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 at least equal in amount and scope 
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to the medical assistance that would otherwise be 
made available to such survivor if the survivor were 
enrolled 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 least 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 
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under the plan or waiver of the home State, the 
usual and customary 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 individual eligible for medical assist-
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ance 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, social workers, or other qualified 
mental or behavioral health professionals 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 and outpatient mental 
health care. 
‘‘(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 
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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 
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 subparagraph (A), 
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(B), or (C) of subsection (b)(1), as applica-
ble)— 
‘‘(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 family caregiver who, 
as a result of the disaster, is no 
longer available to provide services; 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 section 1115 or 1915; or 
‘‘(ii) are disabled (as determined in 
accordance with the State plan of the home 
State of the individual). 
‘‘(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- 
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based services under a waiver de-
scribed in subparagraph (B)(i)(I); 
‘‘(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 
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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 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 
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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. 
‘‘(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 DISASTERS.— 
(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) Centers for independent living, 
as described in part C of title VII of the 
Rehabilitation Act of 1973 (29 U.S.C. 
796f et seq.). 
(ix) 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.— 
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(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, 
$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-
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pended by the State during the fiscal year for medical as-
sistance for an individual who, during the fiscal quarter 
in which the assistance is provided to the individual, is 
a resident of a direct impact area of a disaster during the 
disaster’s relief coverage period (as such terms are defined 
in section 1948).’’. 
(2) EXCLUSION
OF
ENHANCED
PAYMENTS 
FROM
TERRITORIAL
CAPS.—Notwithstanding any 
other provision of law, for purposes of section 1108 
of the Social Security Act (42 U.S.C. 1308), with re-
spect to any additional amount paid to a territory as 
a result of the application of section 1905(jj) of the 
Social Security Act (42 U.S.C. 1396d(jj))— 
(A) the limitation on payments to terri-
tories under subsections (f) and (g) of such sec-
tion 1108 shall not apply to such additional 
amounts; and 
(B) such additional amounts shall be dis-
regarded in applying such subsections. 
(3) APPLICATION TO CHIP.— 
(A) IN GENERAL.—Section 2105(c) of the 
Social Security Act (42 U.S.C. 1397ee(a)) is 
amended by adding at the end the following 
new paragraph: 
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qualified providers, and activities of HCBS emer-
gency response corps (as described in section 3(c)). 
(c) REPORTS.—The Secretary of Health and Human 
Services shall submit to the Committee on Finance of the 
Senate, the Special Committee on Aging of the Senate, 
the Committee on Energy and Commerce of the House 
of Representatives, and the Committee on Ways and 
Means of the House of Representatives the following re-
ports on the evaluation conducted under subsection (a)(1): 
(1) An interim report on the evaluation, to be 
submitted not later than 3 years after the evaluation 
commences. 
(2) A follow-up report on such evaluation, to be 
submitted not later than 24 months after the date 
on which the interim report is issued. 
Æ 
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