[Congressional Bills 105th Congress]
[From the U.S. Government Publishing Office]
[H.R. 4836 Introduced in House (IH)]







105th CONGRESS
  2d Session
                                H. R. 4836

 To amend title XI of the Social Security Act and the Internal Revenue 
   Code of 1986 to establish a mechanism to promote the provision of 
   Medicare cost-sharing assistance to eligible low-income Medicare 
                             beneficiaries.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                            October 14, 1998

 Mr. McDermott (for himself, Mr. Stark, and Mr. Miller of California) 
 introduced the following bill; which was referred to the Committee on 
  Ways and Means, and in addition to the Committee on Commerce, 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 amend title XI of the Social Security Act and the Internal Revenue 
   Code of 1986 to establish a mechanism to promote the provision of 
   Medicare cost-sharing assistance to eligible low-income Medicare 
                             beneficiaries.

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

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``QMB Improvement Act of 1998''.

SEC. 2. MECHANISM PROMOTING PROVISION OF MEDICARE COST-SHARING 
              ASSISTANCE TO ELIGIBLE LOW-INCOME MEDICARE BENEFICIARIES.

    (a) In General.--Part A of title XI of the Social Security Act is 
amended by adding at the end the following:

    ``promoting provision of medicare cost-sharing assistance under 
   medicaid program for identified low-income medicare beneficiaries

    ``Sec. 1147. (a) Requirement for Data Match.--
            ``(1) Requesting matching information.--The Commissioner of 
        Social Security shall, not less often than annually beginning 
        with 2001, transmit to the Secretary of the Treasury a list of 
        the names and TINs of Medicare beneficiaries (as defined in 
        section 6103(l)(15) of the Internal Revenue Code of 1986) and 
        request that such Secretary disclose to the Secretary of Health 
        and Human Services the information described in subparagraph 
        (A) of such section.
            ``(2) Specification of income levels.--The Secretary shall 
        specify--
                    ``(A) the items that will be included in 
                determination of income for purposes of applying this 
                section and section 6103(l)(15)(A)(i) of the Internal 
                Revenue Code of 1986; and
                    ``(B) the levels of such income (based upon a 
                percentage of the Federal poverty guidelines) that 
                individuals may have and qualify for medical assistance 
                under section 1902(a)(10)(E)(i) of the Social Security 
                Act (relating to assistance for Medicare cost-sharing 
                benefits under the Medicaid program).
    ``(b) Notice to Individuals Identified.--
            ``(1) Initial eligibility.--The Secretary promptly shall 
        provide for an appropriate notice to each individual identified 
        under subsection (a) who is described in section 
        6103(l)(15)(A)(i), of the following:
                    ``(A) Subject to subparagraph (B), the individual 
                is deemed eligible for some form of medical assistance 
                for some Medicare cost-sharing under clause (i) or 
                (iii) of section 1902(a)(10)(E), depending on the 
                individual's level of income.
                    ``(B) By accepting such assistance the individual 
                is obligated to notify the Secretary if the individual 
                is not eligible for such assistance due to--
                            ``(i) the individual having tax-exempt 
                        income;
                            ``(ii) the individual having countable 
                        assets in excess of the maximum permissible 
                        assets, if the individual resides in a State 
                        that imposes an asset test for such 
                        eligibility; or
                            ``(iii) the individual otherwise is not 
                        eligible for such assistance.
                    ``(C) If the individual accepts such assistance 
                notwithstanding that the individual is not eligible, 
                the individual is liable to the State for the amount of 
                medical assistance provided (with interest).
            ``(2) Continued eligibility.--The Secretary shall provide 
        for an appropriate notice to each individual identified under 
        subsection (a) who is described in section 6103(l)(15)(A)(ii), 
        of the following: `Unless the individual declines coverage or 
        indicates otherwise, the individual will be enrolled for the 
        appropriate assistance with Medicare cost-sharing under the 
        State plan operated under title XIX for the State in which the 
        individual resides.'
    ``(c) Notice to State.--In the case of an individual who is 
identified under this section and resides in a State, the Secretary 
shall provide for appropriate notice to the State of the individual's 
eligibility for medical assistance under clause (i) or (iii) of section 
1902(a)(10)(E), as the case may be.''.
    (b) Conforming Amendment to Medicaid Program.--Section 1902 of such 
Act (42 U.S.C. 1396a) is amended by adding at the end the following:
    ``(aa) A State shall treat an individual who is identified under 
section 1147(b) as being eligible for medical assistance under clause 
(i) or (ii) of subsection (a)(10)(E) as being so eligible, until the 
Secretary notifies the State otherwise, with respect to medical 
assistance for items and services furnished on or after the date of the 
notice.''.
    (c) Authorization of Disclosure.--Section 6103(l) of the Internal 
Revenue Code of 1986 (relating to disclosure of returns and return 
information for purposes other than tax administration) is amended by 
adding at the end the following new paragraph:
            ``(15) Disclosure of certain information in order to 
        qualify for medicare cost-sharing assistance.--
                    ``(A) In general.--The Secretary shall, upon 
                written request from the Commissioner of Social 
                Security, disclose to the Secretary of Health and Human 
                Services, whether with respect to any Medicare 
                beneficiary (as defined in paragraph (12)(E)(i)) 
                identified by the Commissioner--
                            ``(i) there has not been filed an income 
                        tax return for the most recent period for which 
                        the Secretary has information; or there has 
                        been such a return filed and the amount of the 
                        gross income (or the sum of such elements of 
                        gross income as the Secretary of Health and 
                        Human Services may specify) is below such level 
                        (or levels) as such Secretary may specify to 
                        carry out section 1147(b) of the Social 
                        Security Act, treating the number of dependents 
                        as the size of the family involved; and
                            ``(ii) whether, for such an individual who 
                        qualified for Medicare cost-sharing assistance 
                        described in section 1147 at any time in the 
                        previous year, the individual is still 
                        described in clause (i).
                    ``(B) Disclosure by health care financing 
                administration.--With respect to information disclosed 
                under subparagraph (A), the Administrator of the Health 
                Care Financing Administration may disclose to the 
                appropriate officials of a State responsible for 
                administration of a State plan under title XIX of the 
                Social Security Act the name, address, and TIN of the 
                preliminary eligibility determination.
                    ``(C) Special rules.--
                            ``(i) Restrictions on disclosure.--
                        Information may be disclosed under this 
                        paragraph only for purposes of, and to the 
                        extent necessary in, determining the extent to 
                        which an individual beneficiary is entitled to 
                        medical assistance under a State plan under 
                        title XIX of the Social Security Act for some 
                        or all Medicare cost-sharing.
                            ``(ii) Timely responses to requests.--Any 
                        request made under subparagraph (A) shall be 
                        complied with as soon as possible but in no 
                        event later than 60 days after the date the 
                        request was made.''.
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