Re: Declaration of a Public Health Emergency and Waiver and/or Modification of Certain Medicare, Medicaid, and State Children's Health Insurance Program Requirements

Dear Representative Pelosi:

I am writing to notify you that, as a consequence of severe storms and flooding in the State of Indiana, I determined that a public health emergency exists and has existed since June 6, 2008, in the State of Indiana, pursuant to the authority vested in me under section 319 of the Public Health Service Act, 42 U.S.C. § 247d. In addition, as required under Section 1135(d) ofthe Social Security Act (the Act) (42 U.S.C. § 1320b-5), I hereby notify you that, on June 16, 2008, I intend to waive or modify certain Medicare, Medicaid, or State Children's Health Insurance Program requirements as indicated on the attached document. I certify that these waivers and/or modifications are necessary for to carry out the purposes of Section 1135 of the Act.