Medicare Savings Program Improvement Act of 2009 - Amends title XVIII (Medicare) of the Social Security Act (SSA) to increase the income eligibility level to 150% of the federal poverty level (FPL) for benefits under the Medicare Savings Program (MSP) for qualified Medicare beneficiaries.
Expands the Specified Low-Income Medicare Beneficiary (SLMB) Program to provide for the eligibility of individuals with incomes below 200% of FPL.
Establishes an asset standard for qualified Medicare beneficiary (QMB) eligibility for 2011 of $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) with subsequent years standard increased by the annual percentage increase in the consumer price index.
Exempts pension benefits and life insurance policies from resources under the MSP programs.
Prohibits any medical assistance for some or all Medicare cost-sharing under the MSP programs from being considered income or resources in determining eligibility for, or the amount of assistance or benefits provided under, any other federal, state, or local public benefit program.
Authorizes treatment of QMBs, SLMBs, and other dual eligibles as Medicare beneficiaries.
Prohibits a state plan under SSA title XIX (Medicaid) from denying a claim from a provider or supplier with respect to Medicare cost-sharing for an eligible item or service on the basis that the provider or supplier does not have a Medicaid provider agreement in effect or does not otherwise serve all individuals entitled to Medicaid. Requires the state to create a mechanism through which providers or suppliers that do not otherwise have Medicaid provider agreements with the state can bill the state for Medicare cost-sharing for QMBs.
Requires each state to: (1) identify those individuals who are Medicaid-eligible for Medicare cost-sharing and who are enrolled with a MedicareAdvantage (MA) plan; and (2) provide for Medicaid payment with respect to such individuals for the Medicare cost-sharing to which they are entitled.
Requires the award of grants to: (1) states for outreach regarding Medicare enrollment assistance and benefit availability; and (2) Aging and Disability Resource Centers.
Makes the date of the electronic transmission of low income subsidy (LIS) program data from the Commissioner of Social Security to the state Medicaid agency the date of filing of the application for MSP benefits
Requires a state Medicaid plan to provide that the state enters into a modification of a Medicaid agreement with the Secretary to provide for enrollment in (buy-in to) the Medicare part A (Hospital Insurance) program by QMBs who are uninsured elderly individuals not otherwise eligible for hospital insurance benefits.
Requires states to: (1) make MSP applications available on the Internet; and (2) allow individuals to specify a preferred language other than English for subsequent communication.
Requires a state Medicaid plan to provide that the state coordinates with the state agency that administers the supplemental nutrition assistance program (SNAP) benefits under the Food and Nutrition Act of 2008 to ensure that individuals applying for Medicaid have the opportunity to apply for, establish eligibility for, and, if eligible, receive SNAP program benefits.
Repeals payment limitations on Medicare cost-sharing.
[Congressional Bills 111th Congress]
[From the U.S. Government Publishing Office]
[H.R. 2716 Introduced in House (IH)]
111th CONGRESS
1st Session
H. R. 2716
To amend title XIX of the Social Security Act to provide financial
stability for seniors and people with disabilities through improvements
in the Medicare Savings Program.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
June 4, 2009
Mr. Becerra (for himself and Mr. Doggett) 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 XIX of the Social Security Act to provide financial
stability for seniors and people with disabilities through improvements
in the Medicare Savings Program.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE; TABLE OF CONTENTS.
(a) Short Title.--This Act may be cited as the ``Medicare Savings
Program Improvement Act of 2009''.
(b) Table of Contents.--The table of contents of this Act is as
follows:
Sec. 1. Short title; table of contents.
Sec. 2. Increase in income levels for eligibility.
Sec. 3. Modification of resource standards.
Sec. 4. Eligibility for other programs.
Sec. 5. Effective date of MSP benefits.
Sec. 6. Treatment of qualified Medicare beneficiaries, specified low-
income Medicare beneficiaries, and other
dual eligibles as medicare beneficiaries.
Sec. 7. Monitoring and enforcement of limitation on beneficiary
liability.
Sec. 8. Medicaid treatment of certain Medicare providers.
Sec. 9. State provision of medical assistance to dual eligibles in MA
plans.
Sec. 10. Medicare enrollment assistance.
Sec. 11. Medicaid agency consideration of low-income subsidy
application and data transmittal.
Sec. 12. QMB buy-in of part A and part B premiums.
Sec. 13. Increasing availability of MSP applications through
availability on the Internet and
designation of preferred language.
Sec. 14. Medicare savings program applications.
Sec. 15. Repeal of payment limitation.
SEC. 2. INCREASE IN INCOME LEVELS FOR ELIGIBILITY.
(a) Increase to 150 Percent of FPL for Qualified Medicare
Beneficiaries.--
(1) In general.--Section 1905(p)(2) of the Social Security
Act (42 U.S.C. 1396d(p)(2)) is amended--
(A) in subparagraph (A), by striking ``100
percent'' and inserting ``150 percent'';
(B) 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
(C) 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.''.
(2) Application of income test based on family size.--
Section 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.''.
(3) Not counting in-kind support and maintenance as
income.--Section 1905(p)(2)(D) of such Act (42 U.S.C.
1396d(p)(2)(D)) is amended by adding at the end the following
new clause:
``(iii) In determining income under this
subsection, support and maintenance furnished
in kind shall not be counted as income.''.
(b) Expansion of Specified Low-Income Medicare Beneficiary (SLMB)
Program.--
(1) Eligibility of individuals with incomes below 200
percent of fpl.--Section 1902(a)(10)(E) of the Social Security
Act (42 U.S.C. 1396b(a)(10)(E)) is amended--
(A) by adding ``and'' at the end of clause (ii);
(B) 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 in 2011 and years
thereafter''; and
(ii) by striking ``and'' at the end; and
(C) by striking clause (iv).
(2) References.--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)(13)(iii).''.
(c) Providing 100 Percent Federal Financing.--The 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: ``and with
respect to medical assistance for Medicare cost-sharing provided under
section 1902(a)(10)(E)(iii) and under section 1902(a)(10)(E)(i) with
respect to individuals with income (as determined in accordance with
subsection (p)(1)(B)) is greater than 100 percent of the official
income poverty line applicable to a family of the size involved''.
(d) Effective Date.--
(1) Except as provided in paragraph (2), the amendments
made by this section 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.
(2) 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 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
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.
SEC. 3. MODIFICATION OF RESOURCE STANDARDS.
(a) In General.--Section 1905(p) of the Social Security Act (42
U.S.C. 1396d(p)) is amended--
(1) in paragraph (1), by amending subparagraph (C) to read
as follows:
``(C) whose resources (as determined under section
1613 for purposes of the supplemental income security
program, except as provided in paragraph (6)(B)) do not
exceed the amount described in paragraph (6)(A).'';
(2) by redesignating paragraph (6) as paragraph (7); and
(3) by inserting after paragraph (5) the following:
``(6)(A) The resource level specified in this subparagraph for--
``(i) for 2011, is $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
``(ii) for a subsequent year is the applicable resource
level specified in this subparagraph 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.
Any dollar amount established under clause (ii) that is not a multiple
of $10 shall be rounded to the nearest multiple of $10.
``(B) In determining the resources of an individual (and their
eligible spouse, if any) under section 1613 for purposes of paragraph
(1)(C) (relating to qualified Medicare beneficiaries) or section
1902(a)(10)(E)(iii) (relating to specified low-income medicare
beneficiaries), the following additional exclusions shall apply:
``(i) No part of the value of any life insurance policy
shall be taken into account.
``(ii) 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''.
(b) Effective Date.--
(1) Except as provided in paragraph (2), the amendments
made by this section shall apply to calendar quarters beginning
on or after January 1, 2011.
(2) 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 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
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.
SEC. 4. ELIGIBILITY FOR OTHER PROGRAMS.
(a) In General.--Section 1905(p) of the Social Security Act (42
U.S.C. 1396d(p)), as amended by section 2(a), is amended--
(1) by redesignating paragraph (7) as paragraph (8); and
(2) by inserting after paragraph (6) the following new
paragraph:
``(7) 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.''.
(b) Effective Date.--The amendments made by subsection (a) shall
apply to eligibility for benefits on or after January 1, 2010.
SEC. 5. EFFECTIVE DATE OF MSP BENEFITS.
(a) Providing for 3 Months Retroactive Eligibility.--
(1) In general.-- Section 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) Conforming amendments.--(A) Section 1902(e)(8) of such
Act (42 U.S.C. 1396a(e)(8)) is amended--
(i) by striking the first sentence; and
(ii) by striking ``such determination''.
(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 eligibility.--In 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) Effective Date.--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.
SEC. 6. TREATMENT OF QUALIFIED MEDICARE BENEFICIARIES, SPECIFIED LOW-
INCOME MEDICARE BENEFICIARIES, AND OTHER DUAL ELIGIBLES
AS MEDICARE BENEFICIARIES.
(a) In General.--Section 1862 of the Social Security Act (42 U.S.C.
1395y) is amended by adding at the end the following new subsection:
``(n) Treatment of Qualified Medicare Beneficiaries (QMBs),
Specified Low-Income Medicare Beneficiaries (SLMBs), and Other Dual
Eligibles.--Nothing in this title shall be construed as authorizing a
provider of services or supplier to discriminate (through a private
contractual arrangement or otherwise) against an individual who is
otherwise entitled to services under this title on the basis that the
individual is a qualified medicare beneficiary (as defined in section
1905(p)(1)), a specified low-income medicare beneficiary, or is
otherwise eligible for medical assistance for medicare cost-sharing or
other benefits under title XIX.''.
(b) Effective Date.--The amendment made by subsection (a) shall
apply to items and services furnished on or after the date of the
enactment of this Act.
SEC. 7. MONITORING AND ENFORCEMENT OF LIMITATION ON BENEFICIARY
LIABILITY.
(a) In General.--Section 1902(n) of the Social Security Act (42
U.S.C. 1396b(n)) is amended--
(1) by striking paragraph (2); and
(2) in paragraph (3)--
(A) by striking ``In the case in which'' and all
that follows through `` the application of paragraph
(2)'' and inserting ``With respect to an item or
service'';
(B) in subparagraph (A), by striking ``(if any)'';
and
(C) by redesignating such paragraph as paragraph
(2).
(b) Conforming Amendment.--Section 1905(p)(2) of such Act (42
U.S.C. 1396d(p)(2)) is amended by striking ``(subject to section
1902(n))''.
(c) Effective Date.--The amendments made by this section shall
apply to items and services furnished on or after January 1, 2011.
SEC. 8. MEDICAID TREATMENT OF CERTAIN MEDICARE PROVIDERS.
(a) In General.--Section 1902(n) of the Social Security Act (42
U.S.C. 1396a(n)) is amended by adding at the end the following new
paragraph:
``(3) A State plan shall not deny a claim from a provider or
supplier with respect to medicare cost-sharing described in
subparagraph (B), (C), or (D) of section 1905(p)(3) for an item or
service which is eligible for payment under title XVIII on the basis
that the provider or supplier does not have a provider agreement in
effect under this title or does not otherwise serve all individuals
entitled to medical assistance under this title. The State shall create
a mechanism through which provider or suppliers that do not otherwise
have provider agreements with the State can bill the State for medicare
cost-sharing for qualified medicare beneficiaries.''.
(b) Effective Date.--The amendment made by subsection (a) shall
apply to items and services furnished on or after the date of the
enactment of this Act.
SEC. 9. STATE PROVISION OF MEDICAL ASSISTANCE TO DUAL ELIGIBLES IN MA
PLANS.
(a) In General.--Section 1902(n) of the Social Security Act (42
U.S.C. 1396b(n)), as amended by section 8(a), is further 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 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, not later than one year after
the date of the enactment of this paragraph, 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.''.
(b) Effective Date.--The amendment made by subsection (a) shall be
effective as if included in the enactment of the Medicare Prescription
Drug, Improvement, and Modernization Act of 2003 (Public Law 108-173).
SEC. 10. MEDICARE ENROLLMENT ASSISTANCE.
(a) Additional Funding for State Health Insurance Assistance
Programs.--
(1) Grants.--
(A) In general.--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) Funding.--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) Amount of grants.--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) Allocation to states.--
(A) Allocation based on percentage of low-income
beneficiaries.--The 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
beneficiaries.--The 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 program.--Each 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) Grants.--
(A) In general.--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) Funding.--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 beneficiaries.--The 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) Required use of funds.--
(A) All funds.--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 program.--Subsection (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) Grants.--
(A) In general.--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) Funding.--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) Required use of funds.--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) In general.--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) Funding.--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 Defined.--For 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).
SEC. 11. MEDICAID AGENCY CONSIDERATION OF LOW-INCOME SUBSIDY
APPLICATION AND DATA TRANSMITTAL.
(a) Conforming Amendment to Section 1144.--The first sentence of
section 1144(c)(3) of the Social Security Act (42 U.S.C. 1320b-
14(c)(3)), as added by section 113(a) of Public Law 110-275, is
amended--
(1) by striking ``transmittal''; and
(2) by inserting ``as specified in section 1935(a)(4)''
before the period at the end.
(b) Clarifying Amendment to Section 1935.--Section 1935(a)(4) of
the Social Security Act (42 U.S.C. 1396u-5(a)(4)), as added by section
113(b) of Public Law 110-275, is amended by striking the last sentence
and inserting the following: ``For the purpose of a State's obligation
under section 1902(a)(8) to furnish medical assistance with reasonable
promptness, the date of the electronic transmission of low income
subsidy program data, as described in section 1144(c), from the
Commissioner of Social Security to the State Medicaid Agency, shall
constitute the date of filing of such application for benefits under
the Medicare Savings Program. For the purpose of determining when such
medical assistance will be made available, the State shall consider the
date of the individual's application for the low income subsidy program
to constitute the date of filing of an application for benefits under
the Medicare Savings Program.''.
(c) Effective Date.--The amendments made by this section are
effective as if they had been included in the enactment of section
113(b) of Public Law 110-275.
(d) OIG Study.--The Inspector General of the Department of Health
and Human Services shall examine the extent to which States are
complying with the requirement, under amendments made by the Medicare
Improvements for Patients and Providers Act of 2008 (Public Law 110-
275), that they initiate an application for Medicare Savings Program
from data of the Social Security Administration suggesting eligibility.
SEC. 12. QMB BUY-IN OF PART A AND PART B PREMIUMS.
(a) Requirement.--Section 1902(a) of the Social Security Act (42
U.S.C. 1396a(a)) is amended--
(1) in paragraph (72), by striking ``and'' at the end;
(2) in paragraph (73), by striking the period at the end
and inserting ``; and''; and
(3) by inserting after paragraph (73) the following new
paragraph:
``(74) provide that the State enters into a modification of
an agreement under section 1818(g).''.
(b) Effective Date.--
(1) In general.--Except as provided in paragraph (2), the
amendments made by this section take effect on the first day of
the first calendar quarter beginning 6 months after the date of
the enactment of this Act.
(2) Extension of effective date for state law amendment.--
In 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.
SEC. 13. INCREASING AVAILABILITY OF MSP APPLICATIONS THROUGH
AVAILABILITY ON THE INTERNET AND DESIGNATION OF PREFERRED
LANGUAGE.
(a) Requirement for States.--
(1) In general.--Section 1902(a) of the Social Security Act
(42 U.S.C. 1396a(a)), as amended by section 12, is amended--
(A) in paragraph (73), by striking ``and''at the
end;
(B) in paragraph (74), by striking the period at
the end and inserting ``; and''; and
(C) by inserting after paragraph (74) the following
new paragraph:
``(75) 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) Effective date.--The amendments made by this subsection
take effect on and after the first day of the first calendar
quarter beginning 2 years after the date of the enactment of
this Act.
(b) Requirement for the Secretary.--Section 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.''
SEC. 14. MEDICARE SAVINGS PROGRAM APPLICATIONS.
(a) In General.--Section 1902(a) of the Social Security Act (42
U.S.C. 1396a(a)), as amended by sections 12 and 13, is further
amended--
(1) in paragraph (74), by striking ``and''at the end;
(2) in paragraph (75), by striking the period at the end
and inserting ``; and''; and
(3) by inserting after paragraph (75) the following new
paragraph:
``(76) 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
paragraph (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.''.
(b) Effective Date.--
(1) In general.--Except as provided in paragraph (2), the
amendments made by subsection (a) take effect on the first day
of the first calendar quarter beginning 6 months after the date
of the enactment of this Act.
(2) Extension of effective date for state law amendment.--
In 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 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 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.
(c) Report to Congress.--Not later than 1 year 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)(76) of the Social Security Act, as
added by subsection (a).
SEC. 15. REPEAL OF PAYMENT LIMITATION.
(a) In General.--Section 1902(n) of the Social Security Act (42
U.S.C. 1396a(n)) is amended--
(1) by striking paragraphs (2) and (3); and
(2) in paragraph (1)--
(A) by striking ``(n)(1)'' and inserting ``(n)'';
and
(B) by striking ``may provide'' and inserting
``shall provide''.
(b) Conforming Amendments.--(1) Section 1902(a)(10) of such Act is
amended, in the subclause (VIII) following subparagraph (G), by
striking ``subsection (n) and''.
(2) Section 1905(p)(2) of such Act (42 U.S.C. 1396d(p)(2)) is
amended by striking ``(subject to section 1902(n))''.
(c) Effective Date.--The amendments made by this section shall
apply to items and services furnished on or after January 1, 2010.
<all>
Introduced in House
Introduced in House
Sponsor introductory remarks on measure. (CR E1325-1326)
Referred to House Energy and Commerce
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.
Referred to House Ways and Means
Referred to the Subcommittee on Health.
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