[Congressional Record Volume 152, Number 54 (Monday, May 8, 2006)]
[Senate]
[Pages S4157-S4158]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. SMITH (for himself and Mr. Bingaman):
  S. 2759. A bill to provide for additional outreach and education 
related to the Medicare program and to amend title XVIII of the Social 
Security Act to provide a special enrollment period for individuals who 
qualify for an income-related subsidy under the Medicare prescription 
drug program; to the Committee on Finance.
  Mr. SMITH. Mr. President, today I am proud to file the Medicare Part 
D Outreach and Enrollment Enhancement Act of 2006. This timely piece of 
legislation addresses two very targeted administrative issues that have 
come to light since Medicare's new prescription drug benefit became 
effective earlier this year. I am also pleased that Senator Bingaman is 
joining on this bill.
  With more than 30 million beneficiaries now receiving coverage 
through Medicare Part D, the program is well on its way to helping 
deliver much needed access to lower cost prescription drugs. And with 
the close of the initial enrollment period on May 15 looming, the 
Centers for Medicare and Medicaid Services (CMS) and advocacy 
organizations across the country are working diligently to provide last 
minute assistance to those beneficiaries still wishing to enroll.
  However, even after the May 15 deadline passes, beneficiaries will 
still need counsel on the program's benefits, including the 
availability of the low-income subsidy. For instance, dual eligible 
beneficiaries and those who previously received assistance through a 
Medicare Savings Program have the ability to change their prescription 
drug plan monthly. This particularly vulnerable group of beneficiaries 
likely will need extra assistance in choosing a plan that more 
appropriately meets their medical and financial needs.
  There also are those beneficiaries who will age into Medicare 
throughout the year. They will be provided an initial enrollment period 
to choose a prescription drug plan once they turn age 65. And with the 
first regular enrollment cycle beginning in November, many 
beneficiaries will need advice as they evaluate new plan options or 
consider switching plans if their existing coverage has changed. We owe 
it to our seniors to provide them quality information so they can make 
the best possible prescription drug plan choice.
  That is why I am asking for increased Part D outreach and education 
funding in the bill I am filing today. State Health Insurance Programs 
(SHIPs), which provide a range of valuable services, help beneficiaries 
select quality prescription drug plans, identify additional financial 
help with their drug costs, and resolve general enrollment 
difficulties.
  This year, CMS supported the outreach work of SHIPs with a $30 
million allotment. Despite this funding, there still remains a great 
need to raise further awareness about the new Part D benefit among 
beneficiaries and provide them assistance with selecting an

[[Page S4158]]

appropriate prescription drug plan. The Outreach and Enrollment 
Enhancement Act would allocate SHIPs an additional $13.5 million, 
bringing their total funding to $43.5 million, or, one dollar per 
Medicare beneficiary. To assure that the work of SHIPs is sufficiently 
supported in future years, the bill also creates a new funding 
authorization that is set to increase as the number of Medicare 
beneficiaries grows.
  The legislation I am filing today also provides funding to the Area 
Agencies on Aging (AAA) and Native American aging programs that have 
absorbed an increased workload since the passage of the Medicare 
Modernization Act. In Oregon, the Multnomah County AAA has incurred 
$30,000 in expenses related to Medicare outreach since the beginning of 
this year, but they have received very little new funding in return. 
The bill recognizes the important role AAAs and Native American aging 
programs play in helping elderly Americans enroll in Medicare by 
providing new funding in the amount of $6.3 million this fiscal year.
  Apart from increased funding for outreach and education, the bill 
addresses a very targeted problem with the current enrollment process 
that has recently become apparent. Beneficiaries who believe their 
income and asset levels may qualify them for extra help with their 
prescription drug costs may apply for a low-income subsidy (LIS) at any 
point during the year. If they submit an application to the Social 
Security Administration (SSA) during an initial enrollment period but 
do not receive notification of their eligibility before the enrollment 
deadline, they have one of two options available to them. They could 
enroll into a prescription drug plan before the deadline not knowing 
whether they will have to pay all or part of the costs of the monthly 
premium. This could place a beneficiary in the awkward position if they 
choose a plan that they ultimately are unable to afford.
  Under a recent CMS administrative action, beneficiaries who have 
applied for the LIS subsidy could choose to delay their enrollment in 
the program until they receive notification of their eligibility for a 
subsidy. However, they still would be required to pay a late enrollment 
penalty. While enrolling late may allow a beneficiary to make a more 
informed decision regarding their prescription drug plan, it would not 
be fair to assess them a fee simply because there was administrative 
delay in processing their LIS application. Both of these scenarios 
place beneficiaries in an untenable position. For the enrollment 
process to be successful, beneficiaries need to have as much 
information available to them as possible so they may choose the 
prescription drug plan that best meets their preferences.
  The Outreach and Enrollment Enhancement Act provides a solution to 
this dilemma. The legislation creates a special 30-day enrollment 
period that begins on the day a beneficiary receives a decision 
regarding their LIS eligibility. Most importantly, the late enrollment 
penalty that would be imposed upon them under current law would be 
waived during the special enrollment period, in addition to the time it 
takes SSA to process their application. This small, yet significant, 
change to the existing enrollment process will allow LIS beneficiaries 
sufficient time to effectively consider and evaluate prescription drug 
plan options with all necessary information. We cannot afford to 
undermine seniors' trust in Medicare's prescription drug program by 
penalizing a certain group of beneficiaries for a problem that is 
created by the federal government.
  I understand that many of my colleagues prefer to address 
administrative issues with Medicare Part D at a later date, so that the 
initial implementation process can run its full course without undue 
interference from Congress. While I would agree with that argument in 
principle, there are a number of existing problems that only serve to 
tarnish Medicare's image if we allow them to linger much longer. I 
believe providing additional resources for outreach and educational 
services and correcting the LIS enrollment issue are two such problems 
that Congress should address immediately--before the May 15 deadline 
passes.
  The SSA has estimated that 80,000 beneficiaries might not have been 
notified of their LIS eligibility by the close of the first regular 
enrollment period. It would be entirely unfair to assess even one of 
these beneficiaries a late enrollment penalty, when by their 
understanding, they were playing by the rules CMS and SSA set forth 
regarding the low-income subsidy.
  I ask the Majority Leader and my colleagues to support my call for 
the Outreach and Enrollment Enhancement Act to be treated as an 
emergency measure and provide it quick passage in the Senate. By taking 
up this very targeted measure, Congress can demonstrate to America's 
seniors that we are committed to the continued success of the Medicare 
prescription drug program.
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