1.Short
title; table of contents
(a)This Act may be cited
as the Medicare Financial Stability
for Beneficiaries Act of 2009
.
(b)The table of contents of this Act is as follows:
Sec. 1. Short title; table of
contents.
Sec. 2. Eligibility for other programs.
Sec. 3. Cost-sharing protections for low-income
subsidy-eligible individuals.
Sec. 4. Modification of resource standards for determination of
eligibility for LIS; no consideration of pension or retirement plan in
determination of resources.
Sec. 5. Increase in income levels for eligibility.
Sec. 6. Effective date of MSP benefits.
Sec. 7. Expanding special enrollment process to individuals
eligible for an income-related subsidy.
Sec. 8. Enhanced cost-sharing protections for full-benefit dual
eligible individuals and qualified medicare beneficiaries.
Sec. 9. Two-way deeming between Medicare Savings Program and
Low-Income Subsidy Program.
Sec. 10. Improving linkages between health programs and
snap.
Sec. 11. Expediting low-income subsidies under the Medicare
prescription drug program.
Sec. 12. Enhanced oversight and enforcement relating to
reimbursements for retroactive LIS enrollment.
Sec. 13. Intelligent assignment in enrollment.
Sec. 14. Medicare enrollment assistance.
Sec. 15. QMB buy-in of part A and part B premiums.
Sec. 16. Increasing availability of MSP applications through
availability on the internet and designation of preferred language.
Sec. 17. State Medicaid agency consideration of low-income
subsidy application and data transmittal.
2.Eligibility for
other programs
(a)Section
1860D–14(a)(3) of the Social Security Act (42 U.S.C. 1395w–114(a)(3)), as
amended by section 116 of the Medicare Improvements for Patients and Providers
Act of 2008 (Public Law 110–275), is amended—
(1)in subparagraph
(A), in the matter preceding clause (i), by striking subparagraph
(F)
and inserting subparagraphs (F) and (H)
; and
(2)by adding at the
end the following new subparagraph:
(H)Disregard of
premium and cost-sharing subsidies for purposes of federal and state
programsNotwithstanding any other provision of law, any premium
or cost-sharing subsidy with respect to a subsidy-eligible individual under
this section shall not be considered income or resources in determining
eligibility for, or the amount of assistance or benefits provided under, any
other public benefit provided under Federal law or the law of any State or
political subdivision
thereof.
.
(b)Section
1905(p) of the Social Security Act (42 U.S.C. 1396d(p)) is amended—
(1)by
redesignating paragraph (6) as paragraph (7); and
(2)by inserting after
paragraph (5) the following new paragraph:
(6)Notwithstanding any other provision of law,
any medical assistance for some or all medicare cost-sharing under this title
shall not be considered income or resources in determining eligibility for, or
the amount of assistance or benefits provided under, any other public benefit
provided under Federal law or the law of any State or political subdivision
thereof
.
(c)The amendments made by this section shall apply to
eligibility for benefits on or after January 1, 2010.
3.Cost-sharing
protections for low-income subsidy-eligible individuals
(a)Section 1860D–14(a)
of the Social Security Act (42 U.S.C. 1395w–114(a)) is
amended—
(1)in
paragraph (1)(D), by adding at the end the following new clause:
(iv)Overall
limitation on cost-sharingIn the case of all such individuals, a
limitation on aggregate cost-sharing under this part for a year not to exceed
2.5 percent of income.
;
and
(2)in
paragraph (2), by adding at the end the following new subparagraph:
(F)Overall
limitation on cost-sharingA
limitation on aggregate cost-sharing under this part for a year not to exceed
2.5 percent of
income.
.
(b)The amendments made by subsection (a) shall apply as of
January 1, 2010.
4.Modification of
resource standards for determination of eligibility for LIS; no consideration
of pension or retirement plan in determination of resources
(a)Eliminating the
bifurcation of resource standards
(1)Section 1860D–14(a)(3)(A)(iii) of the Social Security Act
(42 U.S.C. 1395w–114(a)(3)(A)(iii)) is amended by striking meets
the
and all that follows through the period at the end and inserting
“meets—
(I)in the case of
determinations made before January 1, 2011, the resource requirement described
in subparagraph (D) or (E); and
(II)in the case of
determinations made on or after January 1, 2011, the resource requirement
described in subparagraph
(E).
.
(2)Section 1860D–14(a)(3)(D)(ii) of the Social Security
Act (42 U.S.C. 1395w–114(a)(3)(D)(ii)) is amended by inserting (before
2011)
after a subsequent year
.
(b)Increasing the
applicable resource standardSection 1860D–14(a)(3)(E) of the
Social Security Act (42 U.S.C. 1395w–114(a)(3)(E)(i)) is amended—
(1)in the heading,
by striking Alternative
and inserting
Applicable
;
(2)in clause
(i)—
(A)in subclause (I),
by striking and
at the end;
(B)in subclause
(II)—
(i)by
inserting (before 2011)
after a subsequent
year
;
(ii)by
striking the period at the end and inserting a semicolon; and
(iii)by inserting
before the flush sentence at the end 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 subclause (or subclause (III)) 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
(C)in the flush
sentence at the end, by inserting or (IV)
after subclause
(II)
.
(c)Exclusion of
pension and retirement benefits from resources
(1)Section 1860D–14(a)(3) of the Social Security Act (42
U.S.C. 1395w–114(a)(3)), as amended by section 2, is amended—
(A)in subparagraph
(E)(i), in the matter preceding subclause (I), by inserting and the
pension or retirement plan exclusion provided under subparagraph (I)
after (G)
; and
(B)by adding at the
end the following new subparagraph:
(I)Pension and
retirement benefits exclusionIn determining the resources of an
individual (and the eligible spouse of the individual, if any) under section
1613 for purposes of subparagraph (E) no balance in, or benefits received
under, an employee pension benefit plan (as defined in section 3 of the
Employee Retirement Income Security Act of 1974) shall be taken into
account.
.
(2)The amendments made by this subsection shall apply to
determinations made on or after January 1, 2011.
(d)Application of
applicable resource standard under medicare savings program and exemptions from
income and resources
(1)Application of
applicable resource standard and exemptions from
resourcesSection 1905(p)(1)(C) of the Social Security Act (42
U.S.C. 1396d(p)(1)(C)) is amended—
(A)by inserting
without taking into account any part of the value of any life insurance
policy or any balance in, or benefits received under, an employee pension
benefit plan (as defined in section 3 of the Employee Retirement Income
Security Act of 1974)
after (as so determined
;
and
(B)by striking
subparagraph (D)
and all that follows through
section)
and inserting section
1860D–14(a)(3)(E)
.
(2)Exemption of
in-kind support and maintenance
(A)Section 1905(p)(1)(B) of the Social Security Act (42
U.S.C. 1396d(p)(1)(B)) is amended by inserting and except that support
and maintenance furnished in kind shall not be counted as income
after
(2)(D)
.
(B)Section 1860D–14(a)(3)(C)(i) of the Social Security Act
(42 U.S.C. 1395w–114(a)(3)(C)(i)) is amended by striking and except that
support and maintenance furnished in kind shall not be counted as
income
.
(3)The amendments made by this subsection shall apply to
determinations made on or after January 1, 2011.
(e)Clarification
relating to including retirement benefits as incomeNothing in
subparagraph (I) of section 1860D–14(a)(3) of the Social Security Act (42
U.S.C. 1395w–114(a)(3)), as added by subsection (c)(1), or section
1905(p)(1)(C) of such Act (42 U.S.C. 1396d(p)(1)(C)), as amended by subsection
(d)(1), 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)).
5.Increase in
income levels for eligibility
(a)
(1)Section 1860D–14(a) of the Social Security Act (42 U.S.C.
1395w–114(a)) is amended—
(A)in the subsection
heading, by striking 150
and inserting
200
;
(B)in paragraph
(1)—
(i)in the heading,
by striking 135
and inserting 150
; and
(ii)in the matter
preceding subparagraph (A), 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)—
(I)by striking
135
and inserting 150
; and
(II)by striking
150
and inserting 200
; and
(D)in paragraph
(3)(A)(ii), by striking 150
and inserting
200
.
(2)The amendments made by this subsection shall apply to
determinations made on or after January 1, 2011.
(b)
(1)Increase to 150
percent of FPL for qualified Medicare beneficiaries
(A)Section 1905(p)(2) of the Social Security Act (42 U.S.C.
1396d(p)(2)) is amended—
(i)in
subparagraph (A), by striking 100 percent
and inserting
150 percent
;
(ii)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, 2011, is 150
percent.
;
and
(iii)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, 2011, is 150
percent.
.
(B)Application of
income test based on family sizeSection 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.
.
(2)Expansion of
specified low-income Medicare beneficiary (SLMB) program
(A)Eligibility of
individuals with incomes below 200 percent of FPLSection
1902(a)(10)(E) of the Social Security Act (42 U.S.C. 1396b(a)(10)(E)) is
amended—
(i)by adding
and
at the end of clause (ii);
(ii)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 2011, or 200
percent beginning in 2011
; and
(II)by striking
and
at the end; and
(iii)by striking
clause (iv).
(B)Section 1902(a)(10)(E)(iii) of the Social Security
Act (42 U.S.C.
1396b(a)(10)(E)(iii)) is amended by striking who would
be qualified medicare
and all that follows through but is less
than
and inserting whose income (as determined in accordance
with subparagraphs (B) and (C) of section 1905(p)(1)) is less
than
.
(C)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).
.
(3)Providing 100
percent Federal financingThe 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: , with respect to medical assistance for medicare
cost-sharing provided under clause (i) of section 1902(a)(10)(E) for
individuals with incomes greater than 100 percent of the official poverty line
described in subsection (p)(2)(A) and less than or equal to 150 percent of such
official poverty line, and with respect to medical assistance for medicare
cost-sharing provided under clause (iii) of such section
.
(4)
(A)Except as provided
in subparagraph (B), the amendments made by this subsection shall take effect
on January 1, 2011, and, with respect to title XIX of the Social Security Act,
shall apply to calendar quarters beginning on or after January 1, 2011.
(B)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
subsection, 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.
6.Effective date of
MSP benefits
(a)
(1)Effective date
of MSP benefitsSection 1905(a) of the Social Security Act (42
U.S.C. 1396d(a)) is amended, in the matter preceding paragraph (1), by striking
assistance or, in the case of medicare cost-sharing
and all that
follows through beneficiary)
and inserting
assistance)
.
(2)(A)Section 1902(e)(8) of
the Social Security Act (42 U.S.C. 1396a(e)(8)) is amended
by striking 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 eligibilityIn 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)The amendments made by this section shall take effect on
January 1, 2010, but shall not result in eligibility for benefits for medicare
cost-sharing for months before January 2010.
7.Expanding
special enrollment process to individuals eligible for an income-related
subsidy
(a)Section 1860D–1(b)(1)(C) of the Social Security Act (42
U.S.C. 1395w–101(b)(1)(C)) is amended—
(1)by striking
a full-benefit dual eligible individual (as defined in section
1935(c)(6))
and inserting a subsidy-eligible individual (as
defined in section 1860D–14(a)(3))
; and
(2)by striking
1860D–14(a)(1)(A)
and inserting subsection (a)(1)(A) or
(b)(1)(A) of section 1860D–14, as applicable
(b)The amendments made by this section shall apply to
enrollments on or after January 1, 2010.
8.Enhanced cost-sharing
protections for full-benefit dual eligible individuals and qualified medicare
beneficiaries
(a)Elimination of
part D cost-sharing for certain non-institutionalized full-benefit dual
eligible individualsSection 1860D–14(a)(1)(D)(i) of the Social
Security Act (42 U.S.C.
1395w–114(a)(1)(D)(i)) is amended—
(1)in the heading, by
striking Institutionalized
individuals.—In
and
inserting
Elimination of cost-sharing for certain full-benefit dual eligible
individuals.—(I)Institutionalized
individualsIn
;
and
(2)by adding at the
end the following new subclause:
(II)Certain other
individualsIn the case of an
individual who is a full-benefit dual eligible individual who is receiving home
and community based care (whether under section 1915 or under a waiver under
section 1115), the elimination of any beneficiary coinsurance described in
section 1860D–2(b)(2) (for all amounts through the total amount of expenditures
at which benefits are available under section
1860D–2(b)(4)).
.
(b)Repeal of
authority for states To pay medicare cost-sharing at medicaid rates and
provision of medical assistance to dual eligibles in MA plans
(1)Repeal of
authority for states to pay medicare cost-sharing at medicaid
ratesSection 1902(n) of the Social Security Act (42 U.S.C.
1396a(n)) is amended—
(A)by striking
paragraph (2);
(B)by redesignating
paragraph (3) as paragraph (2);
(C)in paragraph (2),
as redesignated by subparagraph (B)—
(i)in
the matter preceding subparagraph (A)—
(I)by striking
In the case in which a State's payment for
and inserting
With respect to
; and
(II)by striking
with respect to an item or service is reduced or eliminated through the
application of paragraph (2)
and inserting for an item or
service
; and
(ii)in
subparagraph (A), by striking (if any)
; and
(D)by adding at the
end the following new paragraph:
(3)Each State shall
establish procedures for receiving and processing claims for payment for
medicare cost-sharing with respect to items or services furnished to qualified
medicare beneficiaries by providers of services and suppliers under title XVIII
who are not participating providers under the State
plan.
.
(2)Provision of
medical assistance to dual eligibles in MA plansSection 1902(n)
of the Social Security Act (42 U.S.C. 1396a(n)), as amended by paragraph (1),
is amended by adding at the end the following new paragraph:
(4)(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 3 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.
.
(3)
(A)Section 1866(a)(1)(A)(ii) of the Social Security Act
(42 U.S.C. 1395cc(a)(1)(A)(ii)) is amended by striking
1902(n)(3)
and inserting 1902(n)(2)
.
(B)Nonparticipating
providersSection 1848(g)(3)(A) of the Social Security Act (42
U.S.C. 1395w–4(g)(3)(A)) is amended by striking 1902(n)(3)(A)
and inserting 1902(n)(2)(A)
.
(4)
(A)Except as provided in subparagraph (B), the amendments
made by this subsection shall take effect on the date of enactment of this
Act.
(B)The
amendment made by paragraph (2) shall be effective and apply as if included in
the enactment of the Medicare Prescription Drug, Improvement, and Modernization
Act of 2003 (Public Law 108–173).
9.Two-way deeming
between Medicare Savings Program and Low-Income Subsidy Program
(a)Low-Income
subsidy programSection 1860D–14(a)(3) of the Social Security Act
(42 U.S.C. 1395w–104(a)(3)), as amended by section 4, is amended by adding at
the end the following new subparagraph:
(J)Deemed treatment
for qualified medicare beneficiaries and specified low-income medicare
beneficiaries
(i)QMBs eligible
for full subsidyA 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 subsidyA 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).
.
(b)Section 1905(p) of the Social Security Act (42 U.S.C.
1396d(p)), as amended by section 4, is amended—
(1)by
redesignating paragraph (8) as paragraph (9); and
(2)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)).
.
(c)The amendments made by this section shall apply to
eligibility for months beginning on or after January 2010.
10.Improving
linkages between health programs and snap
(a)Low-income part
d subsidy programSection 1144(c) of the Social Security Act (42
U.S.C. 1320b–14(c)) is amended—
(1)in paragraph
(1)(C) by striking an application for benefits under the Medicare
Savings Program.
and inserting applications for benefits under
the Medicare Savings Program and the supplemental nutrition assistance
program.
;
(2)by striking
paragraph (3) and inserting the following:
(3)Transmittal of
data to States
(A)Beginning on January 1, 2010, with the consent of an
individual completing an application for benefits described in paragraph
(1)(B), the Commissioner shall electronically transmit data from such
application—
(i)to the
appropriate State Medicaid agency, as determined by the Commissioner, which
transmittal shall initiate an application of the individual for benefits under
the Medicare Savings Program with the State Medicaid agency; and
(ii)to the
appropriate State agency which administers benefits under the supplemental
nutrition assistance program, as determined by the Commissioner, which
transmittal shall initiate an application of the individual for benefits under
the supplemental nutrition assistance program with the State agency that
administers that program.
(B)Consultation
regarding content, time, form, frequency and manner of
transmissionIn order to ensure that such data transmittal
provides effective assistance for purposes of State adjudication of
applications for benefits under the Medicare Savings Program and the
supplemental nutrition assistance program, the Commissioner shall consult with
the Secretary after the Secretary has consulted with the States, regarding the
content, form, frequency, and manner in which data (on a uniform basis for all
States) shall be transmitted under this
paragraph.
;
(3)in paragraph (5),
by adding at the end the following new subparagraph:
(D)Supplemental
nutrition assistance program administrative costsThe costs of
the Social Security Administration’s work related to the supplemental nutrition
assistance program under this subsection shall be eligible for reimbursement
under section 11(j)(2)(C) of the Food and Nutrition Act of 2008 (7 U.S.C.
2020(j)(2)(C)). To the extent necessary the Commissioner and the Secretary of
Agriculture shall revise any memoranda of understanding in effect under such
section.
;
and
(4)by adding at the
end the following new paragraph:
(8)Supplemental
nutrition assistance program definedFor purposes of this
subsection, the term supplemental nutrition assistance program
means the program of temporary benefits authorized under section 11(v) of the
Food and Nutrition Act of 2008 (7 U.S.C.
2020(v)).
.
(b)Temporary
supplemental nutrition assistance benefitsSection 11 of the Food
and Nutrition Act of 2008 (7 U.S.C. 2020) is amended by adding at the end the
following:
(v)Temporary
benefits for medicare part d low income subsidy applicants
(1)Definition of
Medicare part d low income subsidy applicantIn this subsection,
the term Medicare part D low income subsidy applicant
means an
individual, along with any other family members, whose low income subsidy
application information has been electronically transmitted to the State agency
under section 1144(c)(3) of the Social Security Act (42 U.S.C.
1320b–14(c)(3)).
(2)Provision of
temporary benefitsA State agency shall provide temporary
supplemental nutrition assistance program benefits to a Medicare part D low
income subsidy applicant whose—
(A)income does not
exceed 150 percent of the poverty line (as determined in accordance with
section 5(c)(1)); and
(B)financial
resources do not exceed the limit in effect in the State for such households
under section 5.
(3)Determination
based on medicare informationFor purposes of determining
eligibility under paragraph (2) and the amount of temporary benefits under
paragraph (5), information on household members, household income, and
household resources from the Medicare part D low income subsidy application as
transmitted to the State agency under section 1144(c)(3) of the Social Security
Act (42 U.S.C. 1320b–14(c)(3)) shall satisfy the requirements of this Act with
regard to—
(A)the members of
the household under section 3(n); and
(B)the gross income
and financial resources of the household under section 5.
(4)A household shall receive temporary supplemental
nutrition assistance benefits under this subsection for a period of not more
than 2 months.
(5)
(A)During the temporary benefit period under paragraph (4),
except as provided in subparagraph (B), a household shall receive a monthly
amount of supplemental nutrition assistance program benefits calculated under
section 8(a).
(B)In
calculating benefits under subparagraph (A)—
(i)the benefits
shall be determined based on the gross income of the household rather than net
income; and
(ii)the minimum
allotment described in the proviso in section 8(a) shall be equal to 40 percent
of the cost of the thrifty food plan for a household containing 1 member, as
determined by the Secretary under section 3, rounded to the nearest whole
dollar increment.
(6)Determination
of future eligibilityDuring the temporary benefit period under
paragraph (4), the State agency shall provide to the household—
(A)an application to
apply for benefits under the other provisions of this Act; and
(B)an opportunity to
complete the application process by the month immediately following the
temporary benefit period, without a delay or suspension in the benefits of the
household.
(7)This
subsection shall not apply to individuals who—
(A)are members of
households that currently receive benefits under this Act; or
(B)have received
benefits under this subsection in the preceding 12-month
period.
.
(c)Medicare
savings program applications
(1)Section 1902(a) of the Social Security Act (42 U.S.C.
1396a(a)) is amended—
(A)in paragraph
(72), by striking “and” at the end;
(B)in paragraph
(73), by striking the period at the end and inserting “; and”; and
(C)by inserting
after paragraph (73) the following new paragraph:
(74)provide that the
State coordinates with the State agency that administers benefits under the
supplemental nutrition assistance program established under the
Food and Nutrition Act of 2008 (7
U.S.C. 2011 et seq.) to ensure that individuals applying for medical assistance
provided under section 1902(a)(10)(E), as described in sections 1905(p) and
1933, have the opportunity to apply for, establish eligibility for, and, if
eligible, receive supplemental nutrition assistance program
benefits.
.
(2)
(A)Except as provided in subparagraph (B), the amendments
made by paragraph (1) take effect on the date that is 1 year after the date of
enactment of this Act.
(B)Extension of
effective date for state law amendmentIn the case of a State
plan under title XIX of the Social Security Act (42 U.S.C. 1396 et seq.) which
the Secretary of Health and Human Services determines requires State
legislation in order for the plan to meet the additional requirements imposed
by the amendments made by paragraph (1), 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 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 the session is considered to be a separate
regular session of the State legislature.
(3)Not later than 2 years after the date of enactment of
this Act, the Secretary of Health and Human Services shall submit to Congress a
report on the process each State uses to meet the requirements under section
1902(a)(74) of the Social Security Act, as added by subsection (c).
11.Expediting
low-income subsidies under the Medicare prescription drug program
(a)Targeted
outreach for low-income subsidies
(1)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)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
identificationsNot 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 individualsIn 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)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 communicationsIn 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)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 outreachIn 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)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)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 applicationsSection 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)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 safeguardsUnder 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 paidIf 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)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)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)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 disclosuresParagraph (4) of section
6103(p) of such Code is amended by striking or (17)
each place
it appears and inserting (17), or (21)
.
(3)The amendments made by this subsection shall apply to
disclosures made after the date of the enactment of this Act.
12.Enhanced
oversight and enforcement relating to reimbursements for retroactive LIS
enrollment
(a)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)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)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)
(1)By Secretary of
HHS and Commission of the Social Security AdministrationThe
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)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)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)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)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)In this section:
(1)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)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 periodThe 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)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 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)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)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)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)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.
13.Intelligent
assignment in enrollment
(a)Section 1860D–1(b)(1)
of the Social Security Act (42 U.S.C. 1395w–101(b)(1), as
amended by section 7(b), is amended—
(1)in the second
sentence of subparagraph (C), by striking on a random basis among all
such plans
and inserting , subject to subparagraph (E), in the
most appropriate plan for such individual
; and
(2)by adding at the
end the following new subparagraph:
(E)In the case of any auto-enrollment under subparagraph
(C), no part D eligible individual described in such subparagraph shall be
enrolled in a prescription drug plan which does not meet requirements
established by the
Secretary.
.
(b)The amendment made by subsection (a) shall apply to
enrollments effected on or after November 15, 2010.
14.Medicare
enrollment assistance
(a)Additional
Funding for State Health Insurance Assistance Programs
(1)
(A)The Secretary of Health and Human Services (in this
section referred to as the Secretary
) shall use amounts made
available under subparagraph (B) to make grants to States for State health
insurance assistance programs receiving assistance under section 4360 of the
Omnibus Budget Reconciliation Act of 1990.
(B)For purposes of making grants under this
subsection, the Secretary shall provide for the transfer, from the Federal
Hospital Insurance Trust Fund under section 1817 of the Social Security Act (42
U.S.C. 1395i) and the Federal Supplementary Medical Insurance Trust Fund under
section 1841 of such Act (42 U.S.C. 1395t), in the same proportion as the
Secretary determines under section 1853(f) of such Act (42 U.S.C. 1395w–23(f)),
of $14,000,000 to the Centers for Medicare & Medicaid Services Program
Management Account for fiscal year 2011, to remain available until
expended.
(2)The amount of a grant to a State under this subsection
from the total amount made available under paragraph (1) shall be equal to the
sum of the amount allocated to the State under paragraph (3)(A) and the amount
allocated to the State under subparagraph (3)(B).
(3)
(A)Allocation based
on percentage of low-income beneficiariesThe amount allocated to
a State under this subparagraph from 2/3 of the total
amount made available under paragraph (1) shall be based on the number of
individuals who meet the requirement under subsection (a)(3)(A)(ii) of section
1860D–14 of the Social Security Act
(42 U.S.C. 1395w–114) but who have not enrolled to receive a subsidy under such
section 1860D–14 relative to the total number of individuals who meet the
requirement under such subsection (a)(3)(A)(ii) in each State, as estimated by
the Secretary.
(B)Allocation based
on percentage of rural beneficiariesThe amount allocated to a
State under this subparagraph from 1/3 of the total amount
made available under paragraph (1) shall be based on the number of part D
eligible individuals (as defined in section 1860D–1(a)(3)(A) of such Act (42
U.S.C. 1395w–101(a)(3)(A))) residing in a rural area relative to the total
number of such individuals in each State, as estimated by the Secretary.
(4)Portion of grant
based on percentage of low-income beneficiaries to be used to provide outreach
to individuals who may be subsidy eligible individuals or eligible for the
Medicare Savings ProgramEach grant awarded under this subsection
with respect to amounts allocated under paragraph (3)(A) shall be used to
provide outreach to individuals who may be subsidy eligible individuals (as
defined in section 1860D–14(a)(3)(A) of the Social Security Act (42 U.S.C.
1395w–114(a)(3)(A)) or eligible for the Medicare Savings Program (as defined in
subsection (f)).
(b)Additional
Funding for Area Agencies on Aging
(1)
(A)The Secretary, acting through the Assistant Secretary for
Aging, shall make grants to States for area agencies on aging (as defined in
section 102 of the Older Americans Act of 1965 (42 U.S.C. 3002)) and Native
American programs carried out under the Older Americans Act of 1965 (42 U.S.C.
3001 et seq.).
(B)For purposes of making grants under this
subsection, the Secretary shall provide for the transfer, from the Federal
Hospital Insurance Trust Fund under section 1817 of the Social Security Act (42
U.S.C. 1395i) and the Federal Supplementary Medical Insurance Trust Fund under
section 1841 of such Act (42 U.S.C. 1395t), in the same proportion as the
Secretary determines under section 1853(f) of such Act (42 U.S.C. 1395w–23(f)),
of $10,000,000 to the Administration on Aging for fiscal year 2011, to remain
available until expended.
(2)Amount of grant
and allocation to States based on percentage of low-income and rural
beneficiariesThe amount of a grant to a State under this
subsection from the total amount made available under paragraph (1) shall be
determined in the same manner as the amount of a grant to a State under
subsection (a), from the total amount made available under paragraph (1) of
such subsection, is determined under paragraph (2) and subparagraphs (A) and
(B) of paragraph (3) of such subsection.
(3)
(A)Subject to subparagraph (B), each grant awarded under this
subsection shall be used to provide outreach to eligible Medicare beneficiaries
regarding the benefits available under title XVIII of the
Social Security Act.
(B)Outreach to
individuals who may be subsidy eligible individuals or eligible for the
Medicare Savings ProgramSubsection (a)(4) shall apply to each
grant awarded under this subsection in the same manner as it applies to a grant
under subsection (a).
(c)Additional
Funding for Aging and Disability Resource Centers
(1)
(A)The Secretary shall make grants to Aging and Disability
Resource Centers under the Aging and Disability Resource Center grant program
that are established centers under such program on the date of the enactment of
this Act.
(B)For purposes of making grants under this
subsection, the Secretary shall provide for the transfer, from the Federal
Hospital Insurance Trust Fund under section 1817 of the Social Security Act (42
U.S.C. 1395i) and the Federal Supplementary Medical Insurance Trust Fund under
section 1841 of such Act (42 U.S.C. 1395t), in the same proportion as the
Secretary determines under section 1853(f) of such Act (42 U.S.C. 1395w–23(f)),
of $10,000,000 to the Administration on Aging for fiscal year 2011, to remain
available until expended.
(2)Each grant awarded under this subsection shall be used to
provide outreach to individuals regarding the benefits available under the
Medicare prescription drug benefit under part D of title XVIII of the
Social Security Act and under the
Medicare Savings Program.
(d)Coordination of
efforts To inform older americans about benefits available under Federal and
State programs
(1)The Secretary, acting through the Assistant Secretary for
Aging, in cooperation with related Federal agency partners, shall make a grant
to, or enter into a contract with, a qualified, experienced entity under which
the entity shall—
(A)maintain and update
web-based decision support tools, and integrated, person-centered systems,
designed to inform older individuals (as defined in section 102 of the
Older Americans Act of 1965 (42
U.S.C. 3002)) about the full range of benefits for which the individuals may be
eligible under Federal and State programs;
(B)utilize
cost-effective strategies to find older individuals with the greatest economic
need (as defined in such section 102) and inform the individuals of the
programs;
(C)develop and
maintain an information clearinghouse on best practices and the most
cost-effective methods for finding older individuals with greatest economic
need and informing the individuals of the programs; and
(D)provide, in
collaboration with related Federal agency partners administering the Federal
programs, training and technical assistance on the most effective outreach,
screening, and follow-up strategies for the Federal and State programs.
(2)For purposes of making a grant or entering
into a contract under paragraph (1), the Secretary shall provide for the
transfer, from the Federal Hospital Insurance Trust Fund under section 1817 of
the Social Security Act (42 U.S.C. 1395i) and the Federal Supplementary Medical
Insurance Trust Fund under section 1841 of such Act (42 U.S.C. 1395t), in the
same proportion as the Secretary determines under section 1853(f) of such Act
(42 U.S.C. 1395w–23(f)), of $10,000,000 to the Administration on Aging for
fiscal year 2011, to remain available until expended.
(e)Medicare Savings Program
definedFor purposes of this
section, the term Medicare Savings Program means the program of
medical assistance for payment of the cost of medicare cost-sharing under the
Medicaid program pursuant to sections 1902(a)(10)(E) and 1933 of the Social
Security Act (42 U.S.C. 1396a(a)(10)(E), 1396u–3).
15.QMB buy-in of
part A and part B premiums
(a)Section
1902(a) of the Social Security Act (42 U.S.C. 1396a(a)), as amended by section
10, is amended—
(1)in paragraph
(73), by striking “and” at the end;
(2)in paragraph
(74), by striking the period at the end and inserting “; and”; and
(3)by inserting
after paragraph (74) the following new paragraph:
(75)provide that the
State enters into a modification of an agreement under section
1818(g).
.
(b)
(1)Except as provided in paragraph (2), the amendments made
by this section take effect on the date that is 6 months after the date of
enactment of this Act.
(2)Extension of
effective date for state law amendmentIn the case of a State
plan under title XIX of the Social Security Act (42 U.S.C. 1396 et seq.) which
the Secretary of Health and Human Services determines requires State
legislation 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 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 the session is considered to be a separate
regular session of the State legislature.
16.Increasing
availability of MSP applications through availability on the internet and
designation of preferred language
(a)
(1)Section 1902(a) of the Social Security Act (42 U.S.C.
1396a(a)), as amended by section 15, is amended—
(A)in paragraph
(74), by striking “and” at the end;
(B)in paragraph
(75), by striking the period at the end and inserting “; and”; and
(C)by inserting
after paragraph (75) the following new paragraph:
(76)provide—
(A)that the
application for medical assistance for medicare cost-sharing under this title
used by the State allows an individual to specify a preferred language for
subsequent communication and, in the case in which a language other than
English is specified, provide that subsequent communications under this title
to the individual shall be in such language; and
(B)that the State
makes such application available through an Internet website and provides for
such application to be completed on such
website.
.
(2)
(A)Except as provided in subparagraph (B), the amendments
made by this subsection take effect on the date that is 2 years after the date
of enactment of this Act.
(B)Extension of
effective date for state law amendmentIn the case of a State
plan under title XIX of the Social Security Act (42 U.S.C. 1396 et seq.) which
the Secretary of Health and Human Services determines requires State
legislation in order for the plan to meet the additional requirements imposed
by the amendments made by this subsection, 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 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 the session is considered to be a separate
regular session of the State legislature.
(b)Requirement for
the secretarySection 1905(p)(5) of the Social Security Act (42
U.S.C. 1396d(p)(5)) is amended by adding at the end the following new sentence:
Such form shall allow an individual to specify a preferred language for
subsequent communication.
.
17.State Medicaid
agency consideration of low-income subsidy application and data
transmittal
(a)
(1)Section 1144(c)(3)(A)(i) of the Social Security Act (42
U.S.C. 1320b–14(c)(3)(A)(i)), as amended by section 10, is amended—
(A)by striking
transmittal
; and
(B)by inserting
(as specified in section 1935(a)(4))
before the semicolon at the
end.
(2)The amendments made by this subsection shall take effect as
if included in the enactment of section 113(a) of the Medicare Improvements for
Patients and Providers Act of 2008 (Public Law 110–275).
(b)Clarification
of State Medicaid agency consideration of low-income subsidy
applicationSection 1935(a)(4) of the Social Security Act (42
U.S.C. 1396u–5(a)(4)), as added by section 113(b) of the Medicare Improvements
for Patients and Providers Act of 2008 (Public Law 110–275), is amended—
(1)by striking
Program.—The State
and inserting
“Program.—
(A)The
State
;
(2)in subparagraph
(A), as inserting by paragraph (1), by striking the second sentence; and
(3)by adding at the
end the following new subparagraphs:
(B)For purposes of a
State’s obligation under section 1902(a)(8) to furnish medical assistance with
reasonable promptness, the date of the electronic transmission by the
Commissioner of Social Security to the State Medicaid agency of data under
section 1144(c)(3) shall be the date of the filing of such application for
benefits under the Medicare Savings Program.
(C)For the purpose
of determining when medical assistance shall be made available for medicare
cost-sharing under this title, the State shall consider the date of the
application for low-income subsidies under section 1860D–14 to be the date of
the filing of an application for benefits under the Medicare Savings
Program.
.