[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.
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