II 111th CONGRESS 1st Session S. 1680 IN THE SENATE OF THE UNITED STATES September 17, 2009 Mr. Whitehouse introduced the following bill; which was read twice and referred to the Committee on Finance A BILL To amend titles XVIII and XIX of the Social Security Act to provide the authorized representative of a deceased beneficiary full access to information with respect to the deceased beneficiary's benefits under the Medicare and Medicaid programs.

1.

Short title

This Act may be cited as the Expanding Access to Medical Records Act.

2.

Full access to medicare information by the authorized representative of a deceased beneficiary

(a)

In general

Title XVIII of the Social Security Act (42 U.S.C. 1395 et seq.) is amended by adding at the end the following new section:

1899.

Full access to medicare information by the authorized representative of a deceased beneficiary

(a)

In general

In the case of the death of an individual entitled to, or enrolled for, benefits under part A or enrolled for benefits under part B, the Secretary shall— (1)make available to the authorized representative of the individual all information concerning the individual's benefits under this title, including— (A)the coverage and status of such benefits (as of the day before the individual's death); and (B)billing, claims, and payment information regarding items and services furnished to the individual under this title (on or before such day); and (2)provide such authorized representative access to any source of information maintained by the Federal government with respect to such benefits, including online databases, that the individual had access to during his or her lifetime. (b)

Definition of authorized representative; special rules

(1)

In general

In this section, the term authorized representative means an executor, administrator, or other individual who has authority to act on the deceased individual's behalf (as determined by the Secretary under paragraph (2)). (2)

Determination of authorized representative

(A)

In general

The Secretary shall establish procedures under which the Secretary determines whether an individual is an authorized representative of the deceased individual. Under such procedures, the individual seeking such determination shall provide evidence (in such form and such manner as specified by the Secretary) of the individual's legal authority to act on behalf of the deceased individual. (B)

Timeline for determination

The Secretary shall make a determination under subparagraph (A) not later than 30 days after receipt of the evidence described in such subparagraph. (3)

Notification and access to information

After making a determination under paragraph (2) with respect to an individual, the Secretary shall— (A)notify the individual of the determination not later than 7 days after the date on which the determination is made; and (B)in the case where such individual is so determined to be the authorized representative of the deceased individual, as soon as practicable— (i)make available to the authorized representative the information described in paragraph (1) of subsection (a); and (ii)provide the authorized representative access to the sources described in paragraph (2) of such subsection.

. (b)

Effective date

The amendment made by this section shall take effect on the date that is 60 days after the date of enactment of this Act.

3.

Full access to medicaid information by the authorized representative of a deceased beneficiary

(a)

In General

Title XIX of the Social Security Act (42 U.S.C. 1396 et seq.) is amended by adding at the end the following new section:

1943.

Full access to medicaid information by the authorized representative of a deceased beneficiary

(a)

In General

In the case of the death of an individual enrolled under the State plan for medical assistance or under a waiver of such plan, the State Medicaid agency shall— (1)make available to the authorized representative of the individual all information concerning the individual's benefits under this title, including— (A)the coverage and status of such benefits (as of the day before the individual's death); and (B)billing, claims, and payment information regarding items and services furnished to the individual under this title (on or before such day); and (2)provide such authorized representative access to any source of information maintained by the State with respect to such benefits, including online databases, that the individual had access to during his or her lifetime. (b)

Definition of authorized representative; special rules

(1)In this section, the term authorized representative means an executor, administrator, or other individual who has authority to act on the deceased individual's behalf (as determined by the State Medicaid agency under paragraph (2)). (2)

Determination of authorized representative

(A)

In general

The State Medicaid agency shall establish procedures under which such agency determines whether an individual qualifies as an authorized representative of the deceased individual. Under such procedures, the individual seeking such a determination shall provide evidence (in such form and such manner as specified by the State Medicaid Agency) of the individual's legal authority to act on behalf of the deceased individual. (B)

Timeline for determination

The State Medicaid agency shall make a determination under subparagraph (A) not later than 30 days after receipt of the evidence described in such subparagraph. (3)

Notification and access to information

After making a determination under paragraph (2) with respect to an individual, the State Medicaid Agency shall— (A)notify the individual of the determination not later than 7 days after the date on which the determination is made; and (B)in the case where such individual is so determined to be the authorized representative of the deceased individual, as soon as practicable— (i)make available to the authorized representative the information described in paragraph (1) of subsection (a); and (ii)provide the authorized representative access to the sources described in paragraph (2) of such subsection. (c)

Definition of State Medicaid agency

The term State Medicaid agency means the State agency responsible for administering the State plan established under this title or any waiver of such plan.

. (b)

Effective date

(1)

In general

Except as provided in paragraph (2), the amendment made by this section shall take effect on the date that is 60 days after the date of enactment of this Act. (2)

Extension of effective date for State law amendment

In the case of a State plan under this title 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 amendment made by subsection (a), the State plan shall not be regarded as failing to comply with the requirements of such title solely on the basis of its failure to meet these additional requirements before the first day of the first calendar quarter beginning after the close of the first regular session of the State legislature that begins after the date of the enactment of this Act. For purposes of the previous sentence, in the case of a State that has a 2-year legislative session, each year of the session is considered to be a separate regular session of the State legislature.