligibility rules. If a State de-
termines that the individual is not so eligible, 
the State shall provide the individual with writ-
ten notice of the determination, including the 
reasons for such determination. 
(2) SCOPE OF COVERAGE SAME AS CATEGORI-
CALLY NEEDY.—The State shall treat Katrina Sur-
vivors 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 Sur-
vivor 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 informa-
tion from the Social Security Administration, 
the Internal Revenue Service, or the State Med-
icaid 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 de-
termines 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 re-
lief period. 
(4) PENALTY
FOR
FRAUDULENT
APPLICA-
TIONS.— 
(A) INDIVIDUAL LIABLE FOR COSTS.—If a 
State, as the result of verification activities con-
ducted under paragraph (3), determines after a 
fair hearing that an individual has knowingly 
made a false self-attestation described in para-
graph (1)(B)(ii), the State may, subject to sub-
paragraph (B), seek recovery from the indi-
vidual for the full amount of the cost of medical 
assistance provided to the individual under this 
section. 
(B) EXCEPTION.—The Secretary shall ex-
empt a State from seeking recovery under sub-
paragraph (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
PEN-
ALTIES.—All payments attributable to providing 
medical assistance to Katrina Survivors in accord-
ance with this section shall be disregarded for pur-
poses 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 ASSIST-
ANCE.—Notwithstanding section 1905(b) of the So-
cial 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 med-
icaid plan during the disaster relief period, shall be 
100 percent. 
(2) 100 PERCENT FEDERAL MATCH FOR CER-
TAIN
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 re-
late 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 imple-
mentation of this paragraph. 
(b) LIMITATION ON REDUCTION OF FMAP FOR FIS-
CAL 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 percent-
age determined for the State for fiscal year 2005, the Fed-
eral 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 Secu-
rity 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 COV-
ERAGE FOR DUAL ELIGIBLES.—Section 1935(d)(1) 
of such Act shall also not apply, subject to para-
graph (3), before January 2007 to a part D eligible 
individual who is a Katrina Survivor. 
(3) TERMINATION
OF
APPLICATION
OF
SUB-
SECTION.—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 indi-
viduals 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 with-
out a discontinuation in prescription drug coverage 
for any such individual. 
(4) DEFINITION.—For purposes of this sub-
section, the term ‘‘State that experiences a signifi-
cant 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-migra-
tion 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 dis-
aster relief period. 
(b) PART D.— 
(1) EXTENSION OF INITIAL ENROLLMENT PE-
RIOD.—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 Sur-
vivors, the Secretary of Health and Human Services 
shall establish documentation rules for Katrina Sur-
vivors which take into account the loss and unavail-
ability of documents due to Hurricane Katrina. 
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