[Congressional Bills 110th Congress]
[From the U.S. Government Publishing Office]
[S. 2101 Introduced in Senate (IS)]







110th CONGRESS
  1st Session
                                S. 2101

  To amend title XIX of the Social Security Act to assist low-income 
Medicare beneficiaries by improving eligibility and services under the 
           Medicare Savings Program, and for other purposes.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                           September 26, 2007

 Mr. Bingaman (for himself, Mr. Kerry, Mr. Salazar, and Ms. Stabenow) 
introduced the following bill; which was read twice and referred to the 
                          Committee on Finance

_______________________________________________________________________

                                 A BILL


 
  To amend title XIX of the Social Security Act to assist low-income 
Medicare beneficiaries by improving eligibility and services under the 
           Medicare Savings Program, 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 ``Medicare Savings 
Program Improvement Act of 2007''.
    (b) Table of Contents.--The table of contents of this Act is as 
follows:

Sec. 1. Short title; table of contents.
Sec. 2. References to Medicare Savings Program.
Sec. 3. Increase in income levels for eligibility.
Sec. 4. Elimination of application of estate recovery for Medicare 
                            Savings Program beneficiaries.
Sec. 5. Modification of asset test.
Sec. 6. Eligibility for other programs.
Sec. 7. Effective date of MSP benefits.
Sec. 8. Expediting eligibility under the Medicare Savings Program.
Sec. 9. Treatment of qualified medicare beneficiaries, specified low-
                            income medicare beneficiaries, and other 
                            dual eligibles as Medicare beneficiaries.
Sec. 10. Medicaid treatment of certain medicare providers.
Sec. 11. Monitoring and enforcement of limitation on beneficiary 
                            liability.
Sec. 12. State provision of medical assistance to dual eligibles in MA 
                            plans.

SEC. 2. REFERENCES TO MEDICARE SAVINGS PROGRAM.

    The low-income assistance programs for Medicare beneficiaries under 
the Medicaid program under title XIX of the Social Security Act now 
popularly referred to the ``QMB'' and ``SLMB'' programs are to be known 
as the ``Medicare Savings Program''.

SEC. 3. INCREASE IN INCOME LEVELS FOR ELIGIBILITY.

    (a) Increase to 135 Percent of FPL for Qualified Medicare 
Beneficiaries.--
            (1) In general.--Section 1905(p)(2) of the Social Security 
        Act (42 U.S.C. 1396d(p)(2)) is amended--
                    (A) in subparagraph (A), by striking ``100 
                percent'' and inserting ``135 percent'';
                    (B) in subparagraph (B)--
                            (i) by striking ``and'' at the end of 
                        clause (ii);
                            (ii) by striking the period at the end of 
                        clause (iii) and inserting ``, and''; and
                            (iii) by adding at the end the following:
            ``(iv) January 1, 2008, is 135 percent.''; and
                    (C) in subparagraph (C)--
                            (i) by striking ``and'' at the end of 
                        clause (iii);
                            (ii) by striking the period at the end of 
                        clause (iv) and inserting ``, and''; and
                            (iii) by adding at the end the following:
            ``(v) January 1, 2008, is 135 percent.''.
            (2) Application of income test based on family size.--
        Section 1905(p)(2)(A) of such Act (42 U.S.C. 1396d(p)(2)(A)) is 
        amended by adding at the end the following: ``For purposes of 
        this subparagraph, family size means the applicant, the spouse 
        (if any) of the applicant if living in the same household as 
        the applicant, and the number of individuals who are related to 
        the applicant (or applicants), who are living in the same 
        household as the applicant (or applicants), and who are 
        dependent on the applicant (or the applicant's spouse) for at 
        least one-half of their financial support.''.
            (3) Not counting in-kind support and maintenance as 
        income.--Section 1905(p)(2)(D) of such Act (42 U.S.C. 
        1396d(p)(2)(D)) is amended by adding at the end the following 
        new clause:
    ``(iii) In determining income under this subsection, support and 
maintenance furnished in kind shall not be counted as income.''.
    (b) Expansion of Specified Low-Income Medicare Beneficiary (SLMB) 
Program.--
            (1) Eligibility of individuals with incomes below 150 
        percent of fpl.--Section 1902(a)(10)(E) of the Social Security 
        Act (42 U.S.C. 1396b(a)(10)(E)) is amended--
                    (A) by adding ``and'' at the end of clause (ii);
                    (B) in clause (iii)--
                            (i) by striking ``and 120 percent in 1995 
                        and years thereafter'' and inserting ``, or 120 
                        percent in 1995 and any succeeding year before 
                        2008, or 150 percent beginning in 2008''; and
                            (ii) by striking ``and'' at the end; and
                    (C) by striking clause (iv).
            (2) Providing 100 percent federal financing.--The third 
        sentence of section 1905(b) of such Act (42 U.S.C. 1396d(b)) is 
        amended by inserting before the period at the end the 
        following: ``and with respect to medical assistance for 
        medicare cost-sharing provided under section 
        1902(a)(10)(E)(iii)''.
            (3) References.--Section 1905(p)(1) of such Act (42 U.S.C. 
        1396d(p)(1)) is amended by adding at and below subparagraph (C) 
        the following: ``The term `specified low-income medicare 
        beneficiary' means an individual described in section 
        1902(a)(10)(E)(iii).''.
    (c) Effective Date.--
            (1) Except as provided in paragraph (2), the amendments 
        made by this section shall take effect on January 1, 2008, and, 
        with respect to title XIX of the Social Security Act, shall 
        apply to calendar quarters beginning on or after January 1, 
        2008.
            (2) In the case of a State plan for medical assistance 
        under title XIX of the Social Security Act which the Secretary 
        of Health and Human Services determines requires State 
        legislation (other than legislation appropriating funds) in 
        order for the plan to meet the additional requirements imposed 
        by the amendments made by this section, the State plan shall 
        not be regarded as failing to comply with the requirements of 
        such title solely on the basis of its failure to meet these 
        additional requirements before the first day of the first 
        calendar quarter beginning after the close of the first regular 
        session of the State legislature that begins after the date of 
        the enactment of this Act. For purposes of the previous 
        sentence, in the case of a State that has a 2-year legislative 
        session, each year of such session shall be deemed to be a 
        separate regular session of the State legislature.

SEC. 4. ELIMINATION OF APPLICATION OF ESTATE RECOVERY FOR MEDICARE 
              SAVINGS PROGRAM BENEFICIARIES.

    (a) In General.--Section 1917(b)(1)(B)(ii) of the Social Security 
Act (42 U.S.C. 1396p(b)(1)(B)(ii)) is amended by inserting ``(but not 
including medical assistance for medicare cost-sharing or for benefits 
described in section 1902(a)(10)(E))'' before the period at the end.
    (b) Effective Date.--The amendment made by subsection (a) shall 
apply to actions commencing on or after January 1, 2008.

SEC. 5. MODIFICATION OF ASSET TEST.

    (a) For QMBs.--Section 1905(p) of the Social Security Act (42 
U.S.C. 1396d(p)) is amended--
            (1) in paragraph (1), by amending subparagraph (C) to read 
        as follows:
            ``(C) whose resources (as determined under section 1613 for 
        purposes of the supplemental income security program, except as 
        provided in paragraph (6)(C)) do not exceed the amount 
        described in paragraph (6)(A).'';
            (2) by redesignating paragraph (6) as paragraph (7); and
            (3) by inserting after paragraph (5) the following:
    ``(6)(A) The resource level specified in this subparagraph for--
            ``(i) for 2008 is six times the maximum amount of resources 
        that an individual may have and obtain benefits under the 
        supplemental security income program under title XVI; or
            ``(ii) for a subsequent year is the resource level 
        specified in this subparagraph for the previous year increased 
        by the annual percentage increase in the consumer price index 
        (all items; U.S. city average) as of September of such previous 
        year.
Any dollar amount established under clause (ii) that is not a multiple 
of $10 shall be rounded to the nearest multiple of $10.
    ``(B) In determining the resources of an individual (and their 
eligible spouse, if any) under section 1613 for purposes of paragraph 
(1)(C) (relating to qualified medicare beneficiaries) or section 
1902(a)(10)(E)(iii) (relating to individuals popularly known as 
specified low-income medicare beneficiaries), the following additional 
exclusions shall apply--
            ``(i) No part of the value of any life insurance policy 
        shall be taken into account.
            ``(ii) No balance in any pension or retirement plan or 
        account shall be taken into account.''.
    (b) For SLMBs.--
            (1) Permitting greater assets.--Section 1902(a)(10)(E)(iii) 
        of such Act (42 U.S.C. 1396b(a)(10)(E)(iii)) is amended by 
        inserting before the semicolon the following: ``or but for the 
        fact that their resources exceed the resource level specified 
        in section 1905(p)(6)(A) but does not exceed the resource level 
        specified in section 1905(p)(6)(B)''.
            (2) Higher resource level specified.--Section 1905(p)(6) of 
        such Act, as inserted by subsection (a)(3), is amended by 
        inserting after subparagraph (A) the following new 
        subparagraph:
    ``(B) The resource level specified in this subparagraph for--
            ``(i) for 2008, is $27,500 (or $55,000 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
            ``(ii) for a subsequent year is the applicable resource 
        level specified in this subparagraph for the previous year 
        increased by the annual percentage increase in the consumer 
        price index (all items; U.S. city average) as of September of 
        such previous year.
Any dollar amount established under clause (ii) that is not a multiple 
of $10 shall be rounded to the nearest multiple of $10.''.
    (c) Effective Date.--
            (1) Except as provided in paragraph (2), the amendments 
        made by this section shall apply to calendar quarters beginning 
        on or after January 1, 2008.
            (2) In the case of a State plan for medical assistance 
        under title XIX of the Social Security Act which the Secretary 
        of Health and Human Services determines requires State 
        legislation (other than legislation appropriating funds) in 
        order for the plan to meet the additional requirements imposed 
        by the amendments made by this section, the State plan shall 
        not be regarded as failing to comply with the requirements of 
        such title solely on the basis of its failure to meet these 
        additional requirements before the first day of the first 
        calendar quarter beginning after the close of the first regular 
        session of the State legislature that begins after the date of 
        the enactment of this Act. For purposes of the previous 
        sentence, in the case of a State that has a 2-year legislative 
        session, each year of such session shall be deemed to be a 
        separate regular session of the State legislature.

SEC. 6. ELIGIBILITY FOR OTHER PROGRAMS.

    (a) In General.--Section 1905(p) of the Social Security Act (42 
U.S.C. 1396d(p)), as amended by section 4(a), is amended--
            (1) by redesignating paragraph (7) as paragraph (8); and
            (2) by inserting after paragraph (6) the following new 
        paragraph:
    ``(7) Medical assistance for some or all medicare cost-sharing 
under this title shall not be treated as benefits or otherwise taken 
into account in determining an individual's eligibility for, or the 
amount of benefits under, any other Federal program.''.
    (b) Effective Date.--The amendments made by subsection (a) shall 
apply to eligibility for benefits on or after January 1, 2008.

SEC. 7. EFFECTIVE DATE OF MSP BENEFITS.

    (a) Providing for 3 Months Retroactive Eligibility.--
            (1) In general.--Section 1905(a) of the Social Security Act 
        (42 U.S.C. 1396d(a)) is amended, in the matter preceding 
        paragraph (1), by striking ``described in subsection (p)(1), if 
        provided after the month'' and inserting ``described in 
        subsection (p)(1) or a specified low-income medicare 
        beneficiary described in section 1902(a)(10)(E)(iii), if 
        provided in or after the third month before the month in which 
        the individual expresses an interest in applying to become such 
        a beneficiary, as determined in the manner provided for 
        assistance under section 1860D-14''.
            (2) Conforming amendments.--(A) The first sentence of 
        section 1902(e)(8) of such Act (42 U.S.C. 1396a(e)(8)), as 
        amended by section 4(c)(2), is amended by striking ``(8)'' and 
        the first sentence.
            (B) Section 1848(g)(3) of such Act (42 U.S.C. 1395w-
        4(g)(3)) is amended by adding at the end the following new 
        subparagraph:
                    ``(C) Treatment of retroactive eligibility.--In the 
                case of an individual who is determined to be eligible 
                for medical assistance described in subparagraph (A) 
                retroactively, the Secretary shall provide a process 
                whereby claims which are submitted for services 
                furnished during the period of retroactive eligibility 
                and during a month in which the individual otherwise 
                would have been eligible for such assistance and which 
                were not submitted in accordance with such subparagraph 
                are resubmitted and re-processed in accordance with 
                such subparagraph.''.
    (b) Effective Date.--The amendments made by this section shall take 
effect on January 1, 2008, but shall not result in eligibility for 
benefits for medicare cost-sharing for months before January 2008.

SEC. 8. EXPEDITING ELIGIBILITY UNDER THE MEDICARE SAVINGS PROGRAM.

    (a) Increasing Eligibility Through the Social Security Office.--
            (1) In general.--Title XVIII of the Social Security Act is 
        amended by inserting after section 1808 the following new 
        section:

   ``expedited enrollment under the medicare savings program through 
                        social security offices

    ``Sec. 1809.  (a) In General.--The Secretary shall provide, in 
cooperation with the Commissioner of Social Security, for an expedited 
process under this section for individuals to apply and qualify for 
benefits under the Medicare Savings Program. For purposes of this 
section, the term `Medicare Savings Program' means medical assistance 
for medicare cost-sharing (as defined in section 1905(p)(3)) for 
qualified medicare beneficiaries and specified low-income medicare 
beneficiaries under title XIX.
    ``(b) Process.--The process shall be consistent with the following:
            ``(1) Coordination with social security and medicare 
        enrollment process.--The application shall be part of the 
        process for applying for benefits under title II and this 
        title.
            ``(2) Simplified application process.--The application may 
        be made over the Internet, by telephone, or by mail, without 
        the need for an interview in person by the applicant or a 
        representative of the applicant.
            ``(3) Contents of application.--The application shall 
        contain a description (in English, Spanish and other languages 
        determined appropriate by the Secretary) of the availability of 
        and the requirements for obtaining benefits under the Medicare 
        Savings Program.
            ``(4) Training.--Employees of the Social Security office 
        involved shall be trained to assist individuals completing such 
        applications.
            ``(5) Self-certification and verification.--In determining 
        whether an individual is eligible for benefits under the 
        Medicare Savings Program, the Secretary shall permit 
        individuals to qualify on the basis of self certifications of 
        income and resources meeting applicable standards without the 
        need to provide additional documentation. The Secretary shall 
        verify that information provided in the application is correct.
            ``(6) Transmittal of application.--
                    ``(A) Eligible applicants.--In the case of an 
                applicant determined by the Social Security office to 
                be eligible for benefits under the Medicare Savings 
                Program based on income and resources meeting the 
                standards otherwise applicable, the office shall 
                transmit to the applicable State Medicaid office the 
                application so that the applicant can be enrolled 
                within 30 days based on the information collected by 
                the office.
                    ``(B) Use of electronic transfer system.--Not later 
                than two years after the date of implementation of 
                improvements of the electronic data transfer system 
                under section 8(c) of the Medicare Savings Program 
                Improvement Act of 2007, the process under this 
                paragraph shall use the such system for information 
                transmittal.
                    ``(C) Ineligible applicants.--In the case of other 
                applicants whose income and resources do not meet such 
                standards, the Social Security office shall transmit to 
                the applicable State Medicaid office the application so 
                that the application may be considered under State 
                standards that may be more generous than the standards 
                otherwise generally applicable.
The process under this subsection shall be established and implemented 
one year after the date of the enactment of this section.
    ``(c) Distribution of Application Form.--The Secretary shall 
distribute the application form used under subsection (b) to any 
organization that requests them, including entities receiving grants 
from the Secretary for programs designed to provide services to 
individuals 65 years of age or older and people with disabilities. The 
Commissioner of Social Security shall make such forms available at 
local offices of the Social Security Administration.
    ``(d) State Response and Application Process.--
            ``(1) In general.--In the case of an application 
        transmitted under subsection (b)(6), the State agency 
        responsible for determinations of eligibility for benefits 
        under the State's Medicare Savings Program--
                    ``(A) shall make a determination on the application 
                within 30 days of the date of its receipt; and
                    ``(B) shall notify the applicant of the 
                determination within 10 days after it is made.
            ``(2) Use of simplified application process.--In the case 
        of an application other than an application transmitted under 
        subsection (b)(6), a State plan under title XIX shall provide 
        that an application for benefits under the Medicare Savings 
        Program may be made over the Internet, by telephone, or by 
        mail, without the need for an interview in person by the 
        applicant or a representative of the applicant.
    ``(e) Expedited Application and Eligibility Process.--
            ``(1) Expedited process.--
                    ``(A) In general.--As part of the expedited process 
                for obtaining benefits under the Medicare Savings 
                Program, the Secretary shall through a request to the 
                Secretary of the Treasury to obtain information 
                sufficient to identify whether the individual involved 
                is likely eligible for such benefits based on such 
                information and the type of assistance under the 
                Medicare Savings Program 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 
                        Medicare Savings Program provided under this 
                        section; and
                            ``(ii) are provided the opportunity to opt-
                        in to the expedited process described in this 
                        subsection by requesting that the Commissioner 
                        of Social Security screen the individual 
                        involved for eligibility for the Medicare 
                        Savings Program through a request to the 
                        Secretary of the Treasury under section 
                        6103(l)(21) of the Internal Revenue Code of 
                        1986.
                    ``(C) Transition for currently eligible 
                individuals.--In the case of any Medicare Savings 
                Program eligible individual to which subparagraph (B) 
                did not apply at the time of such individual's 
                enrollment, the Secretary shall, not later than 60 days 
                after the date of the implementation of subparagraph 
                (B), request that the Commissioner of Social Security 
                screen such individual for eligibility for the Medicare 
                Savings Program provided under this section through a 
                request to the Secretary of the Treasury under section 
                6103(l)(21) of the Internal Revenue Code of 1986.
            ``(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 the Medicare Savings 
        Program (or who has applied for and been determined ineligible 
        for such benefits based only on standards in effect before 
        January 1, 2008), 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 process under this section, 
                the individual is likely eligible for benefits under 
                the Medicare Savings Program.
                    ``(B) Amount of assistance.--A description of the 
                amount of assistance under such program for which the 
                individual would likely be eligible based on such 
                information.
                    ``(C) 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 
                benefits under the Medicare Savings Program. Such 
                form--
                            ``(i) shall not require the submittal of 
                        additional documentation regarding income or 
                        assets; and
                            ``(ii) shall allow for the specification of 
                        a language (other than English) that is 
                        preferred by the individual for subsequent 
                        communications with respect to the individual 
                        under this title and title XIX.
                    ``(D) Information on outreach groups.--Information 
                on how the individual may contact the a State outreach 
                effort or other groups that receive grants from the 
                Secretary to conduct outreach to individuals to receive 
                benefits under the Medicare Savings Program.
            ``(3) Follow-up communications.--If the individual does not 
        respond to the letter described in paragraph (2) by completing 
        an attestation described in paragraph (2)(C) or declining to do 
        so, 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 in the absence of fraud executes an 
        attestation described in paragraph (2)(C) and is provided 
        benefits under the Medicare Savings Program on the basis of 
        such attestation, if the individual is subsequently found not 
        eligible for such benefits, there shall be no recovery made 
        against the individual because of such benefits improperly 
        paid.
            ``(5) Use of preferred language in subsequent 
        communications.--In the case an attestation described in 
        paragraph (2)(C) is completed and in which a language other 
        than English is specified under clause (ii) of such paragraph, 
        the Secretary shall provide that subsequent communications to 
        the individual under this subsection shall be in such language.
            ``(6) Construction.--Nothing in this subsection shall be 
        construed as precluding the Secretary from taking additional 
        outreach efforts to enroll eligible individuals under the 
        Medicare Savings Program.
    ``(f) Electronic Communication Between Social Security and State 
Medicaid Agencies and the Secretary.--
            ``(1) Notice by social security to secretary and state 
        medicaid agencies.--In the case of a determination of 
        eligibility of an individual under section 1860D-14(a)(3)(B)(i) 
        by the Commissioner of Social Security, the Commissioner shall 
        provide for notice, preferably in electronic form, to the 
        Secretary and to State medicaid agency under title XIX of such 
        determination for purposes of enabling the individual to 
        automatically qualify for benefits under the Medicare Savings 
        Program under such title through the operation of section 
        1905(p)(8).
            ``(2) Notice by states to secretary.--In the case that the 
        State determines that an individual is a qualified medicare 
        beneficiary or a specified low-income medicare beneficiary 
        under title XIX, the State shall provide for notice, preferably 
        in electronic form, to the Secretary of such determination for 
        purposes of enabling the individual to automatically qualify 
        for low-income subsidies under section 1860D-14 through the 
        operation of section 1905(a)(3)(G).
            ``(3) Deadline.--Each State (as defined for purposes of 
        title XIX) and the Secretary shall establish the notification 
        process described in this subsection not later than 1 year 
        after the date of the enactment of this section.''.
            (2) Disclosure of return information for purposes of 
        screening individuals for eligibility for benefits under the 
        medicare savings program.--
                    (A) 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) Disclosure of return information for purposes of 
        providing benefits under the medicare savings program.--
                    ``(A) Return information from internal revenue 
                service to social security administration.--The 
                Secretary, upon written request from the Commissioner 
                of Social Security under section 1809(e)(1)(A) of the 
                Social Security Act, shall disclose to the Commissioner 
                with respect to any taxpayer identified by the 
                Commissioner--
                            ``(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 in order to apply 
                        the 135 and 150 percent poverty lines under 
                        section 1905(p) and section 1902(a)(10)(E)(ii) 
                        of such Act;
                            ``(II) the adjusted gross income (as 
                        determined under subclause (I)), in the case of 
                        a taxpayer with respect to which such adjusted 
                        gross income exceeds the amount so specified 
                        for applying the 135 percent poverty line and 
                        does not exceed the amount so specified for 
                        applying the 150 percent poverty line;
                            ``(III) whether the return was a joint 
                        return for the applicable year; and
                            ``(IV) 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 individuals for whom 
                disclosure is requested.--The Commissioner of Social 
                Security shall only request information under this 
                paragraph with respect to individuals who have 
                requested that such request be made under section 
                1809(e) of the Social Security Act.
                    ``(D) Return information from social security 
                administration to department of health and human 
                services.--The Commissioner of Social Security shall, 
                upon written request from the Secretary of Health and 
                Human Services, disclose to the Secretary of Health and 
                Human Services the information described in clauses (i) 
                and (ii) of subparagraph (A).
                    ``(E) Permissive disclosure to officers, employees, 
                and contractors.--The information described in clauses 
                (i) and (ii) of subparagraph (A) may be disclosed among 
                officers, employees, and contractors of the Social 
                Security Administration and the Department of Health 
                and Human Services for the purposes described in 
                subparagraph (F).
                    ``(F) 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) and (ii) of 
                        section 1902(a)(10)(E) of such Act.''.
                    (B) Confidentiality.--Paragraph (3) of section 
                6103(a) of such Code is amended by striking ``or (20)'' 
                and inserting ``(20), or (21)''.
                    (C) Procedures and record keeping 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)''.
                    (D) Unauthorized disclosure or inspection.--
                Paragraph (2) of section 7213(a) of such Code is 
                amended by striking ``or (20)'' and inserting ``(20), 
                or (21)''.
    (b) Two-Way Deeming Between Medicare Savings Program and Low-Income 
Subsidy Program.--
            (1) Medicare savings program.--Section 1905(p) of the 
        Social Security Act (42 U.S.C. 1396d(p)), as amended by 
        sections 4(a) and 5(a), is amended--
                    (A) by redesignating paragraph (8) as paragraph 
                (9); and
                    (B) by inserting after paragraph (7) the following 
                new paragraph:
    ``(8) An individual who has been determined eligible for premium 
and cost-sharing subsidies under--
            ``(A) section 1860D-14(a)(1) is deemed, for purposes of 
        this title and without the need to file any additional 
        application, to be a qualified medicare beneficiary for 
        purposes of this title; or
            ``(B) section 1860D-14(a)(2) is deemed, for purposes of 
        this title and without the need to file any additional 
        application, to qualify for medical assistance as a specified 
        low-income medicare beneficiary (described in section 
        1902(a)(10)(E)(iii)).''.
            (2) Low-income subsidy program.--Section 1860D-14(a)(3) of 
        such Act (42 U.S.C. 1395w-104(a)(3)) is amended by adding at 
        the end the following new subparagraph:
                    ``(G) Deemed treatment for qualified medicare 
                beneficiaries and specified low-income medicare 
                beneficiaries.--
                            ``(i) Qmbs eligible for full subsidy.--A 
                        part D eligible individual who has been 
                        determined for purposes of title XIX to be a 
                        qualified medicare beneficiary is deemed, for 
                        purposes of this part and without the need to 
                        file any additional application, to be a 
                        subsidy eligible individual described in 
                        paragraph (1).
                            ``(ii) Slmbs eligible for partial 
                        subsidy.--A part D eligible individual who has 
                        been determined to be a specified low-income 
                        medicare beneficiary (as defined in section 
                        1905(p)(1)) and who is not described in 
                        paragraph (1) is deemed, for purposes of this 
                        part and without the need to file any 
                        additional application, to be a subsidy 
                        eligible individual who is not described in 
                        paragraph (1).''.
            (3) Effective date.--The amendments made by this subsection 
        shall apply to eligibility for months beginning on or after 
        January 2008.
    (c) Improvements in Electronic Communication Between Social 
Security, State Medicaid Agencies, and the Secretary of Health and 
Human Services.--
            (1) In general.--Not later than two years after the date of 
        the enactment of this Act, the Commissioner of Social Security, 
        the Secretary of Health and Human Services, and the directors 
        of State Medicaid agencies shall implement improvements to the 
        electronic data transfer system by which they communicate 
        directly and electronically with each other with respect to 
        individuals who have enrolled for benefits under any part of 
        the Medicare Savings Program in order to ensure that each of 
        them has exactly the same list of beneficiaries who are signed 
        up for the Medicare Savings Program.
            (2) Increased administrative match.--In order to implement 
        paragraph (1)--
                    (A) the Medicaid administrative match under section 
                1903(a)(7) of the Social Security Act shall be 
                increased to 75 percent with respect to expenditures 
                made in carrying out such paragraph; and
                    (B) there is appropriated to the Commissioner of 
                Social Security and the Secretary of Health and Human 
                Services, from any amounts in the Treasury not 
                otherwise appropriated, $2,000,000 each for each of 
                fiscal years 2008 and 2009 to implement paragraph (1).
            (3) Use of system.--After the implementation of the 
        improvements to the electronic data transfer system under 
        paragraph (1), the Commissioner of Social Security, State 
        Medicaid agencies, and the Secretary of Health and Human 
        Services shall primarily use this system for the Commissioner 
        and the Secretary to inform the State Medicaid agencies to 
        enroll a beneficiary for the Medicare Savings Program.
    (d) Improved Coordination With State, Local, and Other Partners.--
            (1) State grants.--
                    (A) In general.--The Secretary of Health and Human 
                Services shall enter into contracts with States (as 
                defined for purposes of title XIX of the Social 
                Security Act (42 U.S.C. 1396 et seq.) to provide funds 
                to States to use information identified under 
                subsection (c), and other appropriate information, in 
                order to do ex parte determinations or utilize other 
                methods for identifying and enrolling individuals who 
                are potentially--
                            (i) eligible for benefits under the 
                        Medicare Savings Program (under sections 
                        1905(p) of the Social Security Act, 42 U.S.C. 
                        1396d(p)); or
                            (ii) entitled to a premium or cost-sharing 
                        subsidy under section 1860D-14 of such Act (42 
                        U.S.C. 1395w-114).
                    (B) Authorization of appropriations.--There are 
                authorized to be appropriated such sums as may be 
                necessary to the Secretary of Health and Human Services 
                for the purpose of making contracts under this 
                paragraph.
            (2) Funding of state health insurance counseling and 
        similar programs.--
                    (A) Authorization of appropriations.--In addition 
                to any other funds authorized to be appropriated, there 
                are authorized to be appropriated $3,000,000 for each 
                of calendar years 2008 through 2012 to carry out 
                activities described in subparagraph (B).
                    (B) Activities described.--The activities described 
                in this subparagraph are the following:
                            (i) Activities under section 4360 of the 
                        Omnibus Budget Reconciliation Act of 1990 for 
                        the purpose of outreach to low-income Medicare 
                        beneficiaries to assist in applying for and 
                        obtaining benefits under the Medicare Savings 
                        Program (under title XIX of the Social Security 
                        Act) and the low-income subsidy program under 
                        section 1860D-14 of such Act.
                            (ii) Activities of the National Center on 
                        Senior Benefits Outreach and Enrollment (as 
                        described in section 202(a)(20)(B) of the Older 
                        Americans Act of 1965 (42 U.S.C. 
                        3012(a)(20)(B)).
                            (iii) Similar activities carried out by 
                        other qualified agencies designated by the 
                        Secretary of Health and Human Services.

SEC. 9. TREATMENT OF QUALIFIED MEDICARE BENEFICIARIES, SPECIFIED LOW-
              INCOME MEDICARE BENEFICIARIES, AND OTHER DUAL ELIGIBLES 
              AS MEDICARE BENEFICIARIES.

    (a) In General.--Section 1862 of the Social Security Act (42 U.S.C. 
1395y) is amended by adding at the end the following new subsection:
    ``(n) Treatment of Qualified Medicare Beneficiaries (QMBs), 
Specified Low-Income Medicare Beneficiaries (SLMBs), and Other Dual 
Eligibles.--Nothing in this title shall be construed as authorizing a 
provider of services or supplier to discriminate (through a private 
contractual arrangement or otherwise) against an individual who is 
otherwise entitled to services under this title on the basis that the 
individual is a qualified medicare beneficiary (as defined in section 
1905(p)(1)), a specified low-income medicare beneficiary, or is 
otherwise eligible for medical assistance for medicare cost-sharing or 
other benefits under title XIX.''.
    (b) Effective Date.--The amendment made by subsection (a) shall 
apply to items and services furnished on or after the date of the 
enactment of this Act.

SEC. 10. MEDICAID TREATMENT OF CERTAIN MEDICARE PROVIDERS.

    (a) In General.--Section 1902(n) of the Social Security Act (42 
U.S.C. 1396a(n)) is amended by adding at the end the following new 
paragraph:
            ``(4) A State plan shall not deny a claim from a provider 
        or supplier with respect to medicare cost-sharing described in 
        subparagraph (B), (C), or (D) of section 1905(p)(3) for an item 
        or service which is eligible for payment under title XVIII on 
        the basis that the provider or supplier does not have a 
        provider agreement in effect under this title or does not 
        otherwise serve all individuals entitled to medical assistance 
        under this title.''.
    (b) Effective Date.--The amendment made by subsection (a) shall 
apply to items and services furnished on or after the date of the 
enactment of this Act.

SEC. 11. MONITORING AND ENFORCEMENT OF LIMITATION ON BENEFICIARY 
              LIABILITY.

    Section 1902(n) of the Social Security Act (42 U.S.C. 1396b(n)), as 
amended by section 9(a), is further amended by adding at the end the 
following new paragraph:
            ``(5)(A) The Inspector General of the Department of Health 
        and Human Services shall examine, not later than one year after 
        the date of the enactment of this paragraph and every three 
        years thereafter, whether providers have attempted to make 
        qualified medicare beneficiaries liable for deductibles, 
        coinsurance, and co-payments in violation of paragraph (3)(B). 
        The Inspector General shall submit to the Secretary a report on 
        such examination and a finding as to whether qualified medicare 
        beneficiaries have been held liable in violation of such 
        paragraph.
            ``(B) If a report under subparagraph (A) includes a finding 
        that qualified medicare beneficiaries have been held liable in 
        violation of such paragraph, not later than 60 days after the 
        date of receiving such report the Secretary shall submit to 
        Congress a report that includes a plan of action on how to 
        enforce provisions of such paragraph.''.

SEC. 12. STATE PROVISION OF MEDICAL ASSISTANCE TO DUAL ELIGIBLES IN MA 
              PLANS.

    (a) In General.--Section 1902(n) of the Social Security Act (42 
U.S.C. 1396b(n)), as amended by section 10, is further amended by 
adding at the end the following new paragraph:
            ``(6)(A) Each State shall--
                    ``(i) identify those individuals who are eligible 
                for medical assistance for medicare cost-sharing and 
                who are enrolled with a Medicare Advantage plan under 
                part C of title XVIII; and
                    ``(ii) for the individuals so identified, provide 
                for payment of medical assistance for the medicare 
                cost-sharing (including cost-sharing under a Medicare 
                Advantage plan) to which they are entitled.
            ``(B)(i) The Inspector General of the Department of Health 
        and Human Services shall examine, not later than one year after 
        the date of the enactment of this paragraph and every three 
        years thereafter, whether States are providing for medical 
        assistance for medicare cost-sharing for individuals enrolled 
        in Medicare Advantage plans in accordance with this title. The 
        Inspector General shall submit to the Secretary a report on 
        such examination and a finding as to whether States are failing 
        to provide such medical assistance.
            ``(ii) If a report under clause (i) includes a finding that 
        States are failing to provide such medical assistance, not 
        later than 60 days after the date of receiving such report the 
        Secretary shall submit to Congress a report that includes a 
        plan of action on how to enforce such requirement.''.
    (b) Effective Date.--
            (1) Except as provided in paragraph (2), the amendment made 
        by subsection (a) shall apply to calendar quarters beginning on 
        or after the date of the enactment of this Act.
            (2) In the case of a State plan for medical assistance 
        under title XIX of the Social Security Act which the Secretary 
        of Health and Human Services determines requires State 
        legislation (other than legislation appropriating funds) in 
        order for the plan to meet the additional requirements imposed 
        by the amendment made by subsection (a), the State plan shall 
        not be regarded as failing to comply with the requirements of 
        such title solely on the basis of its failure to meet these 
        additional requirements before the first day of the first 
        calendar quarter beginning after the close of the first regular 
        session of the State legislature that begins after the date of 
        the enactment of this Act. For purposes of the previous 
        sentence, in the case of a State that has a 2-year legislative 
        session, each year of such session shall be deemed to be a 
        separate regular session of the State legislature.
                                 <all>