[Congressional Bills 111th Congress]
[From the U.S. Government Publishing Office]
[H.R. 2700 Introduced in House (IH)]

111th CONGRESS
  1st Session
                                H. R. 2700

  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 and by revising the resource 
  standards used to determine eligibility for such subsidies, and for 
                            other purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                              June 4, 2009

  Mr. Doggett (for himself, Mr. Altmire, Mr. Arcuri, Ms. Baldwin, Mr. 
     Becerra, Ms. Berkley, Mr. Berman, Mr. Bishop of New York, Mr. 
   Blumenauer, Ms. Bordallo, Mr. Boucher, Ms. Clarke, Mr. Clay, Mr. 
    Cleaver, Mr. Clyburn, Mr. Cohen, Mr. Connolly of Virginia, Mr. 
 Costello, Mr. Cummings, Mr. Davis of Alabama, Mr. Davis of Illinois, 
  Mr. DeFazio, Ms. DeGette, Mr. Delahunt, Ms. DeLauro, Mr. Edwards of 
 Texas, Mr. Fattah, Mr. Filner, Mr. Gene Green of Texas, Mr. Grijalva, 
 Mr. Hastings of Florida, Mr. Higgins, Mr. Hinchey, Mr. Hinojosa, Mr. 
Holt, Mr. Inslee, Mr. Israel, Mr. Jackson of Illinois, Ms. Jackson-Lee 
     of Texas, Mr. Johnson of Georgia, Ms. Kaptur, Mr. Kildee, Ms. 
    Kilpatrick of Michigan, Mr. Kucinich, Mr. Langevin, Ms. Lee of 
  California, Mr. Levin, Mr. Lewis of Georgia, Mr. Lipinski, Ms. Zoe 
 Lofgren of California, Ms. McCollum, Mr. McDermott, Mrs. Maloney, Mr. 
   Meek of Florida, Mr. Meeks of New York, Mr. Michaud, Mr. Moore of 
     Kansas, Mr. Nadler of New York, Mrs. Napolitano, Mr. Neal of 
  Massachusetts, Ms. Norton, Mr. Ortiz, Mr. Payne, Mr. Pascrell, Mr. 
  Price of North Carolina, Mr. Rangel, Mr. Rothman of New Jersey, Mr. 
    Rush, Mr. Ryan of Ohio, Ms. Linda T. Sanchez of California, Mr. 
 Sarbanes, Ms. Schakowsky, Ms. Shea-Porter, Mr. Sires, Mr. Stark, Ms. 
 Sutton, Mr. Van Hollen, Ms. Wasserman Schultz, Mr. Weiner, Mr. Welch, 
  Mr. Wexler, Ms. Woolsey, and Mr. Yarmuth) introduced the following 
 bill; which was referred to the Committee on Energy and Commerce, and 
  in addition to the Committee on Ways and Means, 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 and by revising the resource 
  standards used to determine eligibility for such subsidies, 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 ``Prescription 
Coverage Now Act of 2009''.
    (b) Table of Contents.--The table of contents for this Act is as 
follows:

Sec. 1. Short title; table of contents.
Sec. 2. Expediting low-income subsidies under the Medicare prescription 
                            drug program.
Sec. 3. Enhanced oversight and enforcement relating to reimbursements 
                            for retroactive LIS enrollment.
Sec. 4. Modification of resource standards for determination of 
                            eligibility for low-income subsidy; 
                            simplification of income and asset rules.
Sec. 5. Indexing deductible and cost-sharing above annual out-of-pocket 
                            threshold for individuals with income below 
                            150 percent of poverty line.
Sec. 6. No impact on eligibility for benefits under other programs.
Sec. 7. Requiring individuals eligible for Medicare savings programs to 
                            be deemed to be subsidy eligible 
                            individuals.
Sec. 8. Special enrollment period for subsidy eligible individuals.

SEC. 2. EXPEDITING LOW-INCOME SUBSIDIES UNDER THE MEDICARE PRESCRIPTION 
              DRUG PROGRAM.

    (a) Targeted Outreach for Low-Income Subsidies.--
            (1) 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) Targeted Outreach for Low-Income Subsidies.--
            ``(1) Targeted identification of subsidy-eligible 
        individuals.--
                    ``(A) In general.--The Commissioner of Social 
                Security shall provide for the identification of 
                individuals who are potentially eligible for low-income 
                assistance under this section through requests to the 
                Secretary of the Treasury in accordance with the 
                criterion established under section 6103(l)(21) of the 
                Internal Revenue Code of 1986 for information 
                indicating whether the individual involved is likely 
                eligible for such assistance.
                    ``(B) Initiation of identifications.--Not later 
                than 90 days after the date of the enactment of this 
                subsection, the Commissioner of Social Security shall 
                begin the identification of individuals through the 
                process described in subparagraph (A) and shall, by 
                such date and through such process, submit to the 
                Secretary of the Treasury requests for part D eligible 
                individuals who the Commissioner has identified as 
                potentially eligible for low-income subsidies under 
                this section before such date of enactment.
            ``(2) Notification of potentially eligible individuals.--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 on excess income, 
        resources, or both), the Commissioner shall transmit by mail to 
        the individual a letter including the information and 
        application required to be provided under subparagraphs (A), 
        (B), and (D) of section 1144(c)(1).
            ``(3) Follow-up communications.--If an individual to whom a 
        letter is transmitted under paragraph (2) does not 
        affirmatively respond to such letter either by making an 
        enrollment, completing an application, or declining either or 
        both, the Commissioner shall make additional attempts to 
        contact the individual to obtain such an affirmative response.
            ``(4) Use of preferred language in subsequent 
        communications.--In the case an application is completed by an 
        individual pursuant to this subsection in which a language 
        other than English is specified, the Commissioner shall provide 
        that subsequent communications under this part to the 
        individual shall be in such language as needed.
            ``(5) Construction.--Nothing in this subsection shall be 
        construed as precluding the Commissioner from taking additional 
        outreach efforts to enroll eligible individuals under this part 
        and to provide low-income subsidies to eligible individuals.
            ``(6) Maintenance of effort with respect to outreach.--In 
        no case shall the level of effort with respect to outreach to 
        and enrollment of individuals who are potentially eligible for 
        low-income assistance under this section after the date of the 
        enactment of this subsection be less than such level of effort 
        before such date of enactment until at least 90 percent of such 
        potentially eligible individuals have affirmatively responded.
            ``(7) GAO report to congress.--Not later than 2 years after 
        the date of the first submission to the Secretary of the 
        Treasury described in paragraph (1)(B), the Comptroller General 
        of the United States shall submit to Congress a report, with 
        respect to the 18-month period following the establishment of 
        the process described in paragraph (1)(A), on--
                    ``(A) the extent to which the percentage of 
                individuals who are eligible for low-income assistance 
                under this section but not enrolled under this part has 
                decreased during such period;
                    ``(B) how the Commissioner of Social Security has 
                used any savings resulting from the implementation of 
                this section and section 6103(l)(21) of the Internal 
                Revenue Code of 1986 to improve outreach to individual 
                described in subparagraph (A) to increase enrollment of 
                such individuals under this part;
                    ``(C) the effectiveness of using information from 
                the Secretary of the Treasury in accordance with 
                section 6103(l)(21) of the Internal Revenue Code of 
                1986 for purposes of indicating whether individuals are 
                eligible for low-income assistance under this section; 
                and
                    ``(D) the effectiveness of the outreach conducted 
                by the Commissioner of Social Security based on the 
                data described in subparagraph (C).''.
            (2) Conforming amendment.--Section 1144(c)(1) of the Social 
        Security Act (42 U.S.C. 1320b-14(c)(1)) is amended by inserting 
        ``(including through request to the Secretary of the Treasury 
        pursuant to section 1860D-14(e))'' before ``, the Commissioner 
        shall''.
    (b) Improvements to the Low-Income Subsidy Applications.--Section 
1860D-14(a)(3) of the Social Security Act (42 U.S.C. 1395w-114(a)(3)) 
is amended--
            (1) in subparagraph (E), by striking clauses (ii) and (iii) 
        and redesignating clause (iv) as clause (ii);
            (2) by redesignating subparagraphs (F) and (G) as 
        subparagraphs (G) and (H), respectively; and
            (3) by inserting after subparagraph (E) the following new 
        subparagraph:
                    ``(F) Simplified low-income subsidy application and 
                process.--
                            ``(i) In general.--The Secretary, jointly 
                        with the Commissioner of Social Security, 
                        shall--
                                    ``(I) develop a model, simplified 
                                application form and process consistent 
                                with clause (ii) for the determination 
                                and verification of a part D eligible 
                                individual's assets or resources under 
                                this paragraph; and
                                    ``(II) provide such form to States.
                            ``(ii) Documentation and safeguards.--Under 
                        such process--
                                    ``(I) the application form shall 
                                consist of an attestation under penalty 
                                of perjury regarding the level of 
                                assets or resources (or combined assets 
                                and resources in the case of a married 
                                part D eligible individual) and 
                                valuations of general classes of assets 
                                or resources;
                                    ``(II) such form shall not require 
                                the submittal of additional 
                                documentation regarding income or 
                                assets;
                                    ``(III) matters attested to in the 
                                application shall be subject to 
                                appropriate methods of administrative 
                                verification;
                                    ``(IV) the applicant shall be 
                                permitted to authorize another 
                                individual to act as the applicant's 
                                personal representative with respect to 
                                communications under this part and the 
                                enrollment of the applicant into a 
                                prescription drug plan (or MA-PD plan) 
                                and for low-income subsidies under this 
                                section; and
                                    ``(V) the application form 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 part.
                            ``(iii) No recovery for certain subsidies 
                        improperly paid.--If an individual in good 
                        faith and in the absence of fraud is provided 
                        low-income subsidies under this section, and 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.''.
    (c) Disclosures To Facilitate Identification of Individuals Likely 
To Be Eligible for the Low-Income Assistance Under the Medicare 
Prescription Drug Program.--
            (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) Disclosure of return information to facilitate 
        identification of individuals likely to be eligible for low-
        income subsidies under medicare prescription drug program.--
                    ``(A) In general.--The Secretary, upon written 
                request from the Commissioner of Social Security, shall 
                disclose to officers and employees of the Social 
                Security Administration, with respect to any individual 
                identified by the Commissioner--
                            ``(i) whether, based on the criterion 
                        determined under subparagraph (B), such 
                        individual is likely to be eligible for low-
                        income assistance under section 1860D-14 of the 
                        Social Security Act, or
                            ``(ii) that, based on such criterion, there 
                        is insufficient information available to the 
                        Secretary to make the determination described 
                        in clause (i).
                    ``(B) Criterion.--Not later than 90 days after the 
                date of the enactment of this paragraph, the Secretary, 
                in consultation with the Commissioner of Social 
                Security, shall develop the criterion by which the 
                determination under subparagraph (A)(i) shall be made 
                (and the criterion for determining that insufficient 
                information is available to make such determination). 
                Such criterion may include analysis of information 
                available on such individual's return, the return of 
                such individual's spouse, and any information related 
                to such individual or such individual's spouse which is 
                available on any information return.''.
            (2) Procedures and recordkeeping related to disclosures.--
        Paragraph (4) of section 6103(p) of such Code is amended by 
        striking ``or (17)'' each place it appears and inserting 
        ``(17), or (21)''.
            (3) Effective date.--The amendments made by this subsection 
        shall apply to disclosures made after the date of the enactment 
        of this Act.

SEC. 3. ENHANCED OVERSIGHT AND ENFORCEMENT RELATING TO REIMBURSEMENTS 
              FOR RETROACTIVE LIS ENROLLMENT.

    (a) In General.--In the case of a retroactive LIS enrollment 
beneficiary (as defined in subsection (e)(4)) who is enrolled under a 
prescription drug plan under part D of title XVIII of the Social 
Security Act (or an MA-PD plan under part C of such title)--
            (1) the beneficiary (or any eligible third party) is 
        entitled to reimbursement by the plan for covered drug costs 
        (as defined in subsection (e)(1)) incurred by the beneficiary 
        during the retroactive coverage period of the beneficiary in 
        accordance with subsection (b) and in the case of such a 
        beneficiary described in subsection (e)(4)(A)(i), such 
        reimbursement shall be made automatically by the plan upon 
        receipt of appropriate notice the beneficiary is eligible for 
        assistance described in such subsection (e)(4)(A)(i) without 
        further information required to be filed with the plan by the 
        beneficiary;
            (2) the Secretary of Health and Human Services (in this 
        section referred to as the ``Secretary'') shall not make 
        payment to the plan--
                    (A) in the case that the beneficiary is described 
                in subsection (e)(4)(A)(i), for premium subsidies and 
                cost sharing subsidies under section 1860D-14 of the 
                Social Security Act (42 U.S.C. 1395w-114) with respect 
                to the provision of prescription drug coverage to the 
                beneficiary during such retroactive period; and
                    (B) in the case that the beneficiary is described 
                in subsection (e)(4)(A)(ii), for direct subsidies under 
                section 1860D-15(a)(1) of such Act and premium 
                subsidies and cost-sharing subsidies under section 
                1860D-14 of such Act with respect to the provision of 
                prescription drug coverage to the beneficiary during 
                such retroactive period;
        unless the plan demonstrates to the Secretary that the plan has 
        provided timely and accurate reimbursement to the beneficiary 
        (or eligible third party) in accordance with paragraph (1);
            (3) the Secretary shall not make any payment described in 
        paragraph (2) to the plan with respect to such beneficiary for 
        any month of the retroactive enrollment period during which no 
        expenses for covered part D drugs (as defined in section 1860D-
        2(e) of the Social Security Act (42 U.S.C. 1395w-102(e)) were 
        incurred by such beneficiary (or eligible third party on behalf 
        of such beneficiary); and
            (4) any payment owed the plan pursuant to this section, 
        taking into account paragraphs (2) and (3), shall be made at 
        the time the Centers for Medicare & Medicaid Services 
        reconciles payments for the entire plan year following the end 
        of the plan year, and not before such time.
    (b) Administrative Requirements Relating to Reimbursements.--
            (1) Line-item description.--Each reimbursement made by a 
        prescription drug plan or MA-PD plan under subsection (a)(1) 
        shall include a line-item description of the items for which 
        the reimbursement is made.
            (2) Timing of reimbursements.--A prescription drug plan or 
        MA-PD plan must make a reimbursement under subsection (a)(1) to 
        a retroactive LIS enrollment beneficiary, with respect to a 
        claim, not later than 30 days after--
                    (A) in the case of a beneficiary described in 
                subsection (e)(4)(A)(i), the date on which the plan 
                receives notice from the Secretary that the beneficiary 
                is eligible for assistance described in such 
                subsection; or
                    (B) in the case of a beneficiary described in 
                subsection (e)(4)(A)(ii), the date on which the 
                beneficiary files the claim with the plan.
    (c) Notice Requirements.--
            (1) By secretary of hhs and commission of the social 
        security administration.--The Secretary, jointly with the 
        Commissioner of the Social Security Administration, shall 
        ensure that each retroactive LIS enrollment beneficiary 
        receives, with any letter or notification of eligibility for a 
        low-income subsidy under section 1860D-14 of the Social 
        Security Act, a notice of their right to reimbursement 
        described in subsection (a)(1) for covered drug costs incurred 
        during the retroactive coverage period of the beneficiary. Such 
        notice shall--
                    (A) with respect to a beneficiary described in 
                subsection (e)(4)(A)(i), inform the beneficiary of the 
                beneficiary's right to automatic reimbursement as 
                described in subsection (a)(1); and
                    (B) with respect to a beneficiary described in 
                subsection (e)(4)(A)(ii), include a description of a 
                clear process that the beneficiary should follow to 
                seek such reimbursement.
            (2) By prescription drug plans.--
                    (A) In general.--Each prescription drug plan under 
                part D of title XVIII of the Social Security Act (and 
                MA-PD plan under part C of such title) shall include in 
                a notice from the plan to a retroactive LIS enrollment 
                beneficiary described in subsection (e)(4)(A)(ii) a 
                model notice developed under subparagraph (B) 
                describing the process the beneficiary must follow to 
                seek retroactive reimbursement. Such notice shall 
                include any form required by the plan to complete such 
                reimbursement and shall indicate the period of 
                retroactive coverage for which the beneficiary is 
                eligible for such reimbursement.
                    (B) Model notice.--The Secretary, jointly with the 
                Commissioner of Social Security, shall develop a model 
                notice for purposes of subparagraph (A) and shall make 
                such model notice available to all prescription drug 
                plans under part D of title XVIII of the Social 
                Security Act (and MA-PD plans under part C of such 
                title).
    (d) Public Posting To Track Payments.--
            (1) In general.--Not later than one year after the date of 
        the enactment of this Act, the Secretary shall post (and 
        annually update) on the public Internet website of the 
        Department of Health and Human Services information on the 
        total amount of payments made by the Secretary under subsection 
        (a)(2) to prescription drug plans during the most recent plan 
        year for which plan data is available.
            (2) Specific information.--Such information posted--
                    (A) in 2010 or in a subsequent year before 2016, 
                shall include information on payments made for years 
                beginning with 2006 and ending with the year for which 
                the most current information is available; and
                    (B) in 2016 or a subsequent year, shall include 
                information on payments made for at least the 10 
                previous years.
    (e) Definitions.--In this section:
            (1) Covered drug costs.--The term ``covered drug costs'' 
        means, with respect to a retroactive LIS enrollment beneficiary 
        enrolled under a prescription drug plan under part D of title 
        XVIII of the Social Security Act (or an MA-PD plan under part C 
        of such title), the amount by which--
                    (A) the costs incurred by such beneficiary during 
                the retroactive coverage period of the beneficiary for 
                covered part D drugs, premiums, and cost-sharing under 
                such title; exceeds
                    (B) such costs that would have been incurred by 
                such beneficiary during such period if the beneficiary 
                had been both enrolled in the plan and recognized by 
                such plan as qualified during such period for the low 
                income subsidy under section 1860D-14 of the Social 
                Security Act to which the individual is entitled.
            (2) Eligible third party.--The term ``eligible third 
        party'' means, with respect to a retroactive LIS enrollment 
        beneficiary, an organization or other third party that paid on 
        behalf of such beneficiary for covered drug costs incurred by 
        such beneficiary during the retroactive coverage period of such 
        beneficiary.
            (3) Retroactive coverage period.--The term ``retroactive 
        coverage period'' means--
                    (A) with respect to a retroactive LIS enrollment 
                beneficiary described in paragraph (4)(A)(i), the 
                period--
                            (i) beginning on the effective date of the 
                        assistance described in such paragraph for 
                        which the individual is eligible; and
                            (ii) ending on the date the plan 
                        effectuates the status of such individual as so 
                        eligible; and
                    (B) with respect to a retroactive LIS enrollment 
                beneficiary described in paragraph (4)(A)(ii), the 
                period--
                            (i) beginning on the date the individual is 
                        both entitled to benefits under part A, or 
                        enrolled under part B, of title XVIII of the 
                        Social Security Act and eligible for medical 
                        assistance under a State plan under title XIX 
                        of such Act; and
                            (ii) ending on the date the plan 
                        effectuates the status of such individual as a 
                        full-benefit dual eligible individual (as 
                        defined in section 1935(c)(6) of such Act).
            (4) Retroactive lis enrollment beneficiary.--
                    (A) In general.--The term ``retroactive LIS 
                enrollment beneficiary'' means an individual who--
                            (i) is enrolled in a prescription drug plan 
                        under part D of title XVIII of the Social 
                        Security Act (or an MA-PD plan under part C of 
                        such title) and subsequently becomes eligible 
                        as a full-benefit dual eligible individual (as 
                        defined in section 1935(c)(6) of such Act), an 
                        individual receiving a low-income subsidy under 
                        section 1860D-14 of such Act, an individual 
                        receiving assistance under the Medicare Savings 
                        Program implemented under clauses (i), (ii), 
                        (iii), and (iv) of section 1902(a)(10)(E) of 
                        such Act, or an individual receiving assistance 
                        under the supplemental security income program 
                        under section 1611 of such Act; or
                            (ii) subject to subparagraph (B)(i), is a 
                        full-benefit dual eligible individual (as 
                        defined in section 1935(c)(6) of such Act) who 
                        is automatically enrolled in such a plan under 
                        section 1860D-1(b)(1)(C) of such Act.
                    (B) Exception for beneficiaries enrolled in rfp 
                plan.--
                            (i) In general.--In no case shall an 
                        individual described in subparagraph (A)(ii) 
                        include an individual who is enrolled, pursuant 
                        to a RFP contract described in clause (ii), in 
                        a prescription drug plan offered by the sponsor 
                        of such plan awarded such contract.
                            (ii) RFP contract described.--The RFP 
                        contract described in this section is a 
                        contract entered into between the Secretary and 
                        a sponsor of a prescription drug plan pursuant 
                        to the Centers for Medicare & Medicaid 
                        Services' request for proposals issued on 
                        February 17, 2009, relating to Medicare part D 
                        retroactive coverage for certain low income 
                        beneficiaries, or a similar subsequent request 
                        for proposals.
    (f) GAO Report.--Not later than 24 months after the date of the 
enactment of this Act, the Comptroller General of the United States 
shall submit to Congress a report on the extent to which the provisions 
of this section improve reimbursement for covered drug costs to 
retroactive LIS enrollment beneficiaries and lower the amounts of 
payments made by the Secretary, with respect to such beneficiaries, to 
prescription drug plans under part D of title XVIII of the Social 
Security Act (and MA-PD plans under part C of such title).
    (g) Report to Congress.--In the case that an RFP contract described 
in subsection (e)(4)(B)(ii) is awarded, not later than two years after 
the effective date of such contract, the Secretary of Health and Human 
Services shall submit to Congress a report evaluating the program 
carried out through such contract.
    (h) Effective Date.--Paragraphs (2) and (3) of subsection (a) and 
subsections (b) and (c) shall apply to subsidy determinations made on 
or after the date that is 3 months after the date of the enactment of 
this Act.

SEC. 4. MODIFICATION OF RESOURCE STANDARDS FOR DETERMINATION OF 
              ELIGIBILITY FOR LOW-INCOME SUBSIDY; SIMPLIFICATION OF 
              INCOME AND ASSET RULES.

    (a) Single and Increased Resource Standard for Low-Income 
Subsidies.--Section 1860D-14(a) of the Social Security Act (42 U.S.C. 
1395w-114(a)) is amended--
            (1) in paragraph (1), by inserting ``(or, for years after 
        2010, paragraph (3)(E))'' after ``paragraph (3)(D)'';
            (2) in paragraph (3)--
                    (A) in subparagraph (A)(iii), by inserting ``(or 
                for a year after 2010, subparagraph (E))'' before the 
                period;
                    (B) in subparagraph (D)(ii), by inserting ``before 
                2011'' after ``subsequent year''; and
                    (C) in subparagraph (E)(i)--
                            (i) by striking ``and'' at the end of 
                        subclause (I);
                            (ii) in subclause (II)--
                                    (I) by striking ``a subsequent 
                                year'' and inserting ``each of 2007 
                                through 2010'';
                                    (II) by striking the period at the 
                                end and inserting a semicolon;
                            (iii) by inserting after subclause (II) the 
                        following new subclauses:
                                    ``(III) for 2011, $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
                                    ``(IV) for a subsequent year the 
                                dollar amounts specified in this clause 
                                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.''; and
                            (iv) in the last sentence, by inserting 
                        ``or (IV)'' after ``subclause (II)''.
    (b) Exemptions From Resources.--
            (1) In general.--Section 1860D-14(a)(3) of the Social 
        Security Act (42 U.S.C. 1395w-114(a)(3) is further amended--
                    (A) in subparagraphs (D) and (E), by inserting 
                ``and the retirement plan exclusion under subparagraph 
                (H)'' after ``subparagraph (G)'' each place it appears; 
                and
                    (B) by adding at the end the following new 
                subparagraph:
                    ``(H) Retirement benefit exclusion.--In determining 
                the resources of an individual (and their eligible 
                spouse, if any) under section 1613 for purposes of 
                subparagraphs (D) and (E), no retirement benefit, such 
                as an individual retirement account or plan under 
                section 401(k) of the Internal Revenue Code of 1986, 
                shall be taken into account.''.
            (2) Effective date.--The amendments made by paragraph (1) 
        shall apply for months beginning after 2011.
    (c) Clarification Relating to Including Retirement Benefits as 
Income.--Nothing in subparagraph (H) of section 1860D-14(a)(3) of the 
Social Security Act (42 U.S.C. 1395w-114(a)(3)), as added by subsection 
(b), shall be construed as affecting the inclusion of retirement 
benefits as income under section 1612(a)(2)(B) of such Act (42 U.S.C. 
1382a(a)(2)(B)).
    (d) Clarification Relating to MIPPA Effective Date for in Kind 
Exclusions From Income.--Section 116(b) of the Medicare Improvements 
for Patients and Providers Act of 2008 is amended--
            (1) by inserting ``(other than subsection (a)(1))'' after 
        ``this section''; and
            (2) by adding at the end the following new sentence: ``The 
        amendment made by subsection (a)(1) shall take effect with 
        respect to benefits provided after such date.''.
    (e) Increasing Income Limits for Partial LIS Eligibility to 200 
Percent FPL and for Full LIS to 150 Percent FPL.--
            (1) In general.--Section 1860D-14(a) of the Social Security 
        Act (42 U.S.C. 1395w-114(a)) is amended--
                    (A) in the heading, by striking ``150'' and 
                inserting ``200'';
                    (B) in paragraph (1)--
                            (i) in the heading, by striking ``135'' and 
                        inserting ``150''; and
                            (ii) by striking ``135'' and inserting 
                        ``150'';
                    (C) in paragraph (2)--
                            (i) in the heading, by striking ``150'' and 
                        inserting ``200''; and
                            (ii) in subparagraph (A), by striking 
                        ``135'' and ``150'' and inserting ``150'' and 
                        ``200'', respectively; and
                    (D) in paragraph (3)(A)(ii), by striking ``150'' 
                and inserting ``200''.
            (2) Effective date.--The amendments made by paragraph (1) 
        shall apply to determinations made on or after January 1, 2011.

SEC. 5. INDEXING DEDUCTIBLE AND COST-SHARING ABOVE ANNUAL OUT-OF-POCKET 
              THRESHOLD FOR INDIVIDUALS WITH INCOME BELOW 200 PERCENT 
              OF POVERTY LINE.

    (a) Indexing Deductible.--Section 1860D-14(a)(4)(B) of the Social 
Security Act (42 U.S.C. 1395w-114(a)(4)(B)) is amended--
            (1) in clause (i), by striking ``or'';
            (2) in clause (ii)--
                    (A) by striking ``a subsequent year'' and inserting 
                ``2008, 2009, and 2010''; and
                    (B) by striking the period at the end and inserting 
                ``; and'';
            (3) by inserting after clause (ii) the following new 
        clause:
                            ``(iii) for 2011 and each succeeding year, 
                        the amount determined under this clause (or 
                        clause (ii)) 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.''; and
            (4) in the last sentence, by striking ``clause (i) or 
        (ii)'' and inserting ``clause (i), (ii), or (iii)''.
    (b) Indexing Cost-Sharing.--Section 1860D-14(a) of the Social 
Security Act (42 U.S.C. 1395w-114(a)) is amended--
            (1) in paragraph (1)(D)(iii), by striking ``exceed the 
        copayment amount'' and all that follows through the period at 
        the end and inserting ``exceed--
                                    ``(I) for each of 2006 through 
                                2010, the copayment amount specified 
                                under section 1860D-2(b)(4)(A)(i)(I) 
                                for the drug and year involved; and
                                    ``(II) for 2011 and each succeeding 
                                year, the amount determined under 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.''; and
            (2) in paragraph (2)(E), by striking ``exceed the copayment 
        or coinsurance amount'' and all that follows through the period 
        at the end and inserting ``exceed--
                            ``(i) for each of 2006 through 2010, the 
                        copayment or coinsurance amount specified under 
                        section 1860D-2(b)(4)(A)(i)(I) for the drug and 
                        year involved; and
                            ``(ii) for 2011 and each succeeding year, 
                        the amount determined under this clause 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.''.

SEC. 6. NO IMPACT ON ELIGIBILITY FOR BENEFITS UNDER OTHER PROGRAMS.

    (a) In General.--Section 1860D-14(a)(3) of the Social Security Act 
(42 U.S.C. 1395w-114(a)(3)), as amended by section 4(b)(1)(B), is 
further amended--
            (1) in subparagraph (A), in the matter preceding clause 
        (i), by striking ``subparagraph (F)'' and inserting 
        ``subparagraphs (F) and (I)''; and
            (2) by adding at the end the following new subparagraph:
                    ``(I) No impact on eligibility for benefits under 
                other programs.--The availability of premium and cost-
                sharing subsidies under this section 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 premium and cost-sharing subsidies for months beginning after 
the date of the enactment of this Act.

SEC. 7. REQUIRING INDIVIDUALS ELIGIBLE FOR MEDICARE SAVINGS PROGRAMS TO 
              BE DEEMED TO BE SUBSIDY ELIGIBLE INDIVIDUALS.

    (a) In General.--Section 1860D-14(a)(3)(B)(v) of the Social 
Security Act (42 U.S.C. 1395w-114(a)(3)(B)(v)) is amended--
            (1) in subclause (II)--
                    (A) by striking ``may'' and inserting ``shall''; 
                and
                    (B) by inserting ``(ii),'' after ``clause (i),''; 
                and
            (2) by striking the second sentence.
    (b) Effective Date.--The amendment made by subsection (a) shall 
take effect as of the date of the enactment of this Act and apply to 
determinations made for purposes of title XIX on or after the first 
date of the first plan year beginning after the date of the enactment 
of this Act.

SEC. 8. SPECIAL ENROLLMENT PERIOD FOR SUBSIDY ELIGIBLE INDIVIDUALS.

    (a) In General.--Section 1860D-1(b)(3) of the Social Security Act 
(42 U.S.C. 1395w-101(b)(3)) is amended by adding at the end the 
following new subparagraph:
                    ``(F) Eligibility for low-income subsidy.--
                            ``(i) In general.--In the case of an 
                        applicable subsidy eligible individual (as 
                        defined in clause (ii)), the special enrollment 
                        period described in clause (iii).
                            ``(ii) Applicable subsidy eligible 
                        individual defined.--For purposes of this 
                        subparagraph, the term `applicable subsidy 
                        eligible individual' means a part D eligible 
                        individual who is not described in subparagraph 
                        (D) and who is determined under subparagraph 
                        (B) of section 1860D-14(a)(3) to be a subsidy 
                        eligible individual (as defined in subparagraph 
                        (A) of such section), including such an 
                        individual who was enrolled in a prescription 
                        drug plan or an MA-PD plan on the date of such 
                        determination.
                            ``(iii) Special enrollment period 
                        described.--The special enrollment period 
                        described in this clause, with respect to an 
                        applicable subsidy eligible individual, is the 
                        period beginning on the date the individual 
                        receives notification that such individual has 
                        been determined under section 1860D-14(a)(3)(B) 
                        to be a subsidy eligible individual (as so 
                        defined) and ending on the date the individual 
                        is no longer so eligible.''.
    (b) Effective Date.--The amendments made by this section shall 
apply to subsidy determinations made for months beginning with January 
2010.
                                 <all>