[Congressional Bills 106th Congress]
[From the U.S. Government Publishing Office]
[H.R. 854 Introduced in House (IH)]







106th CONGRESS
  1st Session
                                H. R. 854

   To amend title XIX of the Social Security Act to provide for the 
  presumptive eligibility of Medicare beneficiaries for the qualified 
   Medicare beneficiary and special low-income Medicare beneficiary 
                   programs, and for other purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                           February 25, 1999

 Mr. Bentsen introduced the following bill; which was referred to the 
                         Committee on Commerce

_______________________________________________________________________

                                 A BILL


 
   To amend title XIX of the Social Security Act to provide for the 
  presumptive eligibility of Medicare beneficiaries for the qualified 
   Medicare beneficiary and special low-income Medicare beneficiary 
                   programs, 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.

    This Act may be cited as the ``Low-Income Medicare Beneficiary 
Assistance Act of 1999''.

SEC. 2. PRESUMPTIVE ELIGIBILITY OF CERTAIN LOW-INCOME INDIVIDUALS FOR 
              MEDICARE COST-SHARING UNDER THE QMB OR SLMB PROGRAM.

    Title XIX of the Social Security Act is amended by inserting after 
section 1920A the following new section:

      ``presumptive eligibility of certain low-income individuals

    ``Sec. 1920B. (a) A State plan approved under section 1902 shall 
provide for making medical assistance with respect to medicare cost-
sharing covered under the State plan available to a low-income 
individual on the date the low-income individual becomes entitled to 
benefits under part A of title XVIII during a presumptive eligibility 
period.
    ``(b) For purposes of this section:
            ``(1) The term `low-income individual' means an individual 
        who at the age of 65 years is described--
                    ``(A) in section 1902(a)(10)(E)(i), or
                    ``(B) in section 1902(a)(10)(E)(iii).
            ``(2) The term `medicare cost-sharing'--
                    ``(A) with respect to an individual described in 
                paragraph (1)(A), has the meaning given such term in 
                section 1905(p)(3).
                    ``(B) with respect to an individual described in 
                paragraph (1)(B), has the meaning given such term in 
                section 1905(p)(3)(A).
            ``(3) The term `presumptive eligibility period' means, with 
        respect to a low-income individual, the period that--
                    ``(A) begins with the date on which a qualified 
                entity determines, on the basis of preliminary 
                information, that the income and resources of the 
                individual do not exceed the applicable income and 
                resource level of eligibility under the State plan, and
                    ``(B) ends with (and includes) the earlier of--
                            ``(i) the day on which a determination is 
                        made with respect to the eligibility of the 
                        low-income individual for medical assistance 
                        for medical cost-sharing under the State plan, 
                        or
                            ``(ii) in the case of a low-income 
                        individual on whose behalf an application is 
                        not filed by the last day of the month 
                        following the month during which the entity 
                        makes the determination referred to in 
                        subparagraph (A), such last day.
            ``(4)(A) Subject to subparagraph (B), the term `qualified 
        entity' means any of the following:
                    ``(i) Qualified individuals within the Social 
                Security Administration.
                    ``(ii) An entity determined by the State agency to 
                be capable of making determinations of the type 
                described in paragraph (3).
            ``(B) The Secretary may issue regulations further limiting 
        those entities that may become qualified entities in order to 
        prevent fraud and abuse and for other reasons.
    ``(c)(1) The State agency, after consultation with the Secretary, 
shall provide qualified entities with--
            ``(A) such forms as are necessary for an application to be 
        made on behalf of a low-income individual for medical 
        assistance for medical cost-sharing under the State plan, and
            ``(B) information on how to assist low-income individuals 
        and other persons in completing and filing such forms.
    ``(2) A qualified entity that determines under subsection (b)(2)(A) 
that a low-income individual is presumptively eligible for medical 
assistance for medical cost-sharing under a State plan shall--
            ``(A) notify the State agency of the determination within 5 
        working days after the date on which the determination is made, 
        and
            ``(B) inform the low-income individual at the time the 
        determination is made that an application for medical 
        assistance for medical cost-sharing under the State plan is 
        required to be made by not later than the last day of the month 
        following the month during which the determination is made.
    ``(3) In the case of a low-income individual who is determined by a 
qualified entity to be presumptively eligible for medical assistance 
for medical cost-sharing under a State plan, the low-income individual 
shall make application for medical assistance for medical cost-sharing 
under such plan by not later than the last day of the month following 
the month during which the determination is made.
    ``(d) Notwithstanding any other provision of this title, medical 
assistance for medicare cost-sharing that--
            ``(1) is furnished to a low-income individual during a 
        presumptive eligibility period under the State plan; and
            ``(2) is included in the services covered by a State plan;
shall be treated as medical assistance provided by such plan for 
purposes of section 1903.''.

SEC. 3. AUTHORIZATION OF APPROPRIATIONS FOR OUTREACH EFFORTS.

    There is authorized to be appropriated to the Secretary of Health 
and Human Services $12,000,000 for the purpose of conducting outreach 
efforts to increase awareness of the availability of medical assistance 
for medicare cost-sharing under a State plan under title XIX of the 
Social Security Act to eligible low-income medicare beneficiaries 
described in clauses (i) and (iii), respectively, of section 
1902(a)(10)(E) of such Act (42 U.S.C. 1396a(a)(10)(E)).
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