Emergency Health Care Relief Act of 2005

Calendar No. 214

109th CONGRESS
1st Session

S. 1716

To provide emergency health care relief for survivors of Hurricane Katrina, and for other purposes.

IN THE SENATE OF THE UNITED STATES

September 15, 2005

Mr. GRASSLEY (for himself, Mr. BAUCUS, Mr. COCHRAN, Ms. LANDRIEU, Mrs. LINCOLN, Mr. PRYOR, and Mr. SMITH) introduced the following bill; which was read the first time

September 19, 2005

Read the second time and placed on the calendar

A BILL

To provide emergency health care relief for survivors of Hurricane Katrina, and for other purposes.

Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled,

SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

(a) SHORT TITLE- This Act may be cited as the `Emergency Health Care Relief Act of 2005'.

(b) TABLE OF CONTENTS- The table of contents of this Act is as follows:

Sec. 1. Short title; table of contents.

TITLE I--EMERGENCY HEALTH CARE RELIEF

Sec. 101. Definitions.

Sec. 102. Disaster relief medicaid.

Sec. 103. Targeted medicaid relief for direct impact parishes and counties.

Sec. 104. Authority to waive requirements during national emergencies with respect to evacuees from an emergency area.

Sec. 105. Emergency assistance for States with respect to the Federal medical assistance percentage for fiscal year 2006.

Sec. 106. Emergency assistance to medicare beneficiaries.

Sec. 107. Relief for hospitals located in a direct impact parish or county.

Sec. 108. Disaster relief fund.

Sec. 109. Emergency designation.

TITLE II--TANF RELIEF

Sec. 201. Reimbursement of States for TANF benefits provided to assist families from other States affected by Hurricane Katrina.

Sec. 202. Increase in amount of additional TANF funds available for hurricane-damaged States.

Sec. 203. Rules for receipt of Hurricane Katrina emergency TANF benefits and application to child support requirements.

Sec. 204. Emergency designation.

TITLE III--TEMPORARY EXTENDED UNEMPLOYMENT COMPENSATION

Sec. 301. Federal-State agreements.

Sec. 302. Temporary extended unemployment compensation account.

Sec. 303. Payments to States having agreements for the payment of temporary extended unemployment compensation.

Sec. 304. Financing provisions.

Sec. 305. Fraud and overpayments.

Sec. 306. Definitions.

Sec. 307. Applicability.

TITLE IV--MISCELLANEOUS PROVISIONS

Sec. 401. Disclosure based on valid authorization.

Sec. 402. Additional oversight funding for the Inspector General of the Department of Health and Human Services.

Sec. 403. Emergency procurement authority in support of Hurricane Katrina rescue and relief efforts.

TITLE I--EMERGENCY HEALTH CARE RELIEF

SEC. 101. DEFINITIONS.

In this title:

(1) DIRECT IMPACT PARISH OR COUNTY-

(A) IN GENERAL- The term `direct impact parish or county' means a parish in the State of Louisiana, or a county in the State of Mississippi or Alabama, for which a major disaster has been declared in accordance with section 401 of the Robert T. Stafford Disaster Relief and Emergency Assistance Act (42 U.S.C. 5170) as a result of Hurricane Katrina and which the President has determined, before September 14, 2005, warrants individual and public assistance from the Federal Government under such Act.

(B) EXCLUSION- Such term does not include a parish in the State of Louisiana or a county in the State of Mississippi or Alabama which the President has determined warrants only public assistance from the Federal Government under such Act as a result of Hurricane Katrina.

(C) 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 parishes and counties identified as direct impact parishes or counties in accordance with this paragraph. Any such parish or county that is posted on such website as a direct impact parish or county shall be treated for purposes of subparagraph (A) as described in such subparagraph.

(2) DRM COVERAGE PERIOD-

(A) IN GENERAL- The term `DRM coverage period' means the period beginning on August 28, 2005, and, subject to subparagraph (B), ending on the date that is 5 months after the date of enactment of this Act.

(B) PRESIDENTIAL AUTHORITY TO EXTEND DRM COVERAGE PERIOD-

(i) IN GENERAL- The President may extend the DRM coverage period for an additional 5 months. Any reference to the term `DRM coverage period' in this title shall include any extension under this clause.

(ii) NOTICE TO CONGRESS AND STATES- The President shall notify the Majority and Minority Leaders of the Senate, the Speaker of the House of Representatives, the Minority Leader of the House of Representatives, the Chairs and Ranking Members of the Committee on Finance of the Senate and the Committees on Energy and Commerce and Ways and Means of the House of Representatives, and the States at least 30 days prior to--

(I) extending the DRM coverage period; or

(II) if the President determines not to extend such period, the ending date described in subparagraph (A).

(3) KATRINA SURVIVOR-

(A) IN GENERAL- The term `Katrina Survivor' means an individual who is described in subparagraph (B) or (C).

(B) RESIDENTS AND EVACUEES OF DIRECT IMPACT PARISHES AND COUNTIES- An individual who, on any day during the week preceding August 28, 2005, had a primary residence in a direct impact parish or county.

(i) worksite, on any day during the week preceding August 28, 2005, was located in a direct impact parish or county; and

(ii) employment with an employer which conducted an active trade or business on August 28, 2005, in a direct impact parish or county and with respect to whom such trade or business is inoperable on any day after August 28, 2005, and before January 1, 2006, as a result of damage sustained in connection with Hurricane Katrina, is terminated.

(D) TREATMENT OF CURRENT MEDICAID BENEFICIARIES- Nothing in this title 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 title.

(E) TREATMENT OF HOMELESS PERSONS- For purposes of this title, in the case of an individual who was homeless on any day during the week described in subparagraph (B), the individual's `residence' shall be deemed to be the place of residence as otherwise determined for such an individual under title XIX of the Social Security Act.

(4) POVERTY LINE- The term `poverty line' has the meaning given that term in section 2110(c)(5) of the Social Security Act (42 U.S.C. 1397jj(c)(5)).

(5) SECRETARY- The term `Secretary' means the Secretary of Health and Human Services.

(6) STATE- The term `State' has the meaning given that term for purposes of title XIX of the Social Security Act (42 U.S.C 1396 et seq.).

SEC. 102. DISASTER RELIEF MEDICAID.

(a) AUTHORITY TO PROVIDE DISASTER RELIEF MEDICAID- Notwithstanding any provision of title XIX of the Social Security Act, a State shall, as a condition of participation in the Medicaid program established under title XIX of the Social Security Act (42 U.S.C. 1396 et seq.), provide medical assistance to DRM-eligible Katrina Survivors (as defined in subsection (b)) under a State medicaid plan established under such title during the DRM coverage period in accordance with the following provisions of this section and without submitting an amendment to the State Medicaid plan. Such assistance shall be referred to as `DRM assistance'.

(b) DRM-ELIGIBLE KATRINA SURVIVOR DEFINED-

(1) IN GENERAL- In this section, the term `DRM-eligible Katrina Survivor' means a Katrina Survivor whose family income does not exceed the higher of--

(A) 100 percent (200 percent, in the case of such a Survivor who is a pregnant woman, child, or a recipient of disability benefits under section 223 of the Social Security Act) of the poverty line; or

(B) the income eligibility standard which would apply to the Survivor under the State Medicaid plan.

(2) NO RESOURCES, RESIDENCY, OR CATEGORICAL ELIGIBILITY REQUIREMENTS- Eligibility under paragraph (1) shall be determined without application of any resources test, State residency, or categorical eligibility requirements.

(3) INCOME DETERMINATION-

(A) LEAST RESTRICTIVE INCOME METHODOLOGIES- The State shall use the least restrictive methodologies applied under the State medicaid plan under section 1902(r)(2) of the Social Security Act (42 U.S.C. 1396a(r)(2)) in determining income eligibility for Katrina Survivors under paragraph (1).

(B) DISREGARD OF UI BENEFITS- In determining such income eligibility, the State shall disregard any amount received under a law of the United States or of a State which is in the nature of unemployment compensation by a Katrina Survivor during the DRM coverage period.

(4) DEFINITION OF CHILD- For purposes of paragraph (1), a DRM-eligible Katrina Survivor shall be determined to be a `child' in accordance with the definition of `child' under the State Medicaid plan.

(1) STREAMLINED ELIGIBILITY PROCESS- The State shall use the following streamlined procedures in processing applications and determining eligibility for DRM assistance for DRM-eligible Katrina Survivors:

(A) A common 1-page application form developed by the Secretary of Health and Human Services in consultation with the National Association of State Medicaid Directors. Such form shall--

(i) require an applicant to provide an expected address for the duration of the DRM coverage period and to agree to update that information if it changes during such period;

(ii) include notice regarding the penalties for making a fraudulent application under subsection (h);

(iii) require the applicant to assign to the State any rights of the applicant (or any other person who is a DRM-eligible 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; and

(iv) require the applicant to list any health insurance coverage which the applicant was enrolled in immediately prior to submitting such application.

(B) Self-attestation by the applicant that the applicant--

(i) is a DRM-eligible Katrina Survivor; and

(ii) if applicable, requires home and community-based services provided under such DRM assistance in accordance with subsection (d)(3).

(C) No requirement for documentation evidencing the basis on which the applicant qualifies to be a DRM-eligible Katrina Survivor or, if applicable, requires home and community-based services.

(D) Issuance of a DRM assistance eligibility card to an applicant who completes such application, including the self-attestation required under subparagraph (B). Such card shall be valid as long as the DRM coverage period is in effect and shall be accompanied by notice of the termination date for the DRM coverage period and, if applicable, notice that such termination date may be extended. If the President extends the DRM coverage period, the State shall notify DRM-eligible Katrina Survivors enrolled in DRM assistance of the new termination date for the DRM coverage period.

(E) If an applicant completes the application 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 facilities identified in section 1902(a)(55) of the Social Security Act (42 U.S.C. 1396a(a)(55)) and it appears to the provider that the applicant is a DRM-eligible Katrina Survivor based on the information in the application, the applicant will be deemed to be a DRM-eligible Katrina Survivor eligible for DRM assistance in accordance with this section, subject to subsection (g).

(F) Continuous eligibility, without the need for any redetermination of eligibility, for the duration of the DRM coverage period.

(2) NO CONTINUATION OF DRM ASSISTANCE-

(A) IN GENERAL- Except as provided in subparagraphs (B) and (C), no DRM assistance shall be provided after the end of the DRM coverage period.

(B) PRESUMPTIVE ELIGIBILITY- In the case of any DRM-eligible Katrina Survivor who is receiving DRM assistance from a State in accordance with this section and who, as of the end of the DRM coverage period, has an application pending for medical assistance under the State medicaid plan for periods beginning after the end of such period, the State shall provide such Survivor with a period of presumptive eligibility for medical assistance under the State Medicaid plan (not to exceed 60 days) until a determination with respect to the Survivor's application has been made.

(C) PREGNANT WOMEN- In the case of a DRM-eligible Katrina Survivor who is receiving DRM assistance from a State in accordance with this section and whose pregnancy ended during the 60-day period prior to the end of the DRM coverage period, or who is pregnant as of the end of such period, such Survivor shall continue to be eligible for DRM assistance after the end of the DRM coverage period, including (but not limited to) for all pregnancy-related and postpartum medical assistance available under the State Medicaid plan, through the end of the month in which the 60-day period (beginning on the last day of her pregnancy) ends.

(3) TREATMENT OF KATRINA SURVIVORS PROVIDED ASSISTANCE PRIOR TO DATE OF ENACTMENT- Any Katrina Survivor who is provided medical assistance under a State medicaid plan in accordance with guidance from the Secretary during the period that begins on August 28, 2005, and ends on the date of enactment of this Act shall be treated as a DRM-eligible Katrina Survivor, without the need to file an additional application, for purposes of eligibility for DRM assistance under this section.

(d) SCOPE OF COVERAGE-

(1) CATEGORICALLY NEEDY BENEFITS- The State shall treat a DRM-eligible Katrina Survivor as an individual 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 items and services furnished on or after August 28, 2005 (or in the case of applications for DRM assistance submitted after January 1 2006, the first day of the 5th month preceding the date on which such application is submitted).

(2) EXTENDED MENTAL HEALTH AND CARE COORDINATION BENEFITS- The State may provide, without regard to any restrictions on amount, duration, and scope, comparability, or restrictions otherwise applicable under the State medicaid plan (other than restrictions applicable under such plan with respect to services provided in an institution for mental diseases), to DRM-eligible Katrina Survivors extended mental health and care coordination benefits 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 frequencies prescribed by health professionals for depression, post-traumatic stress disorder, and other mental disorders.

(D) Psychotherapy, rehabilitation and other treatments administered by psychiatrists, psychologists, or social workers for conditions exacerbated by, or resulting from, Hurricane Katrina.

(E) In-patient mental health care.

(F) Family counseling for families where a member of the immediate family is a Katrina Survivor or first responder to Hurricane Katrina or includes an individual who has died as a result of Hurricane Katrina.

(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 services, durable medical equipment and supplies, assistive technology, and transportation.

(3) HOME AND COMMUNITY-BASED SERVICES-

(A) IN GENERAL- In the case of a State with a waiver to provide home and community-based services granted under section 1115 of the Social Security Act or under subsection (c) or (d) of section 1915 of such Act, the State may provide such services to DRM-eligible Katrina Survivors who self-attest in accordance with subsection (c)(1)(B)(ii) that they require immediate home and community-based services that are available under such waiver without regard to whether the Survivors would require the level of care provided in a hospital, nursing facility, or intermediate care facility for the mentally retarded, including to DRM-eligible Katrina Survivors who are individuals described in subparagraph (B).

(B) INDIVIDUALS DESCRIBED- Individuals described in this subparagraph are individuals who--

(i) on any day during the week preceding August 28, 2005--

(I) had been receiving home and community-based services under a waiver described in subparagraph (A) in a direct impact parish or county;

(II) had been receiving support services from a primary family caregiver who, as a result of Hurricane Katrina, is no longer available to provide services; or

(III) had been receiving personal care, home health, or rehabilitative services under the State medicaid plan or under a waiver granted under section 1915 or 1115 of the Social Security Act; or

(ii) are disabled (as determined under the State medicaid plan).

(C) WAIVER OF RESTRICTIONS- The Secretary shall waive with respect to the provision of home and community-based services under this paragraph any limitations on--

(i) the number of individuals who shall receive home or community-based services under a waiver described in subparagraph (A);

(ii) budget neutrality requirements applicable to such waiver; and

(iii) targeted populations eligible for services under such waiver.

The Secretary may waive other restrictions applicable under such a waiver, that would prevent a State from providing home and community-based services in accordance with this paragraph.

(4) CHILDREN BORN TO PREGNANT WOMEN- In the case of a child born to a DRM-eligible Katrina Survivor who is provided DRM assistance during the DRM coverage period, such child shall be treated as having been born to a pregnant woman eligible for medical assistance under the State medicaid plan and shall be eligible for medical assistance under such plan in accordance with section 1902(e)(4) of the Social Security Act (42 U.S.C. 1396a(e)(4)). The Federal medical assistance percentage applicable to the State medicaid plan shall apply to medical assistance provided to a child under such plan in accordance with the preceding sentence.

(e) TERMINATION OF COVERAGE; ASSISTANCE WITH APPLYING FOR REGULAR MEDICAID COVERAGE-

(1) NOTICE OF EXPECTED TERMINATION OF DRM COVERAGE PERIOD- A State shall provide DRM-eligible Katrina Survivors who are receiving DRM assistance from the State in accordance with this section, as of the beginning of the 4th month (and, if applicable, 9th month) of the DRM coverage period with--

(A) notice of the expected termination date for DRM assistance for such period;

(B) information regarding eligibility for medical assistance under the State's eligibility rules otherwise applicable under the State medicaid plan; and

(C) an application for such assistance and information regarding where to obtain assistance with completing such application in accordance with paragraph (2).

(2) APPLICATION ASSISTANCE- A State shall provide DRM-eligible Katrina Survivors who are receiving DRM assistance from the State in accordance with this section with assistance in applying for medical assistance under the State medicaid plan for periods beginning after the end of the DRM coverage period, at State Medicaid offices and at locations easily accessible to such Survivors.

(3) STATE REPORTS- A State providing DRM assistance in accordance with this section shall submit to the Secretary the following reports:

(A) TERMINATION AND TRANSITION ASSISTANCE TO REGULAR MEDICAID COVERAGE FOR DRM-ELIGIBLE KATRINA SURVIVORS ELIGIBLE FOR SUCH ASSISTANCE- A report detailing how the State intends to satisfy the requirements of paragraphs (1) and (2).

(B) ENROLLMENT- Reports regarding--

(i) the number of Katrina Survivors who are determined to be DRM-eligible Katrina Survivors; and

(ii) the number of DRM-eligible Katrina Survivors who are determined to be eligible for, and enrolled in, the State medicaid plan.

(4) SECRETARIAL OVERSIGHT- The Secretary of Health and Human Services shall ensure that a State is complying with the requirements of paragraphs (1) and (2) and that applications for medical assistance under the State medicaid plan from DRM-eligible Katrina Survivors for periods beginning after the end of the DRM coverage period are processed in a timely and appropriate manner.

(5) NO PRIVATE RIGHT OF ACTION AGAINST A STATE FOR FAILURE TO PROVIDE NOTICE- No private right of action shall be brought against a State for failure to provide the notices required under paragraph (1) or subsection (c)(1) so long as the State makes a good faith effort to provide such notices.

(f) 100 PERCENT FEDERAL MATCHING PAYMENTS-

(1) IN GENERAL- Notwithstanding section 1905(b) of the Social Security Act (42 U.S.C. 1396d(b), the Federal medical assistance percentage or the Federal matching rate otherwise applied under section 1903(a) of such Act (42 U.S.C. 1396b(a)) shall be 100 percent for--

(A) providing DRM assistance to DRM-eligible Katrina Survivors during the DRM coverage period in accordance with this section;

(B) costs directly attributable to administrative activities related to the provision of such DRM assistance, including costs attributable to obtaining recoveries under subsection (h);

(D) DRM assistance provided in accordance with subparagraph (B) or (C) of subsection (c)(2) after the end of the DRM coverage period.

(2) DISREGARD OF PAYMENTS- Payments provided to a State in accordance with this subsection shall be disregarded for purposes of applying subsections (f) and (g) of section 1108 of the Social Security Act (42 U.S.C. 1308).

(g) VERIFICATION OF STATUS AS A KATRINA SURVIVOR-

(1) IN GENERAL- The State shall make a good faith effort to verify the status of an individual who is enrolled in the State Medicaid plan as a DRM-eligible Katrina Survivor under the provisions of this section. Such effort shall not delay the determination of the eligibility of the Survivor for DRM assistance under this section.

(2) EVIDENCE OF VERIFICATION- A State may satisfy the verification requirement under subparagraph (A) with respect to an individual by showing that the State providing DRM assistance obtained information from the Social Security Administration, the Internal Revenue Service, or the State Medicaid Agency for the State from which individual is from (if the individual was not a resident of such State on any day during the week preceding August 28, 2005).

(h) PENALTY FOR FRAUDULENT APPLICATIONS-

(1) INDIVIDUAL LIABLE FOR COSTS- If a State, as the result of verification activities conducted under subsection (g) or otherwise, determines after a fair hearing that an individual has knowingly made a false self-attestation described in subsection (c)(1)(B), the State may, subject to paragraph (2), seek recovery from the individual for the full amount of the cost of DRM assistance provided to the individual under this section.

(2) EXCEPTION- The Secretary shall exempt a State from seeking recovery 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 GOVERNMENT- Any amounts recovered by a State in accordance with this subsection shall be returned to the Federal government.

(i) EXEMPTION FROM ERROR RATE PENALTIES- All payments attributable to providing DRM assistance in accordance with this section shall be disregarded for purposes of section 1903(u) of the Social Security Act (42 U.S.C. 1396b(u)).

(j) PROVIDER PAYMENT RATES- In the case of any DRM assistance provided in accordance with this section to a DRM-eligible Katrina Survivor that is covered under the State medicaid plan (as applied without regard to this section) the State shall pay a provider of such assistance the same payment rate as the State would otherwise pay for the assistance if the assistance were provided under the State medicaid plan (or, if no such payment rate applies under the State medicaid plan, the usual and customary prevailing rate for the item or service for the community in which it is provided).

(k) APPLICATION TO INDIVIDUALS ELIGIBLE FOR MEDICAL ASSISTANCE- Nothing in this section shall be construed as affecting any rights accorded to an individual who is a recipient of medical assistance under a State medicaid plan who is determined to be a DRM-eligible Katrina Survivor but the provision of DRM assistance to such individual shall be limited to the provision of such assistance in accordance with this section.

SEC. 103. TARGETED MEDICAID RELIEF FOR DIRECT IMPACT PARISHES AND COUNTIES.

(a) 100 PERCENT FEDERAL MATCHING PAYMENTS FOR MEDICAL ASSISTANCE PROVIDED IN DIRECT IMPACT PARISH OR COUNTY-

(1) IN GENERAL- Notwithstanding section 1905(b) of the Social Security Act (42 U.S.C. 1396d(b)), for items and services furnished during the period that begins on August 28, 2005, and ends on December 31, 2006, the Federal medical assistance percentage for providing medical assistance under a State medicaid plan under title XIX of the Social Security Act to any individual, including a Katrina Survivor, residing in a parish of the State of Louisiana described in subsection (c), or a county of the State of Mississippi or Alabama described in that subsection, shall be 100 percent.

(2) APPLICATION TO ENHANCED FMAP- The 100 percent Federal medical assistance percentage applicable under subsection (a) shall also apply for purposes of determining the enhanced FMAP (as defined in section 2105(b) of the Social Security Act (42 U.S.C. 1397ee(b)) for child health assistance provided under a State child health plan under title XXI of such Act in such a parish or county during the period described in such subsection.

(b) MORATORIUM ON REDETERMINATIONS- During the DRM coverage period, the States of Louisiana, Mississippi, and Alabama shall not be required to conduct eligibility redeterminations under the State's medicaid plan.

(c) PARISH OR COUNTY DESCRIBED- For purposes of subsection (a), a parish or county described in this subsection is a parish or county for which a major disaster has been declared in accordance with section 401 of the Robert T. Stafford Disaster Relief and Emergency Assistance Act (42 U.S.C. 5170) as a result of Hurricane Katrina and which the President has determined, as of September 14, 2005, warrant individual or public assistance from the Federal Government under such Act.

SEC. 104. AUTHORITY TO WAIVE REQUIREMENTS DURING NATIONAL EMERGENCIES WITH RESPECT TO EVACUEES FROM AN EMERGENCY AREA.

(a) IN GENERAL- Section 1135(g)(1) of the Social Security Act (42 U.S.C. 1320b-5(g)(1)) is amended by adding at the end the following:

`Any geographical area in which the Secretary determines there are a significant number of evacuees from an area that is considered to be an emergency area under the preceding sentence shall be considered to be an `emergency area' for purposes of this section.'.

(b) EFFECTIVE DATE- The amendment made by subsection (a) shall take effect as if enacted on August 28, 2005.

SEC. 105. EMERGENCY ASSISTANCE FOR STATES WITH RESPECT TO THE FEDERAL MEDICAL ASSISTANCE PERCENTAGE FOR FISCAL YEAR 2006.

If the Federal medical assistance percentage (as defined in section 1905(b) of the Social Security Act (42 U.S.C. 1396d(b))) determined for a State for fiscal year 2006 is less than the Federal medical assistance percentage determined for the State for fiscal year 2005, the Federal medical assistance percentage for the State for fiscal year 2005 shall apply to the State for fiscal year 2006 for purposes of titles XIX and XXI of the Social Security Act (42 U.S.C. 1396 et seq., 1397aa et seq.).

SEC. 106. EMERGENCY ASSISTANCE TO MEDICARE BENEFICIARIES.

(a) EXCLUSION OF DRM COVERAGE PERIOD IN COMPUTING MEDICARE PART B LATE ENROLLMENT PERIOD- In applying the first sentence of section 1839(b) of the Social Security Act (42 U.S.C. 1395r(b)) in the case of an individual who, on any day during the week preceding August 28, 2005, had a residence in a direct impact parish or county, there shall not be taken into account any month any part of which is within the DRM coverage period.

(b) WRITTEN PLAN ON TRANSITION OF CERTAIN FULL-BENEFIT DUAL ELIGIBLE INDIVIDUALS TO PRESCRIPTION DRUG COVERAGE UNDER MEDICARE PART D- Not later than October 7, 2005, the Secretary of Health and Human Services shall submit to Congress a written plan on how the Secretary will provide for the transition of coverage of prescription drugs for full-benefit dual eligible individuals (as defined in section 1935(c)(6) of the Social Security Act (42 U.S.C. 1396u-5(c)(6)) who, on any day during the week preceding August 28, 2005, had a residence in a direct impact parish or county, from the medicaid program under title XIX of such Act to the medicare program under part D of title XVIII of such Act.

SEC. 107. RELIEF FOR HOSPITALS LOCATED IN A DIRECT IMPACT PARISH OR COUNTY.

(a) INCREASE IN MEDICARE PAYMENTS TO HOSPITALS FOR BAD DEBT- During the DRM coverage period, section 1861(v)(1)(T)(iv) of the Social Security Act (42 U.S.C. 1395x(v)(1)(T)(iv)) shall be applied by substituting `0 percent' for `30 percent' with respect to--

(1) a hospital located in a direct impact parish or county; and

(2) any other hospital, but only to the extent that the bad debt is related to items and services furnished to an individual who, on any day during the week preceding August 28, 2005, had a residence in a direct impact parish or county.

(b) WAIVER OF CERTAIN MEDICARE QUALITY REPORTING REQUIREMENTS FOR HOSPITALS- During the DRM coverage period, section 1886(b)(3)(B)(vii) of the Social Security Act (42 U.S.C. 1395ww(b)(3)(B)(vii)) shall not apply to a hospital that is located in a direct impact parish or county.

SEC. 108. DISASTER RELIEF FUND.

(a) ESTABLISHMENT- There is established on the books of the Treasury the Disaster Relief Fund (in this subsection referred to as the `Fund') which--

(1) shall be administered by the Secretary of Health and Human Services (in this subsection referred to as the `Secretary'); and

(2) shall consist of amounts made available under subsection (f).

(b) USE OF AMOUNTS IN FUND- Amounts in the Fund shall be used by the Secretary for the following:

(1) PAYMENTS TO PROVIDERS- The Secretary shall make payments directly to medicaid providers described in subsection (c) to offset costs incurred by such providers as a result of Hurricane Katrina.

(2) PAYMENTS FOR PRIVATE HEALTH INSURANCE COVERAGE- The Secretary shall make payments to State insurance commissioners for the purpose of making payments to health insurance issuers--

(A) on behalf of individuals that would otherwise qualify for DRM assistance from the State under section 102 for such individual's share of their health insurance premium; and

(B) on behalf of qualified employers for the employer share of their employee's health insurance premiums, but only with respect to the days on which the employer meets the definition under subsection (d).

(c) MEDICAID PROVIDERS DESCRIBED- For purposes of subsection (b)(1), medicaid providers described in this paragraph are--

(1) any provider under title XIX of the Social Security Act) that, during a period after August 28, 2005, as determined by the Secretary--

(A) that has a significant increase (as determined by the Secretary of Health and Human Services) in the percentage of patients who are eligible for medical assistance under a State plan approved under title XIX of the Social Security Act or provided with uncompensated care; or

(B) that experiences a significant drop in patient caseload (as determined by the Secretary); and

(2) any other provider determined appropriate by the Secretary.

(d) QUALIFIED EMPLOYER DEFINED- For purposes of subsection (b)(2), the term `qualified employer' means any employer--

(1) which conducted an active trade or business on August 28, 2005, in a Hurricane Katrina disaster area; and

(2)(A) with respect to whom the trade or business described in subparagraph (A) is inoperable on any day during the DRM coverage period as a result of damage sustained in connection with Hurricane Katrina; or

(B) with respect to whom the trade or business described in subparagraph (A) is not paying salary or benefits to employees on any day during the DRM coverage period as a result of damage sustained in connection with Hurricane Katrina.

(e) EXPEDITING IMPLEMENTATION- The Secretary shall promulgate regulations to carry out this section which may be effective and final immediately on an interim basis as of the date of publication of the interim final regulation. If the Secretary provides for an interim final regulation, the Secretary shall provide for a period of public comments on such regulation after the date of publication. The Secretary may change or revise such regulation after completion of the period of public comment.

(f) APPROPRIATION- Out of any money in the Treasury not otherwise appropriated, there is appropriated to the Fund $800,000,000 for fiscal year 2005, to remain available until expended.

SEC. 109. EMERGENCY DESIGNATION.

Each amount provided in this title is designated as an emergency requirement pursuant to section 402 of H. Con. Res. 95 (109th Congress).

TITLE II--TANF RELIEF

SEC. 201. REIMBURSEMENT OF STATES FOR TANF BENEFITS PROVIDED TO ASSIST FAMILIES FROM OTHER STATES AFFECTED BY HURRICANE KATRINA.

(a) IN GENERAL- Section 3 of the TANF Emergency Response and Recovery Act of 2005 is amended to read as follows:

`SEC. 3. REIMBURSEMENT OF STATES FOR TANF BENEFITS PROVIDED TO ASSIST FAMILIES FROM OTHER STATES AFFECTED BY HURRICANE KATRINA.

`(a) ELIGIBILITY FOR PAYMENTS FROM THE CONTINGENCY FUND-

`(1) PERIOD OF APPLICABILITY- Beginning with August 29, 2005, and ending with September 30, 2006, a State described in paragraph (2) or (3) shall be considered a needy State for purposes of section 403(b) of the Social Security Act.

`(2) DIRECT IMPACT STATES- A State described in this paragraph is Louisiana, Mississippi, or Alabama.

`(3) OTHER STATES- A State is described in this paragraph if the State provides any benefit or service that may be provided under the State program funded under part A of title IV of the Social Security Act to a family which--

`(A) has resided in a direct impact State; and

`(B) has travelled (not necessarily directly) to the State from such direct impact State as a result of the hurricane.

`(b) MONTHLY PAYMENTS-

`(1) IN GENERAL- Notwithstanding section 403(b)(3)(C)(i) of the Social Security Act, the total amount paid during a month to a State described in--

`(A) subsection (a)(2), shall not exceed 1/4 of 20 percent of the State family assistance grant; and

`(B) subsection (a)(3), shall not exceed the lesser of--

`(i) total amount of benefits or services provided under the State program funded under part A of title IV of the Social Security Act to families described in subsection (a)(3); or

`(ii) 1/4 of 20 percent of the State family assistance grant.

`(c) No State Match or Maintenance of Effort Required- Sections 403(b)(6) and 409(a)(10) of the Social Security Act shall not apply with respect to a payment made to a State by reason of this section.

`(d) INCREASE IN FUNDING TO THE EXTENT NECESSARY- During the period described in subsection (a)(1), section 403(b)(2) of the Social Security Act (42 U.S.C. 603(b)(2)) shall be applied without regard to the limitation on the total amount specified in that section.'.

(b) RETROACTIVE EFFECTIVE DATE- The amendment made by subsection (a) shall take effect as if included in the enactment of the TANF Emergency Response and Recovery Act of 2005.

SEC. 202. INCREASE IN AMOUNT OF ADDITIONAL TANF FUNDS AVAILABLE FOR HURRICANE-DAMAGED STATES.

(a) IN GENERAL- Section 4 of the TANF Emergency Response and Recovery Act of 2005 is amended--

(1) in subsection (a)(2), by striking `20 percent' and inserting `40 percent'; and

(2) in subsection (b), in the matter preceding paragraph (1), by inserting `(at any time during or after the period described in section 3(a)(1))' after `may not be imposed'.

(b) RETROACTIVE EFFECTIVE DATE- The amendments made by subsection (a) shall take effect as if included in the enactment of the TANF Emergency Response and Recovery Act of 2005.

SEC. 203. RULES FOR RECEIPT OF HURRICANE KATRINA EMERGENCY TANF BENEFITS AND APPLICATION TO CHILD SUPPORT REQUIREMENTS.

(a) IN GENERAL- Section 6 of the TANF Emergency Response and Recovery Act of 2005 is amended to read as follows:

`SEC. 6. RULES OF RECEIPT OF HURRICANE KATRINA EMERGENCY TANF BENEFITS AND APPLICATION TO CHILD SUPPORT REQUIREMENTS.

`(a) IN GENERAL- During the period described in section 3(a)(1), a recipient of Hurricane Katrina Emergency TANF Benefits provided by a State described in paragraph (2) or (3) of section 3(a), or by an Indian tribe under a tribal family assistance plan approved under section 412 of the Social Security Act (42 U.S.C. 612), shall not be considered assistance for purposes of sections 407, paragraphs (2), (3), or (7) of section 408(a), or section 454(29) of the Social Security Act (42 U.S.C. 607, 608(a), 654(29)).

`(b) HURRICANE KATRINA EMERGENCY TANF BENEFITS- For purposes of subsection (a), the term `Hurricane Katrina Emergency TANF Benefits' means any benefit or service that may be provided under a State or tribal program funded under part A of title IV of the Social Security Act to support--

`(1) families described in section 3(a)(3); and

`(2) families residing in a direct impact State which the State deems to be needy families based on their statement, circumstance, or inability to access resources.'.

(b) RETROACTIVE EFFECTIVE DATE- The amendment made by subsection (a) shall take effect as if included in the enactment of the TANF Emergency Response and Recovery Act of 2005.

SEC. 204. EMERGENCY DESIGNATION.

Each amount provided in this title is designated as an emergency requirement pursuant to section 402 of H. Con. Res. 95 (109th Congress).

TITLE III--TEMPORARY EXTENDED UNEMPLOYMENT COMPENSATION

SEC. 301. FEDERAL-STATE AGREEMENTS.

(a) IN GENERAL- Any State which desires to do so may enter into and participate in an agreement under this title with the Secretary of Labor (in this title referred to as the `Secretary'). Any State which is a party to an agreement under this title may, upon providing 30 days' written notice to the Secretary, terminate such agreement.

(b) PROVISIONS OF AGREEMENT- Any agreement under subsection (a) shall provide that the State agency of the State will make payments of temporary extended unemployment compensation to individuals who--

(1) exhausted all rights to regular compensation under the State law or under Federal law after August 27, 2005;

(2) have no rights to regular compensation or extended compensation with respect to a week under such law or any other State unemployment compensation law or to compensation under any other Federal law; and

(3) are not receiving compensation with respect to such week under the unemployment compensation law of Canada.

(c) EXHAUSTION OF BENEFITS- For purposes of subsection (b)(1), an individual shall be deemed to have exhausted such individual's rights to regular compensation under a State law when--

(1) no payments of regular compensation can be made under such law because such individual has received all regular compensation available to such individual based on employment or wages during such individual's base period; or

(2) such individual's rights to such compensation have been terminated by reason of the expiration of the benefit year with respect to which such rights existed.

(d) WEEKLY BENEFIT AMOUNT, ETC- For purposes of any agreement under this title--

(1) the amount of temporary extended unemployment compensation which shall be payable to any individual for any week of total unemployment shall be equal to the amount of the regular compensation (including dependents' allowances) payable to such individual during such individual's benefit year under the State law for a week of total unemployment;

(2) the terms and conditions of the State law which apply to claims for regular compensation and to the payment thereof shall apply to claims for temporary extended unemployment compensation and the payment thereof, except--

(A) that an individual shall not be eligible for temporary extended unemployment compensation under this title unless, in the base period with respect to which the individual exhausted all rights to regular compensation under the State law, the individual had 20 weeks of full-time insured employment or the equivalent in insured wages, as determined under the provisions of the State law implementing section 202(a)(5) of the Federal-State Extended Unemployment Compensation Act of 1970 (26 U.S.C. 3304 note); and

(B) where otherwise inconsistent with the provisions of this title or with the regulations or operating instructions of the Secretary promulgated to carry out this title; and

(3) the maximum amount of temporary extended unemployment compensation payable to any individual for whom a temporary extended unemployment compensation account is established under section 302 shall not exceed the amount established in such account for such individual.

(e) ELECTION BY STATES- Notwithstanding any other provision of Federal law (and if State law permits), the Governor of a State that is in an extended benefit period may provide for the payment of temporary extended unemployment compensation in lieu of extended compensation to individuals who otherwise meet the requirements of this section. Such an election shall not require a State to trigger off an extended benefit period.

SEC. 302. TEMPORARY EXTENDED UNEMPLOYMENT COMPENSATION ACCOUNT.

(a) IN GENERAL- Any agreement under this title shall provide that the State will establish, for each eligible individual who files an application for temporary extended unemployment compensation, a temporary extended unemployment compensation account with respect to such individual's benefit year.

(b) AMOUNT IN ACCOUNT-

(1) IN GENERAL- The amount established in an account under subsection (a) shall be equal to the lesser of--

(A) 100 percent of the total amount of regular compensation (including dependents' allowances) payable to the individual during the individual's benefit year under such law, or

(B) 13 times the individual's average weekly benefit amount for the benefit year.

(2) WEEKLY BENEFIT AMOUNT- For purposes of this subsection, an individual's weekly benefit amount for any week is the amount of regular compensation (including dependents' allowances) under the State law payable to such individual for such week for total unemployment.

SEC. 303. PAYMENTS TO STATES HAVING AGREEMENTS FOR THE PAYMENT OF TEMPORARY EXTENDED UNEMPLOYMENT COMPENSATION.

(a) GENERAL RULE- There shall be paid to each State that has entered into an agreement under this title an amount equal to 100 percent of the temporary extended unemployment compensation paid to individuals by the State pursuant to such agreement.

(b) TREATMENT OF REIMBURSABLE COMPENSATION- No payment shall be made to any State under this section in respect of any compensation to the extent the State is entitled to reimbursement in respect of such compensation under the provisions of any Federal law other than this title or chapter 85 of title 5, United States Code. A State shall not be entitled to any reimbursement under such chapter 85 in respect of any compensation to the extent the State is entitled to reimbursement under this title in respect of such compensation.

(c) DETERMINATION OF AMOUNT- Sums payable to any State by reason of such State having an agreement under this title shall be payable, either in advance or by way of reimbursement (as may be determined by the Secretary), in such amounts as the Secretary estimates the State will be entitled to receive under this title for each calendar month, reduced or increased, as the case may be, by any amount by which the Secretary finds that the Secretary's estimates for any prior calendar month were greater or less than the amounts which should have been paid to the State. Such estimates may be made on the basis of such statistical, sampling, or other method as may be agreed upon by the Secretary and the State agency of the State involved.

SEC. 304. FINANCING PROVISIONS.

(a) IN GENERAL- Funds in the extended unemployment compensation account (as established by section 905(a) of the Social Security Act (42 U.S.C. 1105(a)) of the Unemployment Trust Fund (as established by section 904(a) of such Act (42 U.S.C. 1104(a)) shall be used for the making of payments to States having agreements entered into under this title.

(b) CERTIFICATION- The Secretary shall from time to time certify to the Secretary of the Treasury for payment to each State the sums payable to such State under this title. The Secretary of the Treasury, prior to audit or settlement by the General Accounting Office, shall make payments to the State in accordance with such certification, by transfers from the extended unemployment compensation account (as so established) to the account of such State in the Unemployment Trust Fund (as so established).

(c) ASSISTANCE TO STATES- There are appropriated out of the employment security administration account (as established by section 901(a) of the Social Security Act (42 U.S.C. 1101(a)) of the Unemployment Trust Fund, without fiscal year limitation, such funds as may be necessary for purposes of assisting States (as provided in title III of the Social Security Act (42 U.S.C. 501 et seq.)) in meeting the costs of administration of agreements under this title.

(d) APPROPRIATIONS FOR CERTAIN PAYMENTS- There are appropriated from the general fund of the Treasury, without fiscal year limitation, to the extended unemployment compensation account (as so established) of the Unemployment Trust Fund (as so established) such sums as the Secretary estimates to be necessary to make the payments under this section in respect of--

(1) compensation payable under chapter 85 of title 5, United States Code; and

(2) compensation payable on the basis of services to which section 3309(a)(1) of the Internal Revenue Code of 1986 applies.

Amounts appropriated pursuant to the preceding sentence shall not be required to be repaid.

SEC. 305. FRAUD AND OVERPAYMENTS.

(a) IN GENERAL- If an individual knowingly has made, or caused to be made by another, a false statement or representation of a material fact, or knowingly has failed, or caused another to fail, to disclose a material fact, and as a result of such false statement or representation or of such nondisclosure such individual has received an amount of temporary extended unemployment compensation under this title to which he was not entitled, such individual--

(1) shall be ineligible for further temporary extended unemployment compensation under this title in accordance with the provisions of the applicable State unemployment compensation law relating to fraud in connection with a claim for unemployment compensation; and

(2) shall be subject to prosecution under section 1001 of title 18, United States Code.

(b) REPAYMENT- In the case of individuals who have received amounts of temporary extended unemployment compensation under this title to which they were not entitled, the State shall require such individuals to repay the amounts of such temporary extended unemployment compensation to the State agency, except that the State agency may waive such repayment if it determines that--

(1) the payment of such temporary extended unemployment compensation was without fault on the part of any such individual; and

(2) such repayment would be contrary to equity and good conscience.

(1) IN GENERAL- The State agency may recover the amount to be repaid, or any part thereof, by deductions from any temporary extended unemployment compensation payable to such individual under this title or from any unemployment compensation payable to such individual under any Federal unemployment compensation law administered by the State agency or under any other Federal law administered by the State agency which provides for the payment of any assistance or allowance with respect to any week of unemployment, during the 3-year period after the date such individuals received the payment of the temporary extended unemployment compensation to which they were not entitled, except that no single deduction may exceed 50 percent of the weekly benefit amount from which such deduction is made.

(2) OPPORTUNITY FOR HEARING- No repayment shall be required, and no deduction shall be made, until a determination has been made, notice thereof and an opportunity for a fair hearing has been given to the individual, and the determination has become final.

(d) REVIEW- Any determination by a State agency under this section shall be subject to review in the same manner and to the same extent as determinations under the State unemployment compensation law, and only in that manner and to that extent.

SEC. 306. DEFINITIONS.

(a) IN GENERAL- In this title, the terms `compensation', `regular compensation', `extended compensation', `additional compensation', `benefit year', `base period', `State', `State agency', `State law', and `week' have the respective meanings given such terms under section 205 of the Federal-State Extended Unemployment Compensation Act of 1970 (26 U.S.C. 3304 note).

(b) STATE- In this title, the term State means Louisiana, Mississippi, and Alabama.

SEC. 307. APPLICABILITY.

An agreement entered into under this title shall apply to weeks of unemployment--

(1) beginning after August 27, 2005; and

(2) ending before August 27, 2006.

TITLE IV--MISCELLANEOUS PROVISIONS

SEC. 401. DISCLOSURE BASED ON VALID AUTHORIZATION.

(a) IN GENERAL- Section 223(d)(5) of the Social Security Act (42 U.S.C. 423(d)(5)) is amended by adding at the end the following:

`(C) Notwithstanding any other provision of law, if the Commissioner of Social Security provides to a custodian of records a copy, facsimile, or electronic version of an authorization obtained from the individual to disclose records to the Commissioner, then such custodian shall not be held liable under any applicable Federal or State law for disclosing any record or other information in response to such request, on the basis that the authorization relied upon was a copy, facsimile, or electronic version of the authorization.'.

(b) EFFECTIVE DATE- The amendment made by this section shall apply with respect to disclosures of records or other information made on or after the date of enactment of this Act.

SEC. 402. ADDITIONAL OVERSIGHT FUNDING FOR THE INSPECTOR GENERAL OF THE DEPARTMENT OF HEALTH AND HUMAN SERVICES.

(a) APPROPRIATION- Out of any funds in the Treasury not otherwise appropriated, there are appropriated $5,000,000 to the Office of the Inspector General of the Department of Health and Human Services to carry out accounting, oversight, and audit and investigation activities with respect to funds expended under the Temporary Assistance for Needy Families, Medicare, Medicaid, and State Children's Health Insurance Programs under titles IV-A, XVIII, XIX, and XXI of the Social Security Act (42 U.S.C. 601 et seq., 1395 et seq., 1396 et seq., 1397aa et seq.) to provide assistance to individuals who reside or resided in a direct impact parish or county (as defined in section 101(1)).

(b) REPORT- The Inspector General of the Department of Health and Human Services shall submit a report to the Committee on Finance of the Senate and the Committees on Ways and Means and Energy and Commerce of the House of Representatives regarding the accounting, oversight, and audit and investigation activities conducted with funds made available under subsection (a).

SEC. 403. EMERGENCY PROCUREMENT AUTHORITY IN SUPPORT OF HURRICANE KATRINA RESCUE AND RELIEF EFFORTS.

(a) Availability of Special Emergency Procurement Authority- The authority provided in subsection 32A of the Office of Federal Procurement Policy Act (41 U.S.C. 428a) may be used with respect to any procurement for property or services determined by the head of an executive agency to be necessary for support of Hurricane Katrina rescue and relief operations.

(b) Micro-Purchases-

(1) MODIFIED THRESHOLD- Notwithstanding section 101(2) of the Second Emergency Supplemental Appropriations Act to Meet Immediate Needs Arising From the Consequences of Hurricane Katrina, 2005 (Public Law 109-62), the amount specified in subsections (c), (d), and (f) of the section 32 of the Office of Federal Procurement Policy Act (41 U.S.C. 428) for purchases necessary for support of Hurricane Katrina rescue and relief operations shall be $50,000, or such an amount in excess of $50,000, but not in excess of $250,000, as may be approved by the head of the executive agency concerned (or any delegate of the head of such executive agency, who shall be an officer or employee of such executive agency who is a warranted contracting officer for making Federal acquisitions).

(2) OMB GUIDANCE ON USE OF GOVERNMENT CREDIT CARDS FOR MICRO-PURCHASES-

(A) GUIDANCE REQUIRED- Not later than 14 calendar days after the date of the enactment of this Act, the Director of the Office of Management and Budget shall issue clear and concise guidance regarding the use of government credit cards by Federal agencies to make micro-purchases under subsections (c), (d), and (f) of section 32 of Office of Federal Procurement Policy Act as modified by paragraph (1).

(B) ELEMENTS- The guidance under paragraph (1) shall include--

(i) a list of government officials with the authority to approve purchases under paragraph (1) in amounts in excess of $50,000, designated by agency, title, and pay grade;

(ii) the number of credit cards, by agency, that may be utilized for purchases under paragraph (1) in amounts in excess of $50,000;

(iii) procedures for the immediate review of any purchase under paragraph (1) in an amount in excess of $50,000 that was not approved by an official specified in that paragraph as required by that paragraph; and

(iv) procedures for the audit of all purchases made on government credit cards after expiration of paragraph (1) under subsection (c).

(3) REPORTS ON PURCHASES- Not later than 180 days after the date of the enactment of this Act, the head of each executive agency making any purchase under paragraph (1) in an amount in excess of $50,000 shall submit to the appropriate Congressional committees a report on each such purchase made by such agency, including--

(A) a description of the property or services so purchased;

(B) a statement of the purpose of such purchase;

(D) a statement of the name, title, and pay grade of the officer or employee of such agency making such purchase.

(4) APPROPRIATE CONGRESSIONAL COMMITTEES DEFINED- In this subsection, the term `appropriate Congressional committees' means--

(A) the Committees on Appropriations, Finance, and Homeland Security and Governmental Affairs of the Senate; and

(B) the Committees on Appropriations and Government Reform of the House of Representatives.

(c) Expiration of Authority- The authority in subsections (a) and (b)(1) shall expire 180 days after the date of the enactment of this Act.

(d) Repeal of Superseded Authority- Section 101 of the Second Emergency Supplemental Appropriations Act to Meet Immediate Needs Arising From the Consequences of Hurricane Katrina, 2005 is repealed.

Calendar No. 214

109th CONGRESS

1st Session

S. 1716

A BILL

To provide emergency health care relief for survivors of Hurricane Katrina, and for other purposes.

September 19, 2005

Read the second time and placed on the calendar

END