I 
118TH CONGRESS 
1ST SESSION H. R. 4375 
To amend title XVIII of the Social Security Act to provide coverage of 
medically necessary home resiliency services under Medicare. 
IN THE HOUSE OF REPRESENTATIVES 
JUNE 27, 2023 
Mr. FROST (for himself, Ms. CLARKE of New York, Ms. JAYAPAL, Ms. NOR-
TON, Ms. WASSERMAN SCHULTZ, and Ms. SEWELL) introduced the fol-
lowing bill; which was referred to the Committee on Energy and Com-
merce, and in addition to the Committee on Ways and Means, for a pe-
riod to be subsequently determined by the Speaker, in each case for con-
sideration of such provisions as fall within the jurisdiction of the com-
mittee concerned 
A BILL 
To amend title XVIII of the Social Security Act to provide 
coverage of medically necessary home resiliency services 
under Medicare. 
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 ‘‘Survival Aid For 
Emergencies through Medicare Act’’ or the ‘‘SAFE 
through Medicare Act’’. 
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SEC. 2. MEDICARE COVERAGE OF MEDICALLY NECESSARY 
HOME RESILIENCY SERVICES. 
(a) COVERAGE.—Section 1861 of the Social Security 
Act (42 U.S.C. 1395x) is amended— 
(1) in subsection (s)(2)— 
(A) in subparagraph (II), by striking 
‘‘and’’ at the end; 
(B) in subparagraph (JJ), by inserting 
‘‘and’’ at the end; and 
(C) by adding at the end the following new 
subparagraph: 
‘‘(KK) in the case of an individual who is medi-
cally at-risk in the event of a climate or manmade 
disaster (as determined by the Secretary in accord-
ance with subsection (nnn)), home resiliency services 
(as defined in such subsection);’’; and 
(2) by adding at the end the following new sub-
section: 
‘‘(nnn) HOME RESILIENCY SERVICES; DETERMINA-
TION OF INDIVIDUALS MEDICALLY AT-RISK.— 
‘‘(1) HOME RESILIENCY SERVICES.—The term 
‘home resiliency services’ means items and serv-
ices— 
‘‘(A) furnished on or after January 1, 
2024, to an individual described in subsection 
(s)(2)(KK); and 
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‘‘(B) that the Secretary determines are 
medically necessary for such individual in the 
case of a climate or manmade disaster, such as 
a heat pump for an individual vulnerable to ex-
treme temperatures, solar batteries for an indi-
vidual reliant on electrical medical equipment 
(including home mechanical ventilators), and 
energy efficient cold-storage for heat-sensitive 
medical supplies. 
‘‘(2) DETERMINATION OF INDIVIDUALS MEDI-
CALLY
AT-RISK.—For 
purposes 
of 
subsection 
(s)(2)(KK) and this subsection, the Secretary, in 
consultation with the Office of Climate Change and 
Health Equity, the National Institutes of Health, 
the Centers of Medicare & Medicaid Services, and 
the National Oceanic and Atmospheric Administra-
tion, shall establish a process to determine the con-
ditions under which an individual would be deter-
mined to be medically at-risk in the event of a dis-
aster or climate hazards, including extreme heat, ex-
treme cold, flooding, and loss of power. Such a proc-
ess shall consider— 
‘‘(A) geography-specific climate risks and 
regional preparedness for different climate 
risks; 
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‘‘(B) the regional history of disaster or cli-
mate hazards and infrastructure failure in the 
preceding 20 years or the forward-looking pre-
dicted risk of disaster or climate hazards and 
infrastructure failure in the next 20 years; 
‘‘(C) medical reliance on equipment, phar-
maceuticals, mobility aids, and other supplies 
that are sensitive to exposure to extreme tem-
peratures, poor air quality, flooding and water 
damage, or dependent on electrical power; and 
‘‘(D) chronic medical conditions, disabil-
ities, and comorbidities that increase patient 
vulnerability during disaster.’’. 
(b) PAYMENT.—Section 1833(a)(1) of the Social Se-
curity Act (42 U.S.C. 1395l(a)(1)) is amended— 
(1) by striking ‘‘and’’ before ‘‘(HH)’’; and 
(2) by inserting before the semicolon at the end 
the following: ‘‘and (II) with respect to home resil-
iency services described in section 1861(s)(2)(KK), 
the amount paid shall be an amount equal to 100 
percent of the lesser of the actual charge for the 
services or the amount determined under a fee 
schedule established by the Secretary’’. 
Æ 
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