109 HR 5969 IH: To amend part D of title XVIII of the Social Security Act U.S. House of Representatives 2006-07-28 text/xml EN Pursuant to Title 17 Section 105 of the United States Code, this file is not subject to copyright protection and is in the public domain.

I 109th CONGRESS 2d Session H. R. 5969 IN THE HOUSE OF REPRESENTATIVES July 28, 2006 Mr. Doggett (for himself, Mr. Rangel, Mr. Stark, Mr. Hoyer, Mr. Clyburn, Mr. Larson of Connecticut, Mr. McDermott, Mr. Lewis of Georgia, Mr. Neal of Massachusetts, Mr. McNulty, Mr. Becerra, Mrs. Jones of Ohio, Mr. Emanuel, Mr. Abercrombie, Mr. Ackerman, Mr. Allen, Mr. Andrews, Mr. Baca, Ms. Baldwin, Mr. Berman, Mr. Berry, Mr. Bishop of Georgia, Mr. Bishop of New York, Ms. Corrine Brown of Florida, Mr. Brown of Ohio, Mr. Butterfield, Mrs. Capps, Mr. Capuano, Mr. Cardoza, Ms. Carson, Mrs. Christensen, Mr. Clay, Mr. Cleaver, Mr. Conyers, Mr. Costello, Mr. Crowley, Mr. Cuellar, Mr. Cummings, Mr. Davis of Alabama, Mr. Davis of Illinois, Ms. DeGette, Mr. Delahunt, Ms. DeLauro, Mr. Dicks, Mr. Doyle, Mr. Edwards, Mr. Engel, Mr. Farr, Mr. Fattah, Mr. Filner, Mr. Frank of Massachusetts, Mr. Gonzalez, Mr. Gordon, Mr. Al Green of Texas, Mr. Gene Green of Texas, Mr. Grijalva, Mr. Gutierrez, Ms. Harman, Mr. Hastings of Florida, Mr. Higgins, Mr. Hinchey, Mr. Hinojosa, Mr. Honda, Mr. Inslee, Mr. Israel, Mr. Jackson of Illinois, Ms. Jackson-Lee of Texas, Ms. Eddie Bernice Johnson of Texas, Ms. Kaptur, Mr. Kennedy of Rhode Island, Mr. Kildee, Ms. Kilpatrick of Michigan, Mr. Kucinich, Mr. Langevin, Ms. Lee, Mrs. Lowey, Mrs. Maloney, Ms. Matsui, Ms. McCollum of Minnesota, Mr. McGovern, Ms. McKinney, Mr. Meehan, Mr. Meek of Florida, Mr. Meeks of New York, Ms. Millender-McDonald, Mr. Miller of North Carolina, Mr. George Miller of California, Mr. Mollohan, Ms. Moore of Wisconsin, Mr. Moran of Virginia, Mr. Nadler, Mrs. Napolitano, Ms. Norton, Mr. Oberstar, Mr. Olver, Mr. Ortiz, Mr. Owens, Mr. Pallone, Mr. Pascrell, Mr. Pastor, Mr. Payne, Mr. Price of North Carolina, Mr. Reyes, Ms. Roybal-Allard, Mr. Rush, Mr. Ryan of Ohio, Ms. Linda T. Sánchez of California, Ms. Loretta Sanchez of California, Mr. Sanders, Ms. Schakowsky, Ms. Schwartz of Pennsylvania, Mr. Scott of Virginia, Mr. Scott of Georgia, Mr. Serrano, Ms. Slaughter, Ms. Solis, Mr. Thompson of Mississippi, Mr. Tierney, Mr. Towns, Mr. Udall of New Mexico, Mr. Van Hollen, Ms. Velázquez, Ms. Wasserman Schultz, Ms. Waters, Ms. Watson, Mr. Watt, Mr. Waxman, Mr. Weiner, Mr. Wexler, Ms. Woolsey, Mr. Wu, and Mr. Wynn) introduced the following bill; which was referred to the Committee on Ways and Means, and in addition to the Committee on Energy and 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 part D of title XVIII of the Social Security Act to assist low-income individuals in obtaining subsidized prescription drug coverage under the Medicare prescription drug program by expediting the application and qualification process, by increasing the maximum permissible resource level for eligibility for such subsidies, and by waiving any late enrollment penalty for the first 24 uncovered months.

1.

Short title

This Act may be cited as the Prescription Coverage Now Act of 2006.

2.

Expediting low-income subsidies under the Medicare prescription drug program

(a)

In general

Section 1860D–14 of the Social Security Act (42 U.S.C. 1395w–114) is amended by adding at the end the following new subsection: (e)

Expedited application and eligibility process

(1)

Expedited process

(A)

In general

The Secretary shall provide for an expedited process under this subsection for the qualification for low-income assistance under this section through a request by the Secretary to the Secretary of the Treasury as provided in subparagraphs (B) and (C) for information sufficient to identify whether the individual involved is likely eligible for subsidies under this section based on such information and the amount of premium and cost-sharing subsidies for which they would qualify based on such information. Such process shall be conducted in cooperation with the Commissioner of Social Security. (B)

Opt in for newly eligible individuals

Not later than 60 days after the date of the enactment of this subsection, the Secretary shall ensure that, as part of the Medicare enrollment process, enrolling individuals— (i)receive information describing the low-income subsidy provided under this section; and (ii)are provided the opportunity to opt-in to the expedited process described in this subsection by giving consent for the Secretary to screen the beneficiary for eligibility for such subsidy through a request to the Secretary of the Treasury under section 6103(l)(7) of the Internal Revenue Code of 1986. (C)

Transition for currently eligible individuals

In the case of any part D eligible individual to which subparagraph (B) did not apply at the time of such individual’s enrollment, the Secretary shall, as soon as practicable after implementation of subparagraph (B), request in writing that the Secretary of the Treasury disclose, pursuant to section 6103(l)(21) of the Internal Revenue Code of 1986, whether such individual has either filed no income tax return or whether such individual’s income tax return indicates likely eligibility for the low-income subsidy provided under this section. (2)

Notification of potentially eligible individuals

Under such process, in the case of each individual identified under paragraph (1) who has not otherwise applied for, or been determined eligible for, benefits under this section (or who has applied for and been determined ineligible for such benefits based only on excess resources), the Secretary shall send them a letter (using basic, uncomplicated language) containing the following: (A)

Eligibility

A statement that, based on the information obtained under paragraph (1), the individual is likely eligible for low-income subsidies under this section. (B)

Amount of subsidies

A description of the amount of premium and cost-sharing subsidies under this section for which the individual would likely be eligible based on such information. (C)

Enrollment opportunity

In case the individual is not enrolled in a prescription drug plan or MA–PD plan— (i)a statement that— (I)the individual has the opportunity to enroll in a prescription drug plan or MA–PD plan for benefits under this part, but is not required to be so enrolled; and (II)if the individual has creditable prescription drug coverage, the individual need not so enroll; (ii)a list of the prescription drug plans and MA–PD plans in which the individual is eligible to enroll; (iii)an enrollment form that may be used to enroll in such a plan by mail and that provides that if the individual wishes to enroll but does not designate a plan, the Secretary is authorized to enroll the individual in such a prescription drug plan selected by the Secretary; and (iv)a statement that the individual may also enroll online or by telephone, but, in order to qualify for low-income subsidies, the individual must complete the attestation described in subparagraph (D) or otherwise apply for such subsidies. (D)

Attestation

A one-page application form that provides for a signed attestation, under penalty of law, as to the amount of income and assets of the individual and constitutes an application for the low-income subsidies described in subparagraph (B). Such form— (i)shall not require the submittal of additional documentation regarding income or assets; (ii)shall permit the appointment of a personal representative described in paragraph (6); and (iii)may provide for the specification of a language (other than English) that is preferred for subsequent communications with respect to the individual under this part. (E)

Information on SHIP

Information on how the individual may contact the State Health Insurance Assistance Program (SHIP) for the State in which the individual is located in order to obtain assistance regarding enrollment and benefits under this part. If a State is doing its own outreach to low-income seniors regarding enrollment and low-income subsidies under this part, such process shall be coordinated with the State’s outreach effort.(3)

Follow-up communications

If the individual does not respond to the letter described in paragraph (2) either by making an enrollment described in paragraph (2)(C), completing an attestation described in paragraph (2)(D), or declining either or both, the Secretary shall make additional attempts to contact the individual to obtain such an affirmative response. (4)

Hold-harmless

Under such process, if an individual in good faith and the absence of fraud executes an attestation described in paragraph (2)(D) and is provided low-income subsidies under this section on the basis of such attestation, if the individual is subsequently found not eligible for such subsidies, there shall be no recovery made against the individual because of such subsidies improperly paid. (5)

Use of authorized representative

Under such process, with proper authorization (which may be part of the attestation form described in paragraph (2)(D)), an individual may authorize another individual to act as the individual’s personal representative with respect to communications under this part and the enrollment of the individual under a prescription drug plan (or MA–PD plan) and for low-income subsidies under this section. (6)

Use of preferred language in subsequent communications

In the case an attestation described in paragraph (2)(D) is completed and in which a language other than English is specified under clause (iii) of such paragraph, the Secretary shall provide that subsequent communications to the individual under this part shall be in such language. (7)

Construction

Nothing in this subsection shall be construed as precluding the Secretary from taking additional outreach efforts to enroll eligible individuals under this part and to provide low-income subsidies to eligible individuals. . (b)

Transitional disclosure of return information for purposes of providing low-income subsidies under Medicare

(1)

In general

Subsection (l) of section 6103 of the Internal Revenue Code of 1986 is amended by adding at the end the following new paragraph: (21)

Transitional disclosure of return information for purposes of providing low-income subsidies under Medicare

(A)

In general

The Secretary, upon written request from the Secretary of Health and Human Services under section 1860D–14(e)(1) of the Social Security Act for an individual described in subparagraph (C) of such section, shall disclose to officers and employees of the Department of Health and Human Services and the Social Security Administration with respect to a taxpayer for the applicable year— (i)(I)whether the adjusted gross income, as modified in accordance with specifications of the Secretary of Health and Human Services for purposes of carrying out such section, of such taxpayer and, if applicable, such taxpayer’s spouse, for the applicable year, exceeds the amounts specified by the Secretary of Health and Human Services as indicating likely eligibility for the low-income subsidy provided under section 1860D–14 of such Act, (II)whether the return was a joint return, and (III)the applicable year, or (ii)if applicable, the fact that there is no return filed for such taxpayer for the applicable year. (B)

Definition of applicable year

For the purposes of this paragraph, the term applicable year means the most recent taxable year for which information is available in the Internal Revenue Service’s taxpayer data information systems, or, if there is no return filed for such taxpayer for such year, the prior taxable year. (C)

Restriction on use of disclosed information

Return information disclosed under this paragraph may be used only for the purposes of identifying eligible individuals for, and administering— (i)low-income subsidies under section 1860D–14 of the Social Security Act, and (ii)the Medicare Savings Program implemented under clauses (i), (iii), and (iv) of section 1902(a)(10)(E) of such Act. (D)

Termination

Return information may not be disclosed under this paragraph after the date that is one year after the date of the enactment of this paragraph. . (2)

Confidentiality

Paragraph (3) of section 6103(a) of such Code is amended by striking or (20) and inserting (20), or (21). (3)

Procedures and recordkeeping related to disclosures

Paragraph (4) of section 6103(p) of such Code is amended by striking or (20) each place it appears and inserting (20), or (21). (4)

Unauthorized disclosure or inspection

Paragraph (2) of section 7213(a) of such Code is amended by striking or (20) and inserting (20), or (21).

3.

Increase in permitted resources to obtain low-income subsidies

(a)

Increase in resource limits

Subparagraph (E) of section 1860D–14(a)(3) of the Social Security Act (42 U.S.C. 1395ww–114(a)(3)) is amended— (1)in subclause (I), by striking for 2006 and inserting for months in 2006 before the first day of the first month beginning after the date of the enactment of the Prescription Drug Now Act of 2006 and by striking and at the end; (2)by redesignating subclause (II) as subclause (III); (3)by inserting after subclause (I) the following new subclause: (II)for months in 2006 beginning with the first month that begins after the date of the enactment of the Prescription Drug Now Act of 2006, $50,000 (or $100,000 in the case of the combined value of the individual's assets or resources and the assets or resources of the individual's spouse); and ; and (4)in the last sentence, by striking subclause (II) and inserting subclause (III). (b)

Not counting value of life insurance as resource

Such section is further amended— (1)in subparagraphs (D) and (E), by inserting , except as provided in subparagraph (G) after supplemental security income program; and (2)by adding at the end the following new subparagraph: (G)

Exclusion of life insurance in resources

For purposes of subparagraphs (D) and (E), the value of a life insurance policy shall not be counted as a resource for months beginning after the date of the enactment of this subparagraph. .

4.

Waiver of late enrollment penalty for subsidy eligible individuals for first 24 months of non-enrollment

Section 1860D–13(b)(3)(B) of the Social Security Act (42 U.S.C. 1395w–113(b)(3)(B)) is amended by inserting before the period at the end the following: , except that in the case of a subsidy eligible individual (as defined in section 1860D–14(a)(3)(A)) the first 24 uncovered months shall not be counted.