II 

115TH CONGRESS 

1ST SESSION S. 1909 

To amend title XVIII of the Social Security Act to establish a system 

to educate individuals approaching Medicare eligibility, to simplify and 

modernize the eligibility enrollment process, and for other purposes. 

IN THE SENATE OF THE UNITED STATES 

OCTOBER 3, 2017 

Mr. CASEY (for himself and Mr. YOUNG) introduced the following bill; which 

was read twice and referred to the Committee on Finance 

A BILL 

To amend title XVIII of the Social Security Act to establish 

a system to educate individuals approaching Medicare 

eligibility, to simplify and modernize the eligibility enrollment process, and for other purposes. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Beneficiary Enrollment 

5 Notification and Eligibility Simplification Act of 2017’’ or 

6 the ‘‘BENES Act of 2017’’. 


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1 SEC. 2. ELIGIBILITY AND ENROLLMENT NOTIFICATION. 

2 (a) NOTIFICATION REQUIREMENTS.—Section 1804 

3 of the Social Security Act (42 U.S.C. 1395b–2) is amend4 ed by adding at the end the following new subsection: 

5 ‘‘(d) ELIGIBILITY INFORMATION.— 

6 ‘‘(1) COORDINATION OF NOTICE.—The Sec7 retary, in consultation with representatives of each 

8 of the groups described in paragraph (2)(A), and in 

9 coordination with the Commissioner of Social Secu10 rity and the Secretary of the Treasury, shall prepare 

11 and distribute a notice, in accordance with this sub12 section, to potentially eligible Medicare individuals. 

13 ‘‘(2) GROUPS FOR CONSULTATION.— 

14 ‘‘(A) IN GENERAL.—For purposes of para15 graph (1), the groups described in this subpara16 graph include the following: 

17 ‘‘(i) Individuals who are more than 60 

18 years of age. 

19 ‘‘(ii) Individuals with disabilities. 

20 ‘‘(iii) Individuals with end stage renal 

21 disease. 

22 ‘‘(iv) Low-income individuals and fam23 ilies. 

24 ‘‘(v) Employers (including human re25 sources professionals). 


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1 ‘‘(vi) States (including representatives 

2 of State-run Health Insurance Exchanges, 

3 Medicaid offices, and Departments of In4 surance). 

5 ‘‘(vii) State Health Insurance Assist6 ance Programs. 

7 ‘‘(viii) Health insurers. 

8 ‘‘(ix) Health insurance agents and 

9 brokers. 

10 ‘‘(x) Such other groups as specified by 

11 the Secretary. 

12 ‘‘(B) NONAPPLICATION OF FACA.—The 

13 Federal Advisory Committee Act shall not apply 

14 to consultations made pursuant to paragraph 

15 (1) with groups described in subparagraph (A). 

16 ‘‘(3) CONTENTS OF NOTICE.—The notice re17 quired under paragraph (1) shall contain informa18 tion on (including a clear, simple explanation of)— 

19 ‘‘(A)(i) eligibility for benefits under this 

20 title, and in particular benefits under part B; 

21 ‘‘(ii) the possibility of a late enrollment 

22 penalty for failure to timely enroll (including 

23 the availability of equitable relief); and 

24 ‘‘(iii) how to access the Webpage described 

25 in paragraph (5); and 


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1 ‘‘(B) the need for coordination of benefits 

2 under part B (including secondary and primary 

3 coverage scenarios) imposed under this title, in4 cluding the effects of enrollment in retiree 

5 health coverage; group health coverage; cov6 erage under a group health plan provided by an 

7 employer pursuant to title XXII of the Public 

8 Health Service Act, section 4980B of the Inter9 nal Revenue Code of 1986, or title VI of the 

10 Employee Retirement Income Security Act of 

11 1974; coverage under a qualified health plan of12 fered through an Exchange established under 

13 title I of the Patient Protection and Affordable 

14 Care Act; and other widely available coverage 

15 which may be available to potentially eligible 

16 Medicare individuals. 

17 ‘‘(4) TIMING OF NOTICE TO POTENTIAL EN18 ROLLEES.—Beginning one year after the date of the 

19 enactment of this subsection, a notice required 

20 under paragraph (1) shall be mailed to each poten21 tially eligible Medicare individual no less than two 

22 times in accordance with the following: 

23 ‘‘(A) The notice shall be provided to such 

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1 bination with the individual’s Social Security 

2 statement. 

3 ‘‘(B) In the case that the individual does 

4 not receive a Social Security statement, such 

5 notice shall be mailed no later than 3 months 

6 prior to the date of such individual’s initial en7 rollment period as provided under section 1837 

8 and shall subsequently be provided to such indi9 vidual no later than one month prior to such 

10 date. 

11 ‘‘(5) CREATION OF A CENTRALIZED ENROLL12 MENT WEBPAGE.—The information contained in no13 tices required under this subsection shall be made 

14 available through a new Webpage to be maintained 

15 by the Secretary. Such Webpage shall include both 

16 Social Security and Medicare online tools in a co17 ordinated and organized manner, and shall also con18 tain, or link to, such other eligibility tools, services, 

19 notices (including with respect to the availability of 

20 equitable relief), and other information as deter21 mined by the Secretary, in consultation with groups 

22 described in paragraph (2) for the purposes of being 

23 available to potentially eligible Medicare individuals. 

24 ‘‘(6) INTERAGENCY COORDINATION.—Beginning 

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1 ment of this subsection, the Secretary, along with 

2 the Secretary of the Treasury and the Commissioner 

3 of the Social Security Administration, shall under4 take all necessary action and coordination to identify 

5 potentially eligible individuals and in order to pro6 vide such individuals with notifications under this 

7 subsection in accordance with paragraph (4). 

8 ‘‘(7) NOTIFICATION IMPROVEMENT.—The Sec9 retary shall, no less than once every fiscal year, re10 view the content of the notices required under this 

11 subsection and the practices of providing such no12 tices to individuals, and shall update and revise such 

13 notices and practices as the Secretary deems appro14 priate. 

15 ‘‘(8) POTENTIALLY ELIGIBLE MEDICARE INDI16 VIDUAL DEFINED.—For purposes of this subsection, 

17 the term ‘potentially eligible Medicare individual’ 

18 means an individual, with respect to a month, who 

19 is expected to satisfy the description in paragraph 

20 (1) or (2) of section 1836 during such month or 

21 during any of the subsequent 11 months.’’. 

22 (b) DISCLOSURE AUTHORITY.—Section 6103(l) of 

23 the Internal Revenue Code of 1986 is amended by adding 

24 at the end the following new paragraph: 


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1 ‘‘(23) DISCLOSURE OF RETURN INFORMATION

2 TO CARRY OUT ELIGIBILITY NOTIFICATION REQUIRE3 MENTS FOR CERTAIN PROGRAMS.— 

4 ‘‘(A) IN GENERAL.—The Secretary, upon 

5 request from the Secretary of Health and 

6 Human Services, shall disclose to officers, em7 ployees, and contractors of the Department of 

8 Health and Human Services and the Social Se9 curity Administration return information of any 

10 taxpayer who is a potentially eligible Medicare 

11 individual (as defined in section 1804(d)(8) of 

12 the Social Security Act). Such return informa13 tion shall be limited to— 

14 ‘‘(i) taxpayer identity information 

15 with respect to such taxpayer, including 

16 the age and address or other location of 

17 such taxpayer, 

18 ‘‘(ii) the filing status of such tax19 payer, 

20 ‘‘(iii) such other information as is pre21 scribed by the Secretary of Health and 

22 Human Services by regulation as might in23 dicate whether the taxpayer is eligible for 

24 coverage under such title, and 


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1 ‘‘(iv) the taxable year with respect to 

2 which the preceding information relates or, 

3 if applicable, the fact that such informa4 tion is not available. 

5 ‘‘(B) RESTRICTION ON USE OF DISCLOSED

6 INFORMATION.—Return information disclosed 

7 under subparagraph (A) may be used by offi8 cers, employees, and contractors of the Depart9 ment of Health and Human Services or the So10 cial Security Administration only for the pur11 poses of, and to the extent necessary in, estab12 lishing potential eligibility for benefits under 

13 title XVIII of the Social Security Act.’’. 

14 (c) COMPUTER MATCHING AGREEMENT.—Not later 

15 than 6 months after the date of the enactment of this Act, 

16 the Secretary of Health and Human Services, the Sec17 retary of the Treasury, and the Commissioner of Social 

18 Security shall enter into a computer matching agreement 

19 pursuant to section 552a(o) of title 5 of the United States 

20 Code for the purposes of implementing section 1804(d) of 

21 the Social Security Act, as added by subsection (a), and 

22 section 6103(l)(23) of the Internal Revenue Code of 1986, 

23 as added by subsection (b). 

24 (d) REPORT TO CONGRESS.—Not later than 4 years 

25 after the date of the enactment of this Act, the Secretary 


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1 of Health and Human Services, the Secretary of the 

2 Treasury, and the Commissioner of Social Security shall 

3 submit to Congress a report on the process taken by the 

4 relevant agencies in implementing the notice requirement 

5 under subsection (d) of section 1804 of the Social Security 

6 Act (42 U.S.C. 1395b–2), as added by subsection (a) of 

7 this section, the status of notices created pursuant to such 

8 section, and an evaluation of the effect of such notices on 

9 enrollment under title XVIII of the Social Security Act. 

10 Such report shall be made publicly available. 

11 SEC. 3. BENEFICIARY MEDICARE PART B ENROLLMENT PE12 RIODS AND EFFECTIVE DATE OF COVERAGE. 

13 (a) EFFECTIVE DATES.—Section 1838(a) of the So14 cial Security Act (42 U.S.C. 1395q(a)) is amended— 

15 (1) by amending paragraph (2) to read as fol16 lows: 

17 ‘‘(2)(A) in the case of an individual who enrolls 

18 pursuant to subsection (d) of section 1837 before 

19 the month in which he first satisfies paragraph (1) 

20 or (2) of section 1836, the first day of such month, 

21 ‘‘(B) in the case of an individual not described 

22 in subparagraph (A) who first satisfies such para23 graph in a month beginning before January 2019 

24 and who enrolls— 


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1 ‘‘(i) pursuant to such subsection (d) in 

2 such month in which he first satisfies such 

3 paragraph, the first day of the month following 

4 the month in which he so enrolls, 

5 ‘‘(ii) pursuant to such subsection (d) in the 

6 month following such month in which he first 

7 satisfies such paragraph, the first day of the 

8 second month following the month in which he 

9 so enrolls, or 

10 ‘‘(iii) pursuant to such subsection (d) more 

11 than one month following such month in which 

12 he satisfies such paragraph, the first day of the 

13 third month following the month in which he so 

14 enrolls, 

15 ‘‘(C) in the case of an individual not described 

16 in subparagraph (A) who enrolls pursuant to sub17 section (e) of section 1837 in a month beginning be18 fore January 2019, the July 1 following the month 

19 in which he so enrolls, 

20 ‘‘(D) in the case of an individual not described 

21 in subparagraph (A) who first satisfies such para22 graph in a month beginning on or after January 1, 

23 2019, and who enrolls pursuant to such subsection 

24 (d) in such month in which he first satisfies such 

25 paragraph or in any subsequent month, the first day 


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1 of the month following the month in which he so en2 rolls, or 

3 ‘‘(E) in the case of an individual not described 

4 in subparagraph (A) who enrolls pursuant to sub5 section (e) of section 1837 in a month beginning on 

6 or after October 15, 2018, the first day of the 

7 month following the month in which he so enrolls.’’; 

8 and 

9 (2) by amending paragraph (3) to read as fol10 lows: 

11 ‘‘(3)(A) in the case of an individual who is 

12 deemed to have enrolled on or before the last day of 

13 the third month of his initial enrollment period be14 ginning before January 1, 2019, the first day of the 

15 month in which he first meets the applicable require16 ments of section 1836 or July 1, 1973, whichever is 

17 later, or 

18 ‘‘(B) in the case of an individual who is deemed 

19 to have enrolled on or after the first day of the 

20 fourth month of his initial enrollment period begin21 ning before January 1, 2019, as prescribed under 

22 subparagraphs (B)(i), (B)(ii), (B)(iii), and (C) of 

23 paragraph (2) of this subsection.’’. 


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1 (b) GENERAL AND SPECIAL ENROLLMENT PERI2 ODS.—Section 1837(e) of the Social Security Act (42 

3 U.S.C. 1395p(e)) is amended to read as follows: 

4 ‘‘(e) ENROLLMENT PERIODS.— 

5 ‘‘(1) FOR COVERAGE DURING YEARS BEFORE

6 2019.—There shall be a general enrollment period 

7 during the period beginning on January 1 and end8 ing on March 31 of each year before 2019. 

9 ‘‘(2) FOR COVERAGE DURING YEARS BEGINNING

10 WITH 2019.—For 2019 and each subsequent year: 

11 ‘‘(A) IN GENERAL.—Subject to subpara12 graph (B), there shall be a general enrollment 

13 period beginning on October 15 of the previous 

14 year through December 31 of such previous 

15 year. 

16 ‘‘(B) EXCEPTIONAL CIRCUMSTANCES.— 

17 The Secretary shall establish special enrollment 

18 periods in the case of a potentially eligible 

19 Medicare individual (as defined in section 

20 1804(d)(8)) who meets such exceptional condi21 tions as the Secretary may provide.’’. 

22 (c) TECHNICAL CORRECTION.—Section 1839(b) of 

23 the Social Security Act (42 U.S.C. 1395r(b)) is amended 


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1 by striking ‘‘close of the enrollment period’’ each place it 

2 appears and inserting ‘‘close of the month’’. 

Æ 


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