I 111th CONGRESS 2d Session H. R. 4473 IN THE HOUSE OF REPRESENTATIVES January 20, 2010 Mr. Schrader 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 title XVIII of the Social Security Act to establish an extended special enrollment period for individuals to enroll in part B of Medicare.

1.

Short title

This Act may be cited as the Seniors Medicare Protection Act of 2010.

2.

Medicare part B extended special enrollment period

(a)

In general

Section 1837(i) of the Social Security Act (42 U.S.C. 1395p(i)) is amended by adding at the end the following new paragraph: (5)(A)In the case of an individual who— (i)at the time the individual first satisfies paragraph (1) or (2) of section 1836, is enrolled in a group health plan described in section 1862(b)(1)(A)(v) by reason of the individual's (or the individual's spouse's) current employment status, (ii)has elected not to enroll (or to be deemed enrolled) under this section during the individual's initial enrollment period, and (iii)has not elected to enroll pursuant to the special enrollment period under paragraph (3), there shall be an extended special enrollment period described in subparagraph (B).(B)The extended special enrollment period referred to in subparagraph (A) is the 24-month period beginning on the first day of the month following the end of the special enrollment period described in paragraph (3). . (b)

Coverage period

Section 1838(a)(2) of such Act (42 U.S.C. 1395q(a)(2)) is amended— (1)in subparagraph (E), by striking the semicolon and inserting a comma; and (2)by adding at the end the following new subparagraph: (F)In the case of an individual who enrolls pursuant to subsection (i)(5) of section 1837, the first day of the month following the month in which he so enrolls; or . (c)

Amount of premium

Section 1839 of such Act (42 U.S.C. 1395r) is amended— (1)in subsection (a)(2), by striking and (i) and inserting (i), and (j); and (2)by adding at the end the following new subsection: (j)

Temporary increase in premium based on enrollment pursuant to extended special enrollment period

(1)

In general

In the case of an individual whose coverage period began pursuant to an extended special enrollment period under section 1837(i)(5), the monthly premium determined under subsection (a), adjusted in accordance with subsection (i), shall be increased by 25 percent of the monthly premium (as so adjusted) for months described in paragraph (2). (2)

Application of premium

In the case that an individual enrolls pursuant to the extended special enrollment period described in subsection (i)(5) of section 1837— (A)during a general enrollment period described in subsection (e) of such section, the premium increase under paragraph (1) shall apply to months before the month of July following the date of enrollment; or (B)other than during such general enrollment period, such premium increase shall apply to months before the month of July in the calendar year following the year of enrollment. (3)

Reduction or waiver of temporary increase in premium

The Secretary may reduce or waive the premium increase under paragraph (1) for an individual described in such paragraph if it can be demonstrated to the satisfaction of the Secretary that such individual made a good faith effort to enroll during a special enrollment period (of which such individual was eligible to enroll) under section 1837(i)(3). . (d)

Transition rule

In the case of an individual who had a special enrollment period under paragraph (3) of section 1837(i) of the Social Security Act (42 U.S.C. 1395p(i)) that ended within the 24-month period ending on the date of the enactment of this section and who did not enroll under part B of title XVIII of such Act during or after such period and before the date of the enactment of this section, the individual shall have an extended special enrollment period under paragraph (5) of such section 1837(i) during the 24-month period beginning on the first day of the first month beginning after such date of enactment. (e)

Effective date

The amendments made by this section shall take effect on the first day of the first month beginning more than 120 days after the date of enactment of this section.