I 
117TH CONGRESS 
1ST SESSION H. R. 4937 
To provide Medicaid assistance to individuals and families affected by a 
disaster or emergency, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
AUGUST 6, 2021 
Mr. PANETTA (for himself, Mr. LANGEVIN, and Miss GONZA´LEZ-COLO´N) in-
troduced the following bill; which was referred to the Committee on En-
ergy 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 jurisdic-
tion of the committee concerned 
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-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Disaster Relief Med-
icaid Act’’. 
SEC. 2. MEDICAID RELIEF FOR DISASTER SURVIVORS. 
Title XIX of the Social Security Act (42 U.S.C. 1396 
et seq.) is amended— 
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(1) in section 1902(a)— 
(A) in paragraph (86), by striking ‘‘; and’’ 
and inserting a semicolon; 
(B) in paragraph (87), by striking the pe-
riod at the end and inserting ‘‘; and’’; and 
(C) by inserting after paragraph (87) the 
following new paragraph: 
‘‘(88) beginning January 1, 2023, provide for 
making medical assistance available to relief-eligible 
survivors of disasters during relief coverage periods 
in accordance with section 1948.’’; and 
(2) by adding at the end the following new sec-
tion: 
‘‘SEC. 1948. DISASTER RELIEF MEDICAID FOR SURVIVORS 
OF MAJOR DISASTERS. 
‘‘(a) IN GENERAL.—Notwithstanding any other pro-
vision of this title, a State plan shall provide medical as-
sistance to a relief-eligible survivor of a disaster in accord-
ance with this section. 
‘‘(b) DEFINITIONS.—In this section: 
‘‘(1) DISASTER.—The term ‘disaster’ means a 
major disaster— 
‘‘(A) that is declared on or after January 
1, 2023, by the President in accordance with 
section 401 of the Robert T. Stafford Disaster 
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Relief and Emergency Assistance Act (42 
U.S.C. 5170); and 
‘‘(B) which the President has determined 
warrants individual and public assistance from 
the Federal Government under such Act. 
‘‘(2) DIRECT IMPACT AREA.— 
‘‘(A) IN GENERAL.—The term ‘direct im-
pact area’ means, with respect to a disaster, the 
geographic area in which the disaster exists. 
‘‘(B) WEBSITE
POSTING
OF
DIRECT
IM-
PACT AREAS.—As soon as practicable after a 
disaster is declared (as described in paragraph 
(1)(A)), the Secretary shall post on the website 
of the Centers for Medicare & Medicaid Serv-
ices a list of the areas identified as the direct 
impact areas of the disaster. 
‘‘(3) HOME
STATE.—The term ‘home State’ 
means, with respect to a survivor of a disaster, the 
State in which the survivor was living and was a 
resident, as determined by the State in which the 
survivor is applying for medical assistance under 
this title, during the 7-day period preceding the date 
on which the disaster is declared (as described in 
paragraph (1)(A)). 
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‘‘(4) RELIEF
COVERAGE
PERIOD.—The term 
‘relief coverage period’ means, with respect to a dis-
aster, the period that begins on the date the disaster 
is declared (as described in paragraph (1)(A)) and 
ends on the day that is 2 years after such date. 
‘‘(5) RELIEF-ELIGIBLE SURVIVOR.— 
‘‘(A) IN
GENERAL.—Subject to subpara-
graph (C), the term ‘relief-eligible survivor’ 
means an individual who is a survivor of a dis-
aster whose family income does not exceed the 
higher of— 
‘‘(i) 133 percent (or, in the case of a 
survivor who is a pregnant woman, a child, 
or a recipient of benefits under title II on 
the basis of a disability, 200 percent) of 
the poverty line; or 
‘‘(ii) the income eligibility standard 
that would otherwise apply to the survivor 
under the State plan of the survivor’s 
home State (or a waiver of such plan). 
‘‘(B) DISREGARD OF UNEMPLOYMENT IN-
COME.—For purposes of this section, and not-
withstanding section 1902(e)(14)(B), the in-
come of a survivor of a disaster shall not in-
clude any amount received during the relief cov-
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erage period of the disaster under a law of the 
United States or a State which is in the nature 
of unemployment compensation. 
‘‘(C) LIMITATION
TO
RELIEF
COVERAGE 
PERIOD.— 
‘‘(i) IN
GENERAL.—Except as pro-
vided in clauses (ii) and (iii), for purposes 
of this section, an individual shall not be 
considered to be a relief-eligible survivor on 
the basis of the individual’s status as a 
survivor of a disaster after the end of the 
relief coverage period of the disaster. 
‘‘(ii) CONTINUOUS
ELIGIBILITY
FOR 
DISASTER
RELIEF
COVERAGE
FOR
PREG-
NANT AND POSTPARTUM INDIVIDUALS.—In 
the case of an individual who, while preg-
nant, receives medical assistance as a re-
lief-eligible survivor of a disaster under a 
State plan (or a waiver of such a plan) in 
accordance with this section, such indi-
vidual shall continue to be eligible for med-
ical assistance as a relief-eligible survivor 
through the end of the month in which the 
60-day period (beginning on the last day of 
the pregnancy) ends, without regard to 
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whether the pregnancy ends before or after 
the end of the relief coverage period of the 
disaster. 
‘‘(iii) CONTINUOUS
ELIGIBILITY
FOR 
INDIVIDUALS
WITH
PENDING
APPLICA-
TIONS.—If an individual who receives med-
ical assistance as a relief-eligible survivor 
of a disaster under a State plan (or a 
waiver of such a plan) in accordance with 
this section has an application pending for 
medical assistance under the State plan (or 
waiver) under this title or for child health 
assistance or pregnancy-related assistance 
under a State plan under title XXI (or a 
waiver of such a plan) on the date that the 
relief coverage period of the disaster ends, 
such individual shall continue to be eligible 
for medical assistance as a relief-eligible 
survivor through the earlier of— 
‘‘(I) the end of the month in 
which the 60-day period (beginning on 
the last day of such relief coverage pe-
riod) ends; and 
‘‘(II) the date on which the indi-
vidual’s application for medical assist-
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‘‘(I) conducted an active trade or 
business in such area on any day dur-
ing such 7-day period; and 
‘‘(II) was unable to operate such 
trade or business as a result of the 
disaster on any day during the disas-
ter’s relief coverage period; and 
‘‘(iii) whose employment with such 
employer was terminated. 
‘‘(D) TREATMENT
OF
HOMELESS
PER-
SONS.—In the case of an individual who was 
homeless on any day during the 7-day period 
preceding the date on which a disaster is de-
clared (as so described), the individual’s resi-
dency for purposes of subparagraph (B) shall 
be determined as it would otherwise be deter-
mined by the home State of the individual for 
purposes of this title. 
‘‘(E) EFFECT
OF
CONCURRENT
ELIGI-
BILITY FOR MEDICAID OR CHIP.—An individ-
ual’s eligibility for medical assistance under a 
State plan (or waiver of such plan) (or for child 
health assistance or pregnancy-related assist-
ance under a State plan under title XXI (or a 
waiver of such a plan)) on a basis other than 
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under this section shall not prevent the indi-
vidual from being treated as a survivor under 
this section, and the rights afforded to an indi-
vidual who is eligible for or enrolled under a 
State plan (or waiver) under either such title 
shall not be affected by the individual’s receipt 
of medical assistance as a relief-eligible survivor 
of a disaster in accordance with this section. 
‘‘(c) ELIGIBILITY.— 
‘‘(1) SIMPLIFIED APPLICATION.— 
‘‘(A) IN GENERAL.—For purposes of deter-
mining eligibility for medical assistance under 
this section, each State may accept a simplified, 
streamlined application form (as developed by 
the Secretary in consultation with the National 
Association of State Medicaid Directors), which 
shall— 
‘‘(i) require an applicant for medical 
assistance in accordance with this section 
as a survivor of a disaster to— 
‘‘(I) provide the applicant’s mail-
ing address for the duration of the re-
lief coverage period of the disaster; 
and 
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‘‘(II) agree to update the infor-
mation described in subclause (I) if it 
changes during such period; 
‘‘(ii) provide notice of the penalties for 
making a fraudulent application described 
in subsection (g); 
‘‘(iii) require the applicant to assign 
to the State any rights of the applicant (or 
any other individual who is a relief-eligible 
survivor and on whose behalf the applicant 
has the legal authority to execute an as-
signment of such rights) as described and 
in accordance with the requirements of sec-
tion 1912; 
‘‘(iv) require the applicant to list any 
health insurance coverage in which the ap-
plicant was enrolled immediately prior to 
submitting the application for medical as-
sistance under this section; and 
‘‘(v) require the applicant to self-at-
test that the applicant— 
‘‘(I) is a relief-eligible survivor of 
the disaster; and 
‘‘(II) if applicable, requires home 
and community-based services. 
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‘‘(B) 
NO
DOCUMENTATION
REQUIRE-
MENT.— 
‘‘(i) IN GENERAL.—A State shall not 
require an applicant for medical assistance 
as a survivor of a disaster under this sec-
tion to provide any documentation or other 
evidence— 
‘‘(I) of the applicant’s status as a 
relief-eligible survivor; and 
‘‘(II) if applicable, that the appli-
cant requires home and community- 
based services. 
‘‘(ii) USE OF AVAILABLE ELECTRONIC 
DATA
SOURCES.—In making determina-
tions with respect to the status of an appli-
cant for medical assistance as a survivor of 
a disaster under this section, or such an 
applicant’s need for home and community- 
based services, a State may use data relat-
ing to the applicant that is available to the 
State from electronic data sources. 
‘‘(2) PRESUMPTIVE ELIGIBILITY FOR RELIEF- 
ELIGIBLE SURVIVORS.— 
‘‘(A) IN GENERAL.—A State shall provide 
for making medical assistance available to an 
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individual as a relief-eligible survivor under this 
section during a presumptive eligibility period. 
‘‘(B) PRESUMPTIVE
ELIGIBILITY
PERIOD 
DEFINED.—For purposes of this paragraph— 
‘‘(i) the term ‘presumptive eligibility 
period’ means, with respect to an indi-
vidual, the period that— 
‘‘(I) begins with the date on 
which a qualified provider determines, 
on the basis of preliminary informa-
tion, that the individual satisfies the 
criteria for eligibility for medical as-
sistance as a relief-eligible survivor 
under this section; and 
‘‘(II) ends with (and includes) 
the earlier of— 
‘‘(aa) the day on which a de-
termination is made with respect 
to the eligibility of the individual 
for medical assistance as a relief- 
eligible survivor under this sec-
tion; or 
‘‘(bb) in the case of an indi-
vidual who does not file an appli-
cation by the last day of the 
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month following the month dur-
ing which the provider makes the 
determination referred to in item 
(aa), such last day; and 
‘‘(ii) the term ‘qualified provider’ has 
the meaning given such term in section 
1920. 
‘‘(C) COORDINATION
BETWEEN
STATE 
AGENCIES AND QUALIFIED PROVIDERS.— 
‘‘(i) PROVISION
OF
FORMS
AND
IN-
FORMATION TO QUALIFIED PROVIDERS.— 
The State agency shall provide qualified 
providers with— 
‘‘(I) such forms as are necessary 
for an individual to make application 
for medical assistance under the State 
plan as a relief-eligible survivor; and 
‘‘(II) information on how to as-
sist individuals and their authorized 
representatives in completing and fil-
ing such forms. 
‘‘(ii) PROVISION OF NOTICE OF DE-
TERMINATIONS
TO
STATE
AGENCIES.—A 
qualified provider that determines under 
this subparagraph that an individual is eli-
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‘‘(E) TREATMENT
AS
MEDICAL
ASSIST-
ANCE.—Notwithstanding any other provision of 
this title, items and services that are— 
‘‘(i) furnished to an individual during 
a presumptive eligibility period under this 
paragraph by a provider that is eligible for 
payments under the State plan; and 
‘‘(ii) included in the care and services 
covered by the State plan, 
shall be treated as medical assistance provided 
to a relief-eligible survivor of a disaster during 
the relief coverage period of the disaster under 
this section. 
‘‘(3) CONTINUOUS ELIGIBILITY.— 
‘‘(A) IN
GENERAL.—Subject to subpara-
graph (B), an individual who is determined by 
a State to be a relief-eligible survivor of a dis-
aster shall remain eligible for medical assistance 
under the State plan (or a waiver of such plan) 
as such a survivor, without the need for any re-
determination of eligibility, for the duration of 
the relief coverage period of the disaster. 
‘‘(B) EXCEPTIONS.—A State may termi-
nate the eligibility of an individual who is deter-
mined by a State to be a relief-eligible survivor 
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of a disaster before the end of the relief cov-
erage period of the disaster if— 
‘‘(i) the individual (or the individual’s 
authorized representative) requests a vol-
untary termination of eligibility; 
‘‘(ii) the individual ceases to be a resi-
dent of the State; 
‘‘(iii) the State determines that eligi-
bility was erroneously granted because of 
State error or fraud, abuse, or perjury at-
tributed to the individual (or the individ-
ual’s authorized representative); or 
‘‘(iv) the individual dies. 
‘‘(4) ISSUANCE OF DISASTER RELIEF MEDICAID 
ELIGIBILITY CARD.—A State shall issue a disaster 
relief Medicaid eligibility card to each applicant who 
is determined to be a relief-eligible survivor of a dis-
aster and eligible for medical assistance under this 
section, which shall be valid for the duration of the 
relief coverage period of the disaster. 
‘‘(5) VERIFICATION OF STATUS AS A RELIEF- 
ELIGIBLE SURVIVOR.— 
‘‘(A) IN GENERAL.—The State shall make 
a good faith effort to verify the status of an in-
dividual who is enrolled in the State plan (or a 
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waiver of such plan) as a relief-eligible survivor 
of a disaster in accordance with this section. 
Such effort shall not delay the determination of 
the eligibility of the individual for medical as-
sistance under this section, and a State may en-
roll an individual in the State plan or waiver 
under this section pending such verification. 
‘‘(B) EVIDENCE
OF
VERIFICATION.—A 
State may satisfy the verification requirement 
under subparagraph (A) with respect to an in-
dividual by showing that the State obtained in-
formation from the Social Security Administra-
tion, the Internal Revenue Service, or, if appli-
cable, the State Medicaid agency of the home 
State of the individual. 
‘‘(6) DETERMINATION BY EXPRESS LANE AGEN-
CY.—Any determination or redetermination of eligi-
bility or verification of status made under this sec-
tion shall be made by an Express Lane agency (as 
defined in section 1902(e)(13)(F)). 
‘‘(d) SCOPE OF COVERAGE.— 
‘‘(1) IN GENERAL.—A State providing medical 
assistance to a relief-eligible survivor of a disaster in 
accordance with this section shall provide medical 
assistance that is equal in amount and scope to the 
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medical assistance that would otherwise be made 
available to such survivor if the survivor were en-
rolled in the State plan (or waiver of such plan) as 
an individual described in clause (i) of section 
1902(a)(10)(A), except that, in the case of such a 
survivor whose home State is not the State providing 
medical assistance to the individual, the State shall 
also provide medical assistance for any item or serv-
ice for which medical assistance is available to indi-
viduals 
described 
in 
clause 
(i) 
of 
section 
1902(a)(10)(A) under the State plan (or waiver) of 
the survivor’s home State. 
‘‘(2) PROVIDER
PAYMENT
RATES
FOR
HOME 
STATE SERVICES.—In the case of medical assistance 
provided under this section by a State to a relief-eli-
gible survivor of a disaster whose home State is not 
the State providing such assistance for an item or 
service which is not otherwise available under the 
State plan (or waiver of such plan) but which is 
available under the State plan (or waiver) of the sur-
vivor’s home State, the State shall pay the provider 
of such item or service at the same rate that the 
home State would pay for the item or service if it 
were provided under the plan or waiver of the home 
State (or, if no such payment rate applies under the 
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plan or waiver of the home State, the usual and cus-
tomary prevailing rate for the item or service for the 
community in which it is provided). 
‘‘(3) RETROACTIVE COVERAGE.— 
‘‘(A) IN GENERAL.—Notwithstanding sec-
tion 1905(a), a State shall provide medical as-
sistance for items and services furnished in the 
State beginning with the first day of the relief 
coverage period of a disaster to any relief-eligi-
ble survivor of the disaster who submits an ap-
plication for such assistance before the deadline 
described in subparagraph (B). 
‘‘(B) APPLICATION DEADLINE.—The dead-
line for a relief-eligible survivor of a disaster to 
submit an application for medical assistance in 
accordance with this section is the date that is 
90 days after the end of the disaster’s relief 
coverage period. 
‘‘(4) CHILDREN
BORN
TO
RELIEF-ELIGIBLE 
SURVIVORS OF A DISASTER.—In the case of a child 
born to a relief-eligible survivor of a disaster who is 
provided medical assistance in accordance with this 
section during the relief coverage period of the dis-
aster, the child shall be treated as having been born 
to a pregnant woman eligible for medical assistance 
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under the State plan (or waiver of such plan) and 
shall be eligible for medical assistance under such 
plan (or waiver) in accordance with section 
1902(e)(4). Notwithstanding subsection (f), the Fed-
eral medical assistance percentage determined for a 
State and fiscal year under section 1905(b) shall 
apply to medical assistance provided during the year 
to a child under the State plan (or waiver) in ac-
cordance with the preceding sentence. 
‘‘(5) OPTION TO PROVIDE EXTENDED MENTAL 
HEALTH
AND
CARE
COORDINATION
BENEFITS.—A 
State may provide, without regard to any restric-
tions on amount, duration, scope, or comparability, 
or other restrictions under this title or the State 
plan or waiver of such plan (other than restrictions 
applicable to services provided in an institution for 
mental diseases), medical assistance to relief-eligible 
survivors of a disaster under this section for ex-
tended mental health and care coordination services, 
which may include the following: 
‘‘(A) Screening, assessment, and diagnostic 
services (including specialized assessments for 
individuals with cognitive impairments). 
‘‘(B) Coverage for a full range of mental 
health medications at the dosages and fre-
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quencies prescribed by health professionals for 
depression, post-traumatic stress disorder, and 
other mental disorders. 
‘‘(C) Treatment of alcohol and substance 
abuse determined to result from circumstances 
related to the disaster. 
‘‘(D) Psychotherapy, rehabilitation and 
other treatments administered by psychiatrists, 
psychologists, or social workers for conditions 
exacerbated by, or resulting from, the disaster. 
‘‘(E) Peer support services related to the 
disaster. 
‘‘(F) Mobile crisis services to assist with 
crises related to the disaster. 
‘‘(G) Inpatient mental health care in a 
general hospital. 
‘‘(H) Family counseling for families where 
a member of the immediate family is a survivor 
of the disaster or a first responder to the dis-
aster or includes an individual who has died as 
a result of the disaster. 
‘‘(I) In connection with the provision of 
health and long-term care services, arranging 
for, (and when necessary, enrollment in waiver 
programs or other specialized programs), and 
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coordination related to, primary and specialty 
medical care, which may include personal care 
services, durable medical equipment and sup-
plies, assistive technology, and transportation. 
‘‘(6) OPTION TO PROVIDE HOME AND COMMU-
NITY-BASED SERVICES.— 
‘‘(A) IN GENERAL.—A State may provide 
medical assistance under this section for home 
and community-based services to a relief-eligible 
survivor of a disaster, including any survivor 
who is an individual described in subparagraph 
(B), who self-attests that the survivor imme-
diately requires such services, without regard to 
whether the survivor would require the level of 
care provided in a hospital, nursing facility, or 
intermediate care facility for the develop-
mentally disabled. 
‘‘(B) INDIVIDUALS
DESCRIBED.—Individ-
uals described in this subparagraph are relief- 
eligible survivors of a disaster who— 
‘‘(i) on any day during the week pre-
ceding the date on which the disaster is de-
clared 
(as 
described 
in 
subsection 
(b)(1)(A))— 
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‘‘(I) had been receiving home and 
community-based services in a direct 
impact area under a waiver under sec-
tion 1115 or section 1915; 
‘‘(II) had been receiving support 
services from a primary family care-
giver who, as a result of the disaster, 
is no longer available to provide serv-
ices; or 
‘‘(III) had been receiving per-
sonal care, home health, or rehabilita-
tive services under a State plan under 
this title or under a waiver granted 
under sections 1115 or 1915; or 
‘‘(ii) are disabled (as determined 
under the State plan). 
‘‘(C) WAIVER OF RESTRICTIONS.—With re-
spect to the provision of home and community- 
based services under this paragraph, the Sec-
retary— 
‘‘(i) shall waive any limitations on— 
‘‘(I) the number of individuals 
who may receive home or community- 
based services under a waiver de-
scribed in subparagraph (B)(i)(I); 
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‘‘(II) budget neutrality require-
ments applicable to such waiver; and 
‘‘(III) populations eligible for 
services under such waiver; and 
‘‘(ii) may waive any other restriction 
applicable under such a waiver that would 
prevent a State from providing home and 
community-based services in accordance 
with this paragraph. 
‘‘(e) STATE REPORTS.—Each State shall submit to 
the Secretary an annual report that includes— 
‘‘(1) the number of survivors of a disaster who 
were determined by the State to be relief-eligible 
survivors of a disaster in the preceding year; and 
‘‘(2) the number of relief-eligible survivors of a 
disaster who were determined to be eligible for, and 
enrolled in, the State plan (or waiver of such plan) 
or the State child health plan under title XXI (or 
waiver of such plan) other than under this section. 
‘‘(f) 100-PERCENT
FEDERAL
MATCHING
PAY-
MENTS.— 
‘‘(1) IN
GENERAL.—Notwithstanding section 
1905(b), the Federal medical assistance percentage 
shall be equal to 100 percent with respect to 
amounts expended by a State— 
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‘‘(A) for medical assistance provided in ac-
cordance with this section to relief-eligible sur-
vivors of a disaster during the relief coverage 
period of the disaster and, in the case of indi-
viduals described in clause (ii) or (iii) of sub-
section (b)(5)(C), during the applicable periods 
described in such clauses; and 
‘‘(B) that are directly attributable to ad-
ministrative activities related to the provision of 
medical assistance under this section, including 
costs attributable to obtaining recoveries under 
subsection (g). 
‘‘(2) DISREGARD OF LIMITS ON PAYMENTS TO 
TERRITORIES.—The limitations on payment under 
subsections (f) and (g) of section 1108 shall not 
apply to Federal payments under this title that are 
based on the Federal medical assistance percentage 
described in paragraph (1), and such payments shall 
be disregarded in applying such subsections. 
‘‘(g) PENALTY FOR FRAUDULENT APPLICATIONS.— 
‘‘(1) INDIVIDUAL
LIABLE
FOR
COSTS.—If a 
State, as the result of verification activities con-
ducted by the State or otherwise, determines after a 
fair hearing that an individual has knowingly made 
a false attestation in an application for medical as-
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sistance as a relief-eligible survivor of a disaster 
under this section, the State shall, subject to para-
graph (2), seek recovery from the individual for the 
full amount of the cost of medical assistance pro-
vided to the individual under this section. 
‘‘(2) EXCEPTION.—The Secretary shall exempt 
a State from the requirement to seek recovery from 
an individual under paragraph (1) if the Secretary 
determines that it would not be cost-effective for the 
State to do so. 
‘‘(3) REIMBURSEMENT TO THE FEDERAL GOV-
ERNMENT.—Amounts expended by a State for med-
ical assistance provided to an individual under this 
section that are subsequently recovered by the State 
under this subsection shall be treated as an overpay-
ment under this title to the extent that payments 
were made to the State for such amounts. 
‘‘(h) EXEMPTION FROM ERROR RATE PENALTIES.— 
All payments attributable to providing medical assistance 
to relief-eligible survivors of disasters in accordance with 
this section shall be disregarded for purposes of section 
1903(u).’’. 
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SEC. 3. PROMOTING EFFECTIVE AND INNOVATIVE STATE 
RESPONSES TO INCREASED DEMAND FOR 
MEDICAL ASSISTANCE FOLLOWING A DIS-
ASTER. 
(a) GUIDANCE
ON INCREASING ACCESS
TO PRO-
VIDERS.—Not later than January 1, 2023, the Secretary 
of Health and Human Services (in this section referred 
to as the ‘‘Secretary’’) shall issue (and update as the Sec-
retary determines necessary) guidance to State Medicaid 
directors on best practices for— 
(1) expediting the approval of providers under 
a State Medicaid plan under title XIX of the Social 
Security Act (42 U.S.C. 1396 et seq.), or waiver of 
such plan, after a disaster to meet increased demand 
for medical assistance under the plan or waiver from 
relief-eligible survivors (as defined in section 
1948(b)(5) of such Act) of disasters; and 
(2) using out-of-State providers to provide care 
to relief-eligible survivors of a disaster under the 
plan or waiver. 
(b) TECHNICAL ASSISTANCE AND SUPPORT FOR IN-
NOVATIVE STATE STRATEGIES TO RESPOND
TO IN-
CREASED DEMAND
FOR MEDICAL ASSISTANCE FOL-
LOWING A DISASTER.— 
(1) IN GENERAL.—The Secretary shall provide 
technical assistance and support to States to develop 
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or expand infrastructure, strategies, or innovations 
(including through State Medicaid demonstration 
projects) to provide medical assistance under a State 
Medicaid plan under title XIX of the Social Security 
Act (42 U.S.C. 1396 et seq.), or a waiver of such 
a plan, to relief-eligible survivors (as defined in sec-
tion 1948(b)(5) of such Act) of disasters. 
(2) REPORT.—Not later than 180 days after 
the date of enactment of this Act, the Secretary 
shall issue a report to Congress detailing a plan of 
action to carry out the requirements of paragraph 
(1). 
(c) HCBS EMERGENCY RESPONSE CORPS GRANT 
PROGRAM.— 
(1) IN GENERAL.—The Secretary shall award 
grants under this subsection to States for the pur-
pose of establishing or operating HCBS emergency 
response corps that meet the requirements of para-
graph (2) to provide medical assistance for home 
and community-based services under a State Med-
icaid plan under title XIX of the Social Security Act 
(42 U.S.C. 1396 et seq.) to relief-eligible survivors 
(as defined in section 1948(b)(5) of such Act) of dis-
asters. 
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(2) HOME
AND
COMMUNITY-BASED
SERVICES 
EMERGENCY
RESPONSE
CORPS.—An HCBS emer-
gency response corps meets the requirements of this 
paragraph if it satisfies the following requirements: 
(A) The corps serves a State with a history 
of hosting individuals who are forced to relocate 
to the State from another State due to a dis-
aster (as determined by the Secretary). 
(B) The corps is composed of representa-
tives from each of the following: 
(i) Voluntary organizations delivering 
assistance. 
(ii) Area agencies on aging (as defined 
in section 102 of the Older Americans Act 
of 1965 (42 U.S.C. 3002)). 
(iii) The Medicare program under title 
XVIII of the Social Security Act (42 
U.S.C. 1395 et seq.). 
(iv) The State agency responsible for 
administering the State Medicaid program 
under title XIX of the Social Security Act 
(42 U.S.C. 1396 et seq.). 
(v) State agencies serving older adults 
and people with disabilities. 
(vi) Nonprofit service providers. 
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(vii) Individuals who are enrolled in 
the State Medicaid program under title 
XIX of the Social Security Act (42 U.S.C. 
1396 et seq.) or the Children’s Health In-
surance Program under title XXI of the 
Social Security Act (42 U.S.C. 1397aa et 
seq.). 
(viii) Other organizations that address 
the needs of older adults and people with 
disabilities. 
(C) The corps is led by a representative of 
a State or nonprofit agency serving older adults 
or people with disabilities. 
(D) The corps operates under a plan to 
meet the acute and long-term services and sup-
port needs of relief-eligible survivors (as defined 
in section 1948(b)(5) of the Social Security 
Act) of disasters, and is provided with the re-
sources necessary to execute such plan. 
(3) GRANTS.— 
(A) 
LIMITATION.—The 
Secretary 
may 
award a grant under this subsection to up to 5 
States. 
(B) TERM OF GRANTS.—Grants under this 
subsection shall be made for a term of 2 years. 
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(4) AUTHORIZATION.—There are authorized to 
be appropriated to carry out this subsection, 
$10,000,000 for each of fiscal years 2022 through 
2027, to remain available until expended. 
SEC. 4. TARGETED MEDICAID RELIEF FOR DIRECT IMPACT 
AREAS. 
(a) 100-PERCENT FEDERAL MATCHING PAYMENTS 
FOR MEDICAL ASSISTANCE PROVIDED IN A DIRECT IM-
PACT AREA.— 
(1) IN GENERAL.—Section 1905 of the Social 
Security Act (42 U.S.C. 1396d) is amended— 
(A) in subsection (b), by striking ‘‘and 
(ii)’’ and inserting ‘‘(ii), and (jj)’’; and 
(B) by adding at the end the following new 
subsection: 
‘‘(jj) 100-PERCENT FMAP FOR ALL MEDICAL AS-
SISTANCE
PROVIDED
IN
DISASTER
DIRECT
IMPACT 
AREAS.—Notwithstanding subsection (b), the Federal 
medical assistance percentage for a State and fiscal year 
shall be equal to 100 percent with respect to amounts ex-
pended by the State during the year for medical assistance 
for an individual who, at the time the assistance is pro-
vided to the individual, is a resident of a direct impact 
area of a disaster during the disaster’s relief coverage pe-
riod (as such terms are defined in section 1948).’’. 
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