[Congressional Bills 112th Congress]
[From the U.S. Government Publishing Office]
[H.R. 1654 Introduced in House (IH)]

112th CONGRESS
  1st Session
                                H. R. 1654

    To amend title XVIII of the Social Security Act to provide for 
    additional opportunities to enroll under part B of the Medicare 
                    Program, and for other purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             April 15, 2011

Mr. Schrader (for himself, Mr. Kissell, Mr. Larson of Connecticut, Ms. 
  Baldwin, Mr. Kucinich, and Mr. Farr) 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 provide for 
    additional opportunities to enroll under part B of the Medicare 
                    Program, 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.

    This Act may be cited as the ``Medicare Enrollment Protection Act 
of 2011''.

SEC. 2. MEDICARE PART B SPECIAL ENROLLMENT PERIOD FOR INDIVIDUALS 
              ENROLLED IN COBRA CONTINUATION COVERAGE.

    (a) Special Enrollment Period.--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 COBRA continuation 
        coverage (as defined in subparagraph (D)), and
            ``(ii) has elected not to enroll (or to be deemed enrolled) 
        under this section during the individual's initial enrollment 
        period,
        there shall be a special enrollment period described in 
        subparagraph (B).
    ``(B) The special enrollment period referred to in subparagraph (A) 
is the period including each month during any part of which the 
individual is enrolled in COBRA continuation coverage ending with the 
last day of the eighth consecutive month in which the individual is at 
no time so enrolled.
    ``(C) An individual may only enroll during the special enrollment 
period provided under subparagraph (B) one time during the individual's 
lifetime.
    ``(D) For purposes of this paragraph, the term `COBRA continuation 
coverage' means continuation coverage provided pursuant to part 6 of 
subtitle B of title I of the Employee Retirement Income Security Act of 
1974 (other than under section 609), title XXII of the Public Health 
Service Act, section 4980B of the Internal Revenue Code of 1986 (other 
than subsection (f)(1) of such section insofar as it relates to 
pediatric vaccines), or section 8905a of title 5, United States Code, 
or under a State program that provides comparable continuation 
coverage. Such term does not include coverage under a health flexible 
spending arrangement under a cafeteria plan within the meaning of 
section 125 of the Internal Revenue Code of 1986.''.
    (b) Coverage Period.--Section 1838(e) of such Act (42 U.S.C. 
1395q(e)) is amended--
            (1) by striking ``pursuant to section 1837(i)(3) or 
        1837(i)(4)(B)'' and inserting the following:
``pursuant to--
            ``(1) section 1837(i)(3) or 1837(i)(4)(B)--'';
            (2) by redesignating paragraphs (1) and (2) as 
        subparagraphs (A) and (B), respectively, and moving the 
        indentation of each such subparagraph 2 ems to the right;
            (3) by striking the period at the end of the subparagraph 
        (B), as so redesignated, and inserting ``; or''; and
            (4) by adding at the end the following new paragraph:
            ``(2) section 1837(i)(5), the coverage period shall begin 
        on the first day of the month following the month in which the 
        individual so enrolls.''.
    (c) No Increase in Premium.--Section 1839(b) of such Act (42 U.S.C. 
1395r(b)) is amended--
            (1) in the first sentence, by inserting ``, (i)(5),'' after 
        ``subsection (i)(4)''; and
            (2) in the second sentence, by inserting before the period 
        at the end the following: ``or months for which the individual 
        can demonstrate that the individual was enrolled in COBRA 
        continuation coverage (as such term is defined in section 
        1837(i)(5)(D)).''.
    (d) Effective Date.--
            (1) In general.--The amendments made by this section shall 
        take effect on the date of the enactment of this Act and shall 
        apply to periods of COBRA continuation coverage before, on, or 
        after such date.
            (2) Special enrollment period.--No special enrollment 
        period under section 1837(i)(5)(B) of the Social Security Act 
        (42 U.S.C. 1395p(i)(5)(B)) shall begin before the first day of 
        the first month that begins at least 45 days after the date of 
        the enactment of this Act.
            (3) Premiums.--The amendment made by subsection (c)(2) 
        shall apply to premiums for months beginning with the first 
        month that begins at least 45 days after the date of the 
        enactment of this Act.

SEC. 3. CONTINUOUS OPEN MEDICARE PART B ENROLLMENT.

    (a) Continuous Open Enrollment Period.--Section 1837 of the Social 
Security Act (42 U.S.C. 1395p) is amended by adding at the end the 
following new subsection:
    ``(m)(1) There shall be a continuous open enrollment period 
beginning on the first day of the first month in which an individual 
first satisfies paragraph (1) or (2) of section 1836, except that such 
continuous open enrollment period shall not be available during the 
individual's initial enrollment period or a special enrollment period 
available to the individual.
    ``(2) In the case of an individual seeking enrollment under 
paragraph (1) during a general enrollment period under subsection (e), 
the individual shall be enrolled under such subsection and not under 
paragraph (1), unless the individual specifies otherwise.''.
    (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 (m) of section 1837, the first day of the month 
        following the month in which such individual so enrolls; or''.
    (c) Premium Increase.--Section 1839 of such Act (42 U.S.C. 1395r) 
is amended by adding at the end the following new subsection:
    ``(j) Increase in Premium Based on Enrollment Pursuant to 
Continuous Open Enrollment Period.--In the case of an individual whose 
coverage period began pursuant to a continuous open enrollment period 
under section 1837(m), the monthly premium determined under subsection 
(a), adjusted in accordance with subsection (i), shall, in addition to 
the increase required by subsection (b), be increased by such amount as 
the Secretary considers appropriate, taking into account any additional 
actuarial cost to the insurance program established under this part due 
to enrollment under such section. Any increase under this subsection 
shall apply to all premiums paid by the individual after enrollment 
pursuant to such continuous open enrollment period.''.
    (d) Report to Congress.--Not later than 180 days after the date of 
the enactment of this Act, the Secretary of Health and Human Services 
shall submit to Congress a report describing--
            (1) the average increase in premiums based on enrollment in 
        the insurance program established under part B of title XVIII 
        of the Social Security Act pursuant to a continuous open 
        enrollment period under section 1837(m) of such Act, as added 
        by subsection (a);
            (2) any other regulations promulgated by the Secretary with 
        respect to such enrollment;
            (3) the number and characteristics of individuals choosing 
        such enrollment; and
            (4) any costs of such enrollment to such insurance program 
        that were not covered by the increases in premiums described in 
        the amendment made by subsection (c).
    (e) Effective Date.--The amendments made by this section shall take 
effect on the date of the enactment of this Act, except that no 
individual may enroll pursuant to a continuous open enrollment period 
under the amendment made by subsection (a) before the first day of the 
first month that begins at least 45 days after the date of the 
enactment of this Act.

SEC. 4. SPECIAL ENROLLMENT PERIODS TO CORRECT ERROR, MISREPRESENTATION, 
              OR INACTION OF FEDERAL GOVERNMENT, GROUP HEALTH PLAN, OR 
              PLAN SPONSOR.

    Section 1837(h) of the Social Security Act (42 U.S.C. 1395p(h)) is 
amended by inserting ``or by an officer, employee, or agent of a group 
health plan, or of a plan sponsor (as such term is defined in section 
3(16)(B) of the Employee Retirement Income Security Act of 1974 (29 
U.S.C. 1002(16)(B))) of a group health plan,'' after 
``instrumentalities,''.

SEC. 5. COORDINATION OF MEDICARE PART B WITH AMERICAN HEALTH BENEFIT 
              EXCHANGES.

    Section 1837 of the Social Security Act (42 U.S.C. 1395p), as 
amended by section 3(a), is further amended by adding at the end the 
following new subsection:
    ``(n) The Secretary shall ensure appropriate coordination between 
the insurance program established under this part and American Health 
Benefit Exchanges established under section 1311(b) of the Patient 
Protection and Affordable Care Act (Public Law 111-148), including 
ensuring a smooth transition in enrollment from enrollment in qualified 
health plans offered through Exchanges to enrollment under this 
part.''.

SEC. 6. GAO STUDY AND REPORT ON MEDICARE PART B ENROLLMENT.

    Not later than 2 years after the date of the enactment of this Act, 
the Comptroller General of the United States shall submit to Congress a 
report on enrollment in the insurance program established under part B 
of title XVIII of the Social Security Act (in this section referred to 
as ``Medicare part B''). The report shall include--
            (1) a comprehensive evaluation of problems experienced by 
        individuals with respect to enrollment in Medicare part B, 
        including the causes of such problems and any geographic trends 
        in the manifestation of such problems;
            (2) an assessment of the number of people who lack health 
        insurance coverage because of such problems;
            (3) an evaluation of efforts by the Centers for Medicare & 
        Medicaid Services and the Social Security Administration to 
        educate employers regarding the transition of employees from 
        group health plans to Medicare part B;
            (4) an evaluation of coordination of coverage for 
        individuals with private health insurance who are also eligible 
        for Medicare part B and ways to improve such coordination;
            (5) an evaluation of the coordination between Medicare part 
        B and American Health Benefit Exchanges required by the 
        amendment made by section 5;
            (6) an evaluation of the differences in regulations 
        applicable to individuals who are eligible for Medicare part B 
        based on age and individuals who are eligible based on 
        disability, and ways to improve parity in the treatment of each 
        such group of individuals that may be implemented in 
        regulations and guidance; and
            (7) an evaluation of efforts by the Centers for Medicare & 
        Medicaid Services to provide equitable relief to individuals 
        who suffered adverse consequences due to misinformation or a 
        lack of information on enrollment in Medicare part B, and ways 
        to improve the provision of such equitable relief.
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