[Congressional Bills 116th Congress]
[From the U.S. Government Publishing Office]
[H.R. 2477 Introduced in House (IH)]
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116th CONGRESS
1st Session
H. R. 2477
To amend title XVIII of the Social Security Act to establish a system
to notify individuals approaching Medicare eligibility, to simplify and
modernize the eligibility enrollment process, and for other purposes.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
May 2, 2019
Mr. Ruiz (for himself, Mrs. Walorski, Mr. Schneider, and Mr. Bilirakis)
introduced the following bill; which was referred to the Committee on
Ways and Means, and in addition to the Committee on Energy and
Commerce, 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 a system
to notify individuals approaching Medicare eligibility, to simplify and
modernize the eligibility enrollment process, 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 ``Beneficiary Enrollment Notification
and Eligibility Simplification Act of 2019'' or the ``BENES Act of
2019''.
SEC. 2. BENEFICIARY ENROLLMENT NOTIFICATION AND ELIGIBILITY
SIMPLIFICATION.
(a) Eligibility and Enrollment Notices.--
(1) As part of social security account statement for
individuals age 60 to 65.--Section 1143(a) of the Social
Security Act (42 U.S.C. 1320b-13(a)) is amended by adding at
the end the following new paragraph:
``(4) Medicare eligibility information.--
``(A) In general.--In the case of statements
provided on or after the date that is 2 years after the
date of the enactment of this Act to individuals who
have attained 60 years of age but have not attained 65
years of age, the statement shall also include a notice
containing the information described in subparagraph
(B).
``(B) Contents of notice.--The notice required
under subparagraph (A) shall contain information on
(including a clear, simple explanation of)--
``(i) eligibility for benefits under the
Medicare program under title XVIII, and in
particular benefits under part B of such title;
``(ii) the possibility of a late enrollment
penalty for failure to timely enroll (including
the process for requesting relief under section
1837(h) in plain language);
``(iii) the need for coordination of
benefits under such part B (including primary
and secondary coverage scenarios) imposed under
title XVIII; and
``(iv) populations, such as veterans, for
whom there are special considerations with
respect to enrollment under this title.
``(C) Development of notice.--
``(i) In general.--The Secretary, in
consultation with representatives of each of
the groups described in subparagraph (D)(i),
and in coordination with the Commissioner of
Social Security, shall develop the notice to be
provided pursuant to subparagraph (A).
``(ii) Notice improvement.--The Secretary,
not less than once every two years, shall--
``(I) review the content of the
notice to be provided under
subparagraph (A); and
``(II) update and revise such
notice as the Secretary deems
appropriate.
``(D) Groups for consultation.--
``(i) In general.--For purposes of
subparagraph (C), the groups described in this
clause include the following:
``(I) Individuals who are more than
60 years of age.
``(II) Veterans.
``(III) Individuals with
disabilities.
``(IV) Individuals with end stage
renal disease.
``(V) Low-income individuals and
families.
``(VI) Employers (including human
resources professionals).
``(VII) States (including
representatives of State-run Health
Insurance Exchanges, Medicaid offices,
and Departments of Insurance).
``(VIII) State Health Insurance
Assistance Programs.
``(IX) Health insurers.
``(X) Health insurance agents and
brokers.
``(XI) Such other groups as
specified by the Secretary.
``(ii) Nonapplication of faca.--The Federal
Advisory Committee Act shall not apply to
consultations made pursuant to subparagraph (C)
with groups described in clause (i).
``(E) Posting of notice on websites.--The
Commissioner of Social Security and the Secretary shall
each ensure that the notice being used under
subparagraph (A) is posted in a prominent location on
their respective Department Internet website.''.
(2) Individuals in medicare waiting period.--Title XI of
the Social Security Act is amended by inserting after section
1144 the following new section:
``medicare enrollment notification and eligibility notices for
individuals in medicare waiting period
``Notices
``Sec. 1144A. (a)
``(1) In General.--The Commissioner of Social Security, in
coordination with the Secretary, shall distribute the notice
developed and used by the Commissioner under section 1143(a)(4)
to individuals in the Medicare waiting period under section
226(b) of this Act.
``(2) Authority to Modify Notice.--The Secretary, in
coordination with the Commissioner of Social Security, may
modify the notice to be distributed under paragraph (1) as
necessary to take into account the population receiving the
notice.
``(3) Posting of Notice on Websites.--The Commissioner of
Social Security and the Secretary shall each ensure that the
notice being distributed under paragraph (1) is posted in a
prominent location on their respective Department Internet
website.
``Timing
``(b) Beginning two years after the date of the enactment of this
section, a notice required under subsection (a)(1) shall be mailed to
an individual no less than two times in accordance with the following:
``(1) The notice shall be provided to such individual no
later than 3 months prior to the date of such individual's
enrollment period as provided under section 1837.
``(2) The notice shall subsequently be provided to such
individual no later than one month prior to such date.''.
(b) Beneficiary Medicare Part B Enrollment Periods and Effective
Date of Coverage.--
(1) Effective dates.--Section 1838(a) of the Social
Security Act (42 U.S.C. 1395q(a)) is amended--
(A) by amending paragraph (2) to read as follows:
``(2)(A) in the case of an individual who enrolls pursuant
to subsection (d) of section 1837 before the month in which he
first satisfies paragraph (1) or (2) of section 1836, the first
day of such month;
``(B) in the case of an individual not described in
subparagraph (A) who first satisfies such paragraph in a month
beginning before January 2021 and who enrolls--
``(i) pursuant to such subsection (d) in such month
in which he first satisfies such paragraph, the first
day of the month following the month in which he so
enrolls;
``(ii) pursuant to such subsection (d) in the month
following such month in which he first satisfies such
paragraph, the first day of the second month following
the month in which he so enrolls; or
``(iii) pursuant to such subsection (d) more than
one month following such month in which he satisfies
such paragraph, the first day of the third month
following the month in which he so enrolls;
``(C) in the case of an individual not described in
subparagraph (A) who first satisfies such paragraph in a month
beginning on or after January 1, 2021, and who enrolls pursuant
to such subsection (d) in such month in which he first
satisfies such paragraph or in any subsequent month of his
initial enrollment period, the first day of the month following
the month in which he so enrolls;
``(D) in the case of an individual not described in
subparagraph (A) who enrolls pursuant to subsection (e) of
section 1837 in a month beginning before October 15, 2020, the
July 1 following the month in which he so enrolls; or
``(E) in the case of an individual not described in
subparagraph (A) who enrolls pursuant to subsection (e) of
section 1837 in a month beginning on or after October 15, 2020,
the first day of the month following the month in which he so
enrolls.''; and
(B) by amending paragraph (3) to read as follows:
``(3)(A) in the case of an individual who is deemed to have
enrolled on or before the last day of the third month of his
initial enrollment period, the first day of the month in which
he first meets the applicable requirements of section 1836 or
July 1, 1973, whichever is later;
``(B) in the case of an individual who is deemed to have
enrolled on or after the first day of the fourth month of his
initial enrollment period beginning before January 1, 2021, as
prescribed under subparagraphs (B)(i), (B)(ii), (B)(iii), and
(D) of paragraph (2) of this subsection; or
``(C) in the case of an individual who is deemed to have
enrolled on or after the first day of the fourth month of his
initial enrollment period beginning on or after January 1,
2021, as prescribed under paragraph (2)(C) of this
subsection.''.
(2) General and special enrollment periods.--Section
1837(e) of the Social Security Act (42 U.S.C. 1395p(e)) is
amended to read as follows:
``(e) Enrollment Periods.--
``(1) For coverage during years before 2022.--There shall
be a general enrollment period during the period beginning on
January 1 and ending on March 31 of each year before 2022.
``(2) For coverage during years beginning with 2022.--For
coverage during years beginning with 2022 and each subsequent
year, there shall be a general enrollment period beginning on
October 15 of the previous year through December 31 of such
previous year.
``(3) Exceptional circumstances.--The Secretary may
establish a special enrollment period in the case that an
individual meets such exceptional conditions as the Secretary
may provide.''.
(3) Technical correction.--
(A) In general.--Section 1839(b) of the Social
Security Act (42 U.S.C. 1395r(b)) is amended by
striking ``close of the enrollment period'' each place
it appears and inserting ``close of the month''.
(B) Effective date.--The amendment made by
subparagraph (A) shall take effect on November 1, 2021.
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