S. 2101Senate110th Congress (2007-2009)In Committee

Medicare Savings Program Improvement Act of 2007

Introduced September 26, 2007

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SenateIntro Referral Latest Action

Read twice and referred to the Committee on Finance. (text of measure as introduced: CR S12149-12153)

September 26, 2007

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SenateIntro Referral

Introduced in Senate

September 26, 2007

SenateIntro Referral

Sponsor introductory remarks on measure. (CR S12148-12149)

September 26, 2007

SenateIntro Referral

Read twice and referred to the Committee on Finance. (text of measure as introduced: CR S12149-12153)

September 26, 2007

Floor Debate

4 members

What members said about S. 2101 on the floor

3 Democrats1 Independent
Jeff Bingaman
Sen. Jeff BingamanD-NM · Sep 26, 2007

Mr. President, I rise today with Senators Kerry, Salazar and Stabenow to introduce the Medicare Savings Program Improvement Act of 2007. This legislation would make critical improvements to the…

Jeff Bingaman
Sen. Jeff BingamanD-NM · Sep 26, 2007

Mr. President, I rise today with Senators Kerry, Salazar and Stabenow to introduce the Medicare Savings Program Improvement Act of 2007. This legislation would make critical improvements to the…

Russell D. Feingold
Sen. Russell D. FeingoldD-WI · Sep 26, 2007

Mr. President, today I am introducing legislation to address an injustice in the Tax Code that is threatening family farmers and other self-employed individuals. Some of my constituents, primarily…

Bernard Sanders
Sen. Bernard SandersI-VT · Sep 26, 2007

Mr. President, today I am introducing the Increasing American Wages and Benefits Act of 2007. Since 2000, key economic indicators confirm that the economic security of Americans is moving in the…

Byron L. Dorgan
Sen. Byron L. DorganD-ND · Sep 26, 2007

Mr. President, today I am introducing, along with Senators Stevens, Schumer, Ensign, Kerry, Kohl, Feingold, Clinton, Feinstein, and Nelson of Florida, the Do-Not-Call Improvement Act of 2007. We seek…

Bill Text

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Introduced in SenateIssued September 26, 2007
        [Congressional Bills 110th Congress]
[From the U.S. Government Publishing Office]
[S. 2101 Introduced in Senate (IS)]

110th CONGRESS
1st Session
S. 2101

To amend title XIX of the Social Security Act to assist low-income
Medicare beneficiaries by improving eligibility and services under the
Medicare Savings Program, and for other purposes.

_______________________________________________________________________

IN THE SENATE OF THE UNITED STATES

September 26, 2007

Mr. Bingaman (for himself, Mr. Kerry, Mr. Salazar, and Ms. Stabenow)
introduced the following bill; which was read twice and referred to the
Committee on Finance

_______________________________________________________________________

A BILL

To amend title XIX of the Social Security Act to assist low-income
Medicare beneficiaries by improving eligibility and services under the
Medicare Savings 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; TABLE OF CONTENTS.

(a) Short Title.--This Act may be cited as the ``Medicare Savings
Program Improvement Act of 2007''.
(b) Table of Contents.--The table of contents of this Act is as
follows:

Sec. 1. Short title; table of contents.
Sec. 2. References to Medicare Savings Program.
Sec. 3. Increase in income levels for eligibility.
Sec. 4. Elimination of application of estate recovery for Medicare
Savings Program beneficiaries.
Sec. 5. Modification of asset test.
Sec. 6. Eligibility for other programs.
Sec. 7. Effective date of MSP benefits.
Sec. 8. Expediting eligibility under the Medicare Savings Program.
Sec. 9. Treatment of qualified medicare beneficiaries, specified low-
income medicare beneficiaries, and other
dual eligibles as Medicare beneficiaries.
Sec. 10. Medicaid treatment of certain medicare providers.
Sec. 11. Monitoring and enforcement of limitation on beneficiary
liability.
Sec. 12. State provision of medical assistance to dual eligibles in MA
plans.

SEC. 2. REFERENCES TO MEDICARE SAVINGS PROGRAM.

The low-income assistance programs for Medicare beneficiaries under
the Medicaid program under title XIX of the Social Security Act now
popularly referred to the ``QMB'' and ``SLMB'' programs are to be known
as the ``Medicare Savings Program''.

SEC. 3. INCREASE IN INCOME LEVELS FOR ELIGIBILITY.

(a) Increase to 135 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 ``135 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, 2008, is 135 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, 2008, is 135 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 150
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
2008, or 150 percent beginning in 2008''; and
(ii) by striking ``and'' at the end; and
(C) by striking clause (iv).
(2) 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)''.
(3) 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)(10)(E)(iii).''.
(c) Effective Date.--
(1) Except as provided in paragraph (2), the amendments
made by this section shall take effect on January 1, 2008, and,
with respect to title XIX of the Social Security Act, shall
apply to calendar quarters beginning on or after January 1,
2008.
(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. ELIMINATION OF APPLICATION OF ESTATE RECOVERY FOR MEDICARE
SAVINGS PROGRAM BENEFICIARIES.

(a) In General.--Section 1917(b)(1)(B)(ii) of the Social Security
Act (42 U.S.C. 1396p(b)(1)(B)(ii)) is amended by inserting ``(but not
including medical assistance for medicare cost-sharing or for benefits
described in section 1902(a)(10)(E))'' before the period at the end.
(b) Effective Date.--The amendment made by subsection (a) shall
apply to actions commencing on or after January 1, 2008.

SEC. 5. MODIFICATION OF ASSET TEST.

(a) For QMBs.--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)(C)) 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 2008 is six times the maximum amount of resources
that an individual may have and obtain benefits under the
supplemental security income program under title XVI; or
``(ii) for a subsequent year is the 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 individuals popularly known as
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 any pension or retirement plan or
account shall be taken into account.''.
(b) For SLMBs.--
(1) Permitting greater assets.--Section 1902(a)(10)(E)(iii)
of such Act (42 U.S.C. 1396b(a)(10)(E)(iii)) is amended by
inserting before the semicolon the following: ``or but for the
fact that their resources exceed the resource level specified
in section 1905(p)(6)(A) but does not exceed the resource level
specified in section 1905(p)(6)(B)''.
(2) Higher resource level specified.--Section 1905(p)(6) of
such Act, as inserted by subsection (a)(3), is amended by
inserting after subparagraph (A) the following new
subparagraph:
``(B) The resource level specified in this subparagraph for--
``(i) for 2008, 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.''.
(c) 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, 2008.
(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. 6. 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 4(a), is amended--
(1) by redesignating paragraph (7) as paragraph (8); and
(2) by inserting after paragraph (6) the following new
paragraph:
``(7) Medical assistance for some or all medicare cost-sharing
under this title shall not be treated as benefits or otherwise taken
into account in determining an individual's eligibility for, or the
amount of benefits under, any other Federal program.''.
(b) Effective Date.--The amendments made by subsection (a) shall
apply to eligibility for benefits on or after January 1, 2008.

SEC. 7. 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 ``described in subsection (p)(1), if
provided after the month'' and inserting ``described in
subsection (p)(1) or a specified low-income medicare
beneficiary described in section 1902(a)(10)(E)(iii), if
provided in or after the third month before the month in which
the individual expresses an interest in applying to become such
a beneficiary, as determined in the manner provided for
assistance under section 1860D-14''.
(2) Conforming amendments.--(A) The first sentence of
section 1902(e)(8) of such Act (42 U.S.C. 1396a(e)(8)), as
amended by section 4(c)(2), is amended by striking ``(8)'' and
the first sentence.
(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, 2008, but shall not result in eligibility for
benefits for medicare cost-sharing for months before January 2008.

SEC. 8. EXPEDITING ELIGIBILITY UNDER THE MEDICARE SAVINGS PROGRAM.

(a) Increasing Eligibility Through the Social Security Office.--
(1) In general.--Title XVIII of the Social Security Act is
amended by inserting after section 1808 the following new
section:

``expedited enrollment under the medicare savings program through
social security offices

``Sec. 1809.  (a) In General.--The Secretary shall provide, in
cooperation with the Commissioner of Social Security, for an expedited
process under this section for individuals to apply and qualify for
benefits under the Medicare Savings Program. For purposes of this
section, the term `Medicare Savings Program' means medical assistance
for medicare cost-sharing (as defined in section 1905(p)(3)) for
qualified medicare beneficiaries and specified low-income medicare
beneficiaries under title XIX.
``(b) Process.--The process shall be consistent with the following:
``(1) Coordination with social security and medicare
enrollment process.--The application shall be part of the
process for applying for benefits under title II and this
title.
``(2) Simplified application process.--The application may
be made over the Internet, by telephone, or by mail, without
the need for an interview in person by the applicant or a
representative of the applicant.
``(3) Contents of application.--The application shall
contain a description (in English, Spanish and other languages
determined appropriate by the Secretary) of the availability of
and the requirements for obtaining benefits under the Medicare
Savings Program.
``(4) Training.--Employees of the Social Security office
involved shall be trained to assist individuals completing such
applications.
``(5) Self-certification and verification.--In determining
whether an individual is eligible for benefits under the
Medicare Savings Program, the Secretary shall permit
individuals to qualify on the basis of self certifications of
income and resources meeting applicable standards without the
need to provide additional documentation. The Secretary shall
verify that information provided in the application is correct.
``(6) Transmittal of application.--
``(A) Eligible applicants.--In the case of an
applicant determined by the Social Security office to
be eligible for benefits under the Medicare Savings
Program based on income and resources meeting the
standards otherwise applicable, the office shall
transmit to the applicable State Medicaid office the
application so that the applicant can be enrolled
within 30 days based on the information collected by
the office.
``(B) Use of electronic transfer system.--Not later
than two years after the date of implementation of
improvements of the electronic data transfer system
under section 8(c) of the Medicare Savings Program
Improvement Act of 2007, the process under this
paragraph shall use the such system for information
transmittal.
``(C) Ineligible applicants.--In the case of other
applicants whose income and resources do not meet such
standards, the Social Security office shall transmit to
the applicable State Medicaid office the application so
that the application may be considered under State
standards that may be more generous than the standards
otherwise generally applicable.
The process under this subsection shall be established and implemented
one year after the date of the enactment of this section.
``(c) Distribution of Application Form.--The Secretary shall
distribute the application form used under subsection (b) to any
organization that requests them, including entities receiving grants
from the Secretary for programs designed to provide services to
individuals 65 years of age or older and people with disabilities. The
Commissioner of Social Security shall make such forms available at
local offices of the Social Security Administration.
``(d) State Response and Application Process.--
``(1) In general.--In the case of an application
transmitted under subsection (b)(6), the State agency
responsible for determinations of eligibility for benefits
under the State's Medicare Savings Program--
``(A) shall make a determination on the application
within 30 days of the date of its receipt; and
``(B) shall notify the applicant of the
determination within 10 days after it is made.
``(2) Use of simplified application process.--In the case
of an application other than an application transmitted under
subsection (b)(6), a State plan under title XIX shall provide
that an application for benefits under the Medicare Savings
Program may be made over the Internet, by telephone, or by
mail, without the need for an interview in person by the
applicant or a representative of the applicant.
``(e) Expedited Application and Eligibility Process.--
``(1) Expedited process.--
``(A) In general.--As part of the expedited process
for obtaining benefits under the Medicare Savings
Program, the Secretary shall through a request to the
Secretary of the Treasury to obtain information
sufficient to identify whether the individual involved
is likely eligible for such benefits based on such
information and the type of assistance under the
Medicare Savings Program for which they would qualify
based on such information. Such process shall be
conducted in cooperation with the Commissioner of
Social Security.
``(B) Opt in for newly eligible individuals.--Not
later than 60 days after the date of the enactment of
this subsection, the Secretary shall ensure that, as
part of the Medicare enrollment process, enrolling
individuals--
``(i) receive information describing the
Medicare Savings Program provided under this
section; and
``(ii) are provided the opportunity to opt-
in to the expedited process described in this
subsection by requesting that the Commissioner
of Social Security screen the individual
involved for eligibility for the Medicare
Savings Program through a request to the
Secretary of the Treasury under section
6103(l)(21) of the Internal Revenue Code of
1986.
``(C) Transition for currently eligible
individuals.--In the case of any Medicare Savings
Program eligible individual to which subparagraph (B)
did not apply at the time of such individual's
enrollment, the Secretary shall, not later than 60 days
after the date of the implementation of subparagraph
(B), request that the Commissioner of Social Security
screen such individual for eligibility for the Medicare
Savings Program provided under this section through a
request to the Secretary of the Treasury under section
6103(l)(21) of the Internal Revenue Code of 1986.
``(2) Notification of potentially eligible individuals.--
Under such process, in the case of each individual identified
under paragraph (1) who has not otherwise applied for, or been
determined eligible for, benefits under the Medicare Savings
Program (or who has applied for and been determined ineligible
for such benefits based only on standards in effect before
January 1, 2008), the Secretary shall send them a letter (using
basic, uncomplicated language) containing the following:
``(A) Eligibility.--A statement that, based on the
information obtained under process under this section,
the individual is likely eligible for benefits under
the Medicare Savings Program.
``(B) Amount of assistance.--A description of the
amount of assistance under such program for which the
individual would likely be eligible based on such
information.
``(C) Attestation.--A one-page application form
that provides for a signed attestation, under penalty
of law, as to the amount of income and assets of the
individual and constitutes an application for the
benefits under the Medicare Savings Program. Such
form--
``(i) shall not require the submittal of
additional documentation regarding income or
assets; and
``(ii) shall allow for the specification of
a language (other than English) that is
preferred by the individual for subsequent
communications with respect to the individual
under this title and title XIX.
``(D) Information on outreach groups.--Information
on how the individual may contact the a State outreach
effort or other groups that receive grants from the
Secretary to conduct outreach to individuals to receive
benefits under the Medicare Savings Program.
``(3) Follow-up communications.--If the individual does not
respond to the letter described in paragraph (2) by completing
an attestation described in paragraph (2)(C) or declining to do
so, the Secretary shall make additional attempts to contact the
individual to obtain such an affirmative response.
``(4) Hold-harmless.--Under such process, if an individual
in good faith and in the absence of fraud executes an
attestation described in paragraph (2)(C) and is provided
benefits under the Medicare Savings Program on the basis of
such attestation, if the individual is subsequently found not
eligible for such benefits, there shall be no recovery made
against the individual because of such benefits improperly
paid.
``(5) Use of preferred language in subsequent
communications.--In the case an attestation described in
paragraph (2)(C) is completed and in which a language other
than English is specified under clause (ii) of such paragraph,
the Secretary shall provide that subsequent communications to
the individual under this subsection shall be in such language.
``(6) Construction.--Nothing in this subsection shall be
construed as precluding the Secretary from taking additional
outreach efforts to enroll eligible individuals under the
Medicare Savings Program.
``(f) Electronic Communication Between Social Security and State
Medicaid Agencies and the Secretary.--
``(1) Notice by social security to secretary and state
medicaid agencies.--In the case of a determination of
eligibility of an individual under section 1860D-14(a)(3)(B)(i)
by the Commissioner of Social Security, the Commissioner shall
provide for notice, preferably in electronic form, to the
Secretary and to State medicaid agency under title XIX of such
determination for purposes of enabling the individual to
automatically qualify for benefits under the Medicare Savings
Program under such title through the operation of section
1905(p)(8).
``(2) Notice by states to secretary.--In the case that the
State determines that an individual is a qualified medicare
beneficiary or a specified low-income medicare beneficiary
under title XIX, the State shall provide for notice, preferably
in electronic form, to the Secretary of such determination for
purposes of enabling the individual to automatically qualify
for low-income subsidies under section 1860D-14 through the
operation of section 1905(a)(3)(G).
``(3) Deadline.--Each State (as defined for purposes of
title XIX) and the Secretary shall establish the notification
process described in this subsection not later than 1 year
after the date of the enactment of this section.''.
(2) Disclosure of return information for purposes of
screening individuals for eligibility for benefits under the
medicare savings program.--
(A) In general.--Subsection (l) of section 6103 of
the Internal Revenue Code of 1986 is amended by adding
at the end the following new paragraph:
``(21) Disclosure of return information for purposes of
providing benefits under the medicare savings program.--
``(A) Return information from internal revenue
service to social security administration.--The
Secretary, upon written request from the Commissioner
of Social Security under section 1809(e)(1)(A) of the
Social Security Act, shall disclose to the Commissioner
with respect to any taxpayer identified by the
Commissioner--
``(i)(I) whether the adjusted gross income,
as modified in accordance with specifications
of the Secretary of Health and Human Services
for purposes of carrying out such section, of
such taxpayer and, if applicable, such
taxpayer's spouse, for the applicable year,
exceeds the amounts specified by the Secretary
of Health and Human Services in order to apply
the 135 and 150 percent poverty lines under
section 1905(p) and section 1902(a)(10)(E)(ii)
of such Act;
``(II) the adjusted gross income (as
determined under subclause (I)), in the case of
a taxpayer with respect to which such adjusted
gross income exceeds the amount so specified
for applying the 135 percent poverty line and
does not exceed the amount so specified for
applying the 150 percent poverty line;
``(III) whether the return was a joint
return for the applicable year; and
``(IV) the applicable year; or
``(ii) if applicable, the fact that there
is no return filed for such taxpayer for the
applicable year.
``(B) Definition of applicable year.--For the
purposes of this paragraph, the term `applicable year'
means the most recent taxable year for which
information is available in the Internal Revenue
Service's taxpayer data information systems, or, if
there is no return filed for such taxpayer for such
year, the prior taxable year.
``(C) Restriction on individuals for whom
disclosure is requested.--The Commissioner of Social
Security shall only request information under this
paragraph with respect to individuals who have
requested that such request be made under section
1809(e) of the Social Security Act.
``(D) Return information from social security
administration to department of health and human
services.--The Commissioner of Social Security shall,
upon written request from the Secretary of Health and
Human Services, disclose to the Secretary of Health and
Human Services the information described in clauses (i)
and (ii) of subparagraph (A).
``(E) Permissive disclosure to officers, employees,
and contractors.--The information described in clauses
(i) and (ii) of subparagraph (A) may be disclosed among
officers, employees, and contractors of the Social
Security Administration and the Department of Health
and Human Services for the purposes described in
subparagraph (F).
``(F) Restriction on use of disclosed
information.--Return information disclosed under this
paragraph may be used only for the purposes of
identifying eligible individuals for, and
administering--
``(i) low-income subsidies under section
1860D-14 of the Social Security Act; and
``(ii) the Medicare Savings Program
implemented under clauses (i) and (ii) of
section 1902(a)(10)(E) of such Act.''.
(B) Confidentiality.--Paragraph (3) of section
6103(a) of such Code is amended by striking ``or (20)''
and inserting ``(20), or (21)''.
(C) Procedures and record keeping related to
disclosures.--Paragraph (4) of section 6103(p) of such
Code is amended by striking ``or (20)'' each place it
appears and inserting ``(20), or (21)''.
(D) Unauthorized disclosure or inspection.--
Paragraph (2) of section 7213(a) of such Code is
amended by striking ``or (20)'' and inserting ``(20),
or (21)''.
(b) Two-Way Deeming Between Medicare Savings Program and Low-Income
Subsidy Program.--
(1) Medicare savings program.--Section 1905(p) of the
Social Security Act (42 U.S.C. 1396d(p)), as amended by
sections 4(a) and 5(a), is amended--
(A) by redesignating paragraph (8) as paragraph
(9); and
(B) by inserting after paragraph (7) the following
new paragraph:
``(8) An individual who has been determined eligible for premium
and cost-sharing subsidies under--
``(A) section 1860D-14(a)(1) is deemed, for purposes of
this title and without the need to file any additional
application, to be a qualified medicare beneficiary for
purposes of this title; or
``(B) section 1860D-14(a)(2) is deemed, for purposes of
this title and without the need to file any additional
application, to qualify for medical assistance as a specified
low-income medicare beneficiary (described in section
1902(a)(10)(E)(iii)).''.
(2) Low-income subsidy program.--Section 1860D-14(a)(3) of
such Act (42 U.S.C. 1395w-104(a)(3)) is amended by adding at
the end the following new subparagraph:
``(G) Deemed treatment for qualified medicare
beneficiaries and specified low-income medicare
beneficiaries.--
``(i) Qmbs eligible for full subsidy.--A
part D eligible individual who has been
determined for purposes of title XIX to be a
qualified medicare beneficiary is deemed, for
purposes of this part and without the need to
file any additional application, to be a
subsidy eligible individual described in
paragraph (1).
``(ii) Slmbs eligible for partial
subsidy.--A part D eligible individual who has
been determined to be a specified low-income
medicare beneficiary (as defined in section
1905(p)(1)) and who is not described in
paragraph (1) is deemed, for purposes of this
part and without the need to file any
additional application, to be a subsidy
eligible individual who is not described in
paragraph (1).''.
(3) Effective date.--The amendments made by this subsection
shall apply to eligibility for months beginning on or after
January 2008.
(c) Improvements in Electronic Communication Between Social
Security, State Medicaid Agencies, and the Secretary of Health and
Human Services.--
(1) In general.--Not later than two years after the date of
the enactment of this Act, the Commissioner of Social Security,
the Secretary of Health and Human Services, and the directors
of State Medicaid agencies shall implement improvements to the
electronic data transfer system by which they communicate
directly and electronically with each other with respect to
individuals who have enrolled for benefits under any part of
the Medicare Savings Program in order to ensure that each of
them has exactly the same list of beneficiaries who are signed
up for the Medicare Savings Program.
(2) Increased administrative match.--In order to implement
paragraph (1)--
(A) the Medicaid administrative match under section
1903(a)(7) of the Social Security Act shall be
increased to 75 percent with respect to expenditures
made in carrying out such paragraph; and
(B) there is appropriated to the Commissioner of
Social Security and the Secretary of Health and Human
Services, from any amounts in the Treasury not
otherwise appropriated, $2,000,000 each for each of
fiscal years 2008 and 2009 to implement paragraph (1).
(3) Use of system.--After the implementation of the
improvements to the electronic data transfer system under
paragraph (1), the Commissioner of Social Security, State
Medicaid agencies, and the Secretary of Health and Human
Services shall primarily use this system for the Commissioner
and the Secretary to inform the State Medicaid agencies to
enroll a beneficiary for the Medicare Savings Program.
(d) Improved Coordination With State, Local, and Other Partners.--
(1) State grants.--
(A) In general.--The Secretary of Health and Human
Services shall enter into contracts with States (as
defined for purposes of title XIX of the Social
Security Act (42 U.S.C. 1396 et seq.) to provide funds
to States to use information identified under
subsection (c), and other appropriate information, in
order to do ex parte determinations or utilize other
methods for identifying and enrolling individuals who
are potentially--
(i) eligible for benefits under the
Medicare Savings Program (under sections
1905(p) of the Social Security Act, 42 U.S.C.
1396d(p)); or
(ii) entitled to a premium or cost-sharing
subsidy under section 1860D-14 of such Act (42
U.S.C. 1395w-114).
(B) Authorization of appropriations.--There are
authorized to be appropriated such sums as may be
necessary to the Secretary of Health and Human Services
for the purpose of making contracts under this
paragraph.
(2) Funding of state health insurance counseling and
similar programs.--
(A) Authorization of appropriations.--In addition
to any other funds authorized to be appropriated, there
are authorized to be appropriated $3,000,000 for each
of calendar years 2008 through 2012 to carry out
activities described in subparagraph (B).
(B) Activities described.--The activities described
in this subparagraph are the following:
(i) Activities under section 4360 of the
Omnibus Budget Reconciliation Act of 1990 for
the purpose of outreach to low-income Medicare
beneficiaries to assist in applying for and
obtaining benefits under the Medicare Savings
Program (under title XIX of the Social Security
Act) and the low-income subsidy program under
section 1860D-14 of such Act.
(ii) Activities of the National Center on
Senior Benefits Outreach and Enrollment (as
described in section 202(a)(20)(B) of the Older
Americans Act of 1965 (42 U.S.C.
3012(a)(20)(B)).
(iii) Similar activities carried out by
other qualified agencies designated by the
Secretary of Health and Human Services.

SEC. 9. 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. 10. 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:
``(4) 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.''.
(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. 11. MONITORING AND ENFORCEMENT OF LIMITATION ON BENEFICIARY
LIABILITY.

Section 1902(n) of the Social Security Act (42 U.S.C. 1396b(n)), as
amended by section 9(a), is further amended by adding at the end the
following new paragraph:
``(5)(A) The Inspector General of the Department of Health
and Human Services shall examine, not later than one year after
the date of the enactment of this paragraph and every three
years thereafter, whether providers have attempted to make
qualified medicare beneficiaries liable for deductibles,
coinsurance, and co-payments in violation of paragraph (3)(B).
The Inspector General shall submit to the Secretary a report on
such examination and a finding as to whether qualified medicare
beneficiaries have been held liable in violation of such
paragraph.
``(B) If a report under subparagraph (A) includes a finding
that qualified medicare beneficiaries have been held liable in
violation of such paragraph, 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 provisions of such paragraph.''.

SEC. 12. 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 10, is further amended by
adding at the end the following new paragraph:
``(6)(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, not later than one year after
the date of the enactment of this paragraph and every three
years thereafter, 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 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.--
(1) Except as provided in paragraph (2), the amendment made
by subsection (a) shall apply to calendar quarters beginning on
or after the date of the enactment of this Act.
(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 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 such session shall be deemed to be a
separate regular session of the State legislature.
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