I 
116TH CONGRESS 
1ST SESSION H. R. 3215 
To provide Medicaid assistance to individuals and families affected by a 
disaster or emergency, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
JUNE 11, 2019 
Ms. SHALALA (for herself, Mr. LANGEVIN, Ms. NORTON, and Miss GONZA´LEZ- 
COLO´N of Puerto Rico) introduced the following bill; which was referred 
to the Committee on Energy and Commerce, and in addition to the Com-
mittee 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 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 (85), by striking ‘‘; and’’ 
and inserting a semicolon; 
(B) in paragraph (86), by striking the pe-
riod at the end and inserting ‘‘; and’’; and 
(C) by inserting after paragraph (86) the 
following new paragraph: 
‘‘(87) beginning January 1, 2020, provide for 
making medical assistance available to relief-eligible 
survivors of disasters during relief coverage periods 
in accordance with section 1947.’’; and 
(2) by adding at the end the following new sec-
tion: 
‘‘SEC. 1947. 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, 2020, 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 a resident during 
the 7-day period preceding the date on which the 
disaster is declared (as described in paragraph 
(1)(A)). 
‘‘(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 
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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.—The term ‘relief-eligi-
ble survivor’ means an individual who is a sur-
vivor of a disaster 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 or waiver of the sur-
vivor’s host State. 
‘‘(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-
erage period of the disaster under a law of the 
United States or a State which is in the nature 
of unemployment compensation. 
‘‘(6) SURVIVOR.— 
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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.—For purposes of subparagraph (B), 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 declared (as so de-
scribed), the individual’s ‘residence’ during such 
period shall be determined as it would otherwise 
be determined for purposes of this title. 
‘‘(E) EFFECT
OF
CONCURRENT
ELIGI-
BILITY FOR MEDICAID.—An individual’s eligi-
bility for medical assistance under a State plan 
(or waiver of such plan) on a basis other than 
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) shall not be affected by 
the individual’s receipt of medical assistance as 
a relief-eligible survivor of a disaster in accord-
ance with this section. 
‘‘(c) ELIGIBILITY.— 
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‘‘(1) SIMPLIFIED APPLICATION.— 
‘‘(A) IN GENERAL.—For purposes of deter-
mining eligibility for medical assistance under 
this section, each State shall use a simplified, 
1-page application form (as developed by the 
Secretary in consultation with the National As-
sociation 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 ex-
pected address for the duration of the 
relief coverage period of the disaster; 
and 
‘‘(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 (h); 
‘‘(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 
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has the legal authority to execute an as-
signment of such rights) in accordance 
with the requirements of section 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. 
‘‘(B) 
NO
DOCUMENTATION
REQUIRE-
MENT.—A State shall not require an applicant 
for medical assistance as a survivor of a dis-
aster under this section to provide any docu-
mentation or other evidence— 
‘‘(i) of the applicant’s status as a re-
lief-eligible survivor; and 
‘‘(ii) if applicable, that the applicant 
requires home and community-based serv-
ices. 
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‘‘(C) PRESUMPTIVE
ELIGIBILITY.—If an 
applicant submits a completed application to a 
provider 
or 
facility 
described 
in 
section 
1902(a)(55) (or any other provider or facility 
participating in the State plan or under a waiv-
er of such plan that is qualified to make pre-
sumptive eligibility determinations under such 
plan or waiver) and it appears to the provider 
or facility that the applicant is a relief-eligible 
survivor of a disaster who is eligible for medical 
assistance under the plan based on the informa-
tion in the application, the applicant will be 
deemed to be a relief-eligible survivor for med-
ical assistance under such plan in accordance 
with this section. 
‘‘(D) CONTINUOUS ELIGIBILITY.—An ap-
plicant who is determined to be a relief-eligible 
survivor of a disaster shall be eligible for med-
ical assistance under this section, without the 
need for any redetermination of eligibility, for 
the duration of the relief coverage period of the 
disaster. 
‘‘(E) TIMELY
PROCESSING
OF
APPLICA-
TIONS.—Each State shall establish such proc-
esses as are necessary to ensure that applica-
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tions for medical assistance under this section 
are processed in a timely manner. 
‘‘(2) 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. 
‘‘(3) 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 as a 
relief-eligible survivor of a disaster in accord-
ance with this section. Such effort shall not 
delay the determination of the eligibility of the 
individual for medical assistance under this sec-
tion. 
‘‘(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-
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cable, the State Medicaid agency of the home 
State of the individual. 
‘‘(4) 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) TERMINATION OF ELIGIBILITY.— 
‘‘(1) IN GENERAL.—Except as provided in para-
graph (4), no medical assistance shall be provided 
under this section to a relief-eligible survivor of a 
disaster after the end of the relief coverage period 
of the disaster. 
‘‘(2) NOTICE OF TERMINATION OF ELIGIBILITY; 
ASSISTANCE
IN
APPLYING
FOR
REGULAR
MED-
ICAID.— 
‘‘(A) IN
GENERAL.—No later than 2 
months before the end of a relief coverage pe-
riod of a disaster, a State shall provide each re-
lief-eligible survivor of the disaster who is re-
ceiving medical assistance under the State plan 
in accordance with this section with written no-
tice that includes— 
‘‘(i) the date after which, subject to 
the exception described in paragraph (4), 
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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 plan or 
waiver of the home State, the usual and customary 
prevailing rate for the item or service for the com-
munity 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 PREGNANT WOMEN.— 
In the case of a child born to a relief-eligible sur-
vivor of a disaster who is provided medical assist-
ance in accordance with this section during the relief 
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coverage period of the disaster, the child shall be 
treated as having been born to a pregnant woman el-
igible for medical assistance 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 
(g), the Federal medical assistance percentage deter-
mined 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 accordance 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). 
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‘‘(B) Coverage for a full range of mental 
health medications at the dosages and fre-
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) In-patient mental health care. 
‘‘(F) Family counseling for families where 
a member of the immediate family is a survivor 
of the disaster or first responder to the disaster 
or includes an individual who has died as a re-
sult of the disaster. 
‘‘(G) 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 
coordination related to, primary and specialty 
medical care, which may include personal care 
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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))— 
‘‘(I) had been receiving home and 
community-based services in a direct 
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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); 
‘‘(II) budget neutrality require-
ments applicable to such waiver; and 
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‘‘(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. 
‘‘(f) STATE REPORTS.—Each State shall submit to 
the Secretary an annual report that includes— 
‘‘(1) information on how the State is satisfying 
the requirements of subsection (d)(2) (relating to 
providing notice of termination of medical assistance 
under this section and assistance in applying for 
medical assistance other than under this section); 
‘‘(2) 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 
‘‘(3) 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. 
‘‘(g) 100 PERCENT
FEDERAL
MATCHING
PAY-
MENTS.— 
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‘‘(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— 
‘‘(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; 
‘‘(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 (h); 
‘‘(C) that are directly attributable to pro-
viding application assistance in accordance with 
subsection (d)(2)(B); and 
‘‘(D) for medical assistance provided to re-
lief-eligible survivors of a disaster after the end 
of the relief coverage period of the disaster in 
accordance with subsection (d)(4). 
‘‘(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 
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described in paragraph (1), and such payments shall 
be disregarded in applying such subsections. 
‘‘(h) 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-
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. 
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‘‘(i) 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).’’. 
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 October 1, 2020, 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 
1947(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. 
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(b) TECHNICAL ASSISTANCE AND SUPPORT FOR IN-
NOVATIVE STATE STRATEGIES TO RESPOND
TO IN-
CREASED DEMAND
FOR MEDICAL ASSISTANCE FOL-
LOWING A DISASTERS.— 
(1) IN GENERAL.—The Secretary shall provide 
technical assistance and support to States to develop 
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 1947(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 
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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 1947(b)(5) of such Act) of dis-
asters. 
(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 
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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. 
(vii) 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 1947(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. 
(4) AUTHORIZATION.—There are authorized to 
be appropriated to carry out this subsection, 
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$10,000,000 for each of fiscal years 2020 through 
2025, 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 
(aa)’’ and inserting ‘‘(aa), and (ff)’’; and 
(B) by adding at the end the following new 
subsection: 
‘‘(ff) 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 1947).’’. 
(2) APPLICATION TO CHIP.—Section 2105(a) of 
the Social Security Act (42 U.S.C. 1397ee(a)) is 
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amended by adding at the end the following new 
paragraph: 
‘‘(5) 100 PERCENT
MATCH
FOR
ALL
CHILD 
HEALTH
ASSISTANCE
PROVIDED
IN
DISASTER
DI-
RECT IMPACT AREAS.—Notwithstanding paragraph 
(1), the Secretary shall pay to each State with a 
plan approved under this title, from its allotment 
under section 2104, an amount for each quarter 
equal to 100 percent of expenditures in the quarter 
for child health assistance under the plan for tar-
geted low-income children or pregnancy-related as-
sistance for targeted low-income women that is pro-
vided to such a child or woman who, at the time the 
assistance is provided, is a resident of a direct im-
pact area of a disaster during the disaster’s relief 
coverage period (as such terms are defined in section 
1947).’’. 
(b) MORATORIUM ON REDETERMINATIONS.—During 
the relief coverage period (as defined in paragraph (4) of 
section 1947(b) of the Social Security Act, as added by 
section 2)) of a disaster, a State that contains a direct 
impact area (as defined in paragraph (2) of such section) 
of the disaster shall not be required to conduct eligibility 
redeterminations under the State’s plans or waivers of 
such plans under title XIX or XXI of such Act (42 U.S.C. 
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1396 et seq., 1397aa) with respect to individuals who re-
side in such area. 
SEC. 5. AUTHORITY TO WAIVE REQUIREMENTS DURING NA-
TIONAL EMERGENCIES WITH RESPECT TO 
EVACUEES FROM AN EMERGENCY AREA. 
Section 1135(g)(1) of the Social Security Act (42 
U.S.C. 1320b–5(g)(1)) is amended— 
(1) by redesignating subparagraphs (A) and 
(B) as clauses (i) and (ii), respectively; 
(2) by striking ‘‘An ‘emergency area’ ’’ and in-
serting the following: 
‘‘(A) IN GENERAL.—An emergency area’’; 
and 
(3) by adding at the end the following new sub-
paragraph: 
‘‘(B) ADDITIONAL
AREAS.—Any geographical 
area in which the Secretary determines there are a 
significant number of evacuees from an area de-
scribed in subparagraph (A) shall also be considered 
to be an ‘emergency area’ for purposes of this sec-
tion.’’. 
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SEC. 6. EXCLUSION OF DISASTER RELIEF COVERAGE PE-
RIOD IN COMPUTING MEDICARE PART B 
LATE ENROLLMENT PERIOD. 
Section 1839(b) of such Act (42 U.S.C. 1395r(b)) is 
amended, in the second sentence, by inserting before the 
period at the end the following: ‘‘or, in the case of an indi-
vidual who is a survivor of a disaster (as defined in para-
graph (6) of section 1947(b)), any month any part of 
which is within the relief coverage period (as defined in 
paragraph (4) of such section) of such disaster’’. 
SEC. 7. EFFECTIVE DATE. 
(a) IN GENERAL.—Subject to subsection (b), this Act 
and the amendments made by this Act shall take effect 
on the date of enactment of this Act. 
(b) DELAY PERMITTED IF STATE LEGISLATION RE-
QUIRED.—In the case of a State plan approved under title 
XIX of the Social Security Act which the Secretary of 
Health and Human Services determines requires State 
legislation (other than legislation appropriating funds) in 
order for the plan to meet the additional requirement im-
posed by this section, the State plan shall not be regarded 
as failing to comply with the requirements of such title 
solely on the basis of the failure of the plan to meet such 
additional requirement before the 1st day of the 1st cal-
endar quarter beginning after the close of the 1st regular 
session of the State legislature that ends after the 1-year 
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period beginning with the date of the enactment of this 
section. For purposes of the preceding sentence, in the 
case of a State that has a 2-year legislative session, each 
year of the session is deemed to be a separate regular ses-
sion of the State legislature. 
Æ 
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