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[Congressional Bills 111th Congress]
[From the U.S. Government Publishing Office]
[S. 1185 Introduced in Senate (IS)]

111th CONGRESS
  1st Session
                                S. 1185

To amend titles XVIII and XIX of the Social Security Act to ensure that 
low-income beneficiaries have improved access to health care under the 
                    Medicare and Medicaid programs.

_______________________________________________________________________

                   IN THE SENATE OF THE UNITED STATES

                              June 4, 2009

 Mr. Bingaman introduced the following bill; which was read twice and 
                  referred to the Committee on Finance

_______________________________________________________________________

                                 A BILL

 
To amend titles XVIII and XIX of the Social Security Act to ensure that 
low-income beneficiaries have improved access to health care under the 
                    Medicare and Medicaid programs.

    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 Financial 
Stability for Beneficiaries 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. Eligibility for other programs.
Sec. 3. Cost-sharing protections for low-income subsidy-eligible 
                            individuals.
Sec. 4. Modification of resource standards for determination of 
                            eligibility for LIS; no consideration of 
                            pension or retirement plan in determination 
                            of resources.
Sec. 5. Increase in income levels for eligibility.
Sec. 6. Effective date of MSP benefits.
Sec. 7. Expanding special enrollment process to individuals eligible 
                            for an income-related subsidy.
Sec. 8. Enhanced cost-sharing protections for full-benefit dual 
                            eligible individuals and qualified medicare 
                            beneficiaries.
Sec. 9. Two-way deeming between Medicare Savings Program and Low-Income 
                            Subsidy Program.
Sec. 10. Improving linkages between health programs and snap.
Sec. 11. Expediting low-income subsidies under the Medicare 
                            prescription drug program.
Sec. 12. Enhanced oversight and enforcement relating to reimbursements 
                            for retroactive LIS enrollment.
Sec. 13. Intelligent assignment in enrollment.
Sec. 14. Medicare enrollment assistance.
Sec. 15. QMB buy-in of part A and part B premiums.
Sec. 16. Increasing availability of MSP applications through 
                            availability on the internet and 
                            designation of preferred language.
Sec. 17. State Medicaid agency consideration of low-income subsidy 
                            application and data transmittal.

SEC. 2. ELIGIBILITY FOR OTHER PROGRAMS.

    (a) LIS.--Section 1860D-14(a)(3) of the Social Security Act (42 
U.S.C. 1395w-114(a)(3)), as amended by section 116 of the Medicare 
Improvements for Patients and Providers Act of 2008 (Public Law 110-
275), is amended--
            (1) in subparagraph (A), in the matter preceding clause 
        (i), by striking ``subparagraph (F)'' and inserting 
        ``subparagraphs (F) and (H)''; and
            (2) by adding at the end the following new subparagraph:
                    ``(H) Disregard of premium and cost-sharing 
                subsidies for purposes of federal and state programs.--
                Notwithstanding any other provision of law, any premium 
                or cost-sharing subsidy with respect to a subsidy-
                eligible individual under this section 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) MSP.--Section 1905(p) of the Social Security Act (42 U.S.C. 
1396d(p)) is amended--
            (1) by redesignating paragraph (6) as paragraph (7); and
            (2) by inserting after paragraph (5) the following new 
        paragraph:
    ``(6) 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''.
    (c) Effective Date.--The amendments made by this section shall 
apply to eligibility for benefits on or after January 1, 2010.

SEC. 3. COST-SHARING PROTECTIONS FOR LOW-INCOME SUBSIDY-ELIGIBLE 
              INDIVIDUALS.

    (a) In General.--Section 1860D-14(a) of the Social Security Act (42 
U.S.C. 1395w-114(a)) is amended--
            (1) in paragraph (1)(D), by adding at the end the following 
        new clause:
                            ``(iv) Overall limitation on cost-
                        sharing.--In the case of all such individuals, 
                        a limitation on aggregate cost-sharing under 
                        this part for a year not to exceed 2.5 percent 
                        of income.''; and
            (2) in paragraph (2), by adding at the end the following 
        new subparagraph:
                    ``(F) Overall limitation on cost-sharing.--A 
                limitation on aggregate cost-sharing under this part 
                for a year not to exceed 2.5 percent of income.''.
    (b) Effective Date.--The amendments made by subsection (a) shall 
apply as of January 1, 2010.

SEC. 4. MODIFICATION OF RESOURCE STANDARDS FOR DETERMINATION OF 
              ELIGIBILITY FOR LIS; NO CONSIDERATION OF PENSION OR 
              RETIREMENT PLAN IN DETERMINATION OF RESOURCES.

    (a) Eliminating the Bifurcation of Resource Standards.--
            (1) In general.--Section 1860D-14(a)(3)(A)(iii) of the 
        Social Security Act (42 U.S.C. 1395w-114(a)(3)(A)(iii)) is 
        amended by striking ``meets the'' and all that follows through 
        the period at the end and inserting ``meets--
                                    ``(I) in the case of determinations 
                                made before January 1, 2011, the 
                                resource requirement described in 
                                subparagraph (D) or (E); and
                                    ``(II) in the case of 
                                determinations made on or after January 
                                1, 2011, the resource requirement 
                                described in subparagraph (E).''.
            (2) Conforming amendment.--Section 1860D-14(a)(3)(D)(ii) of 
        the Social Security Act (42 U.S.C. 1395w-114(a)(3)(D)(ii)) is 
        amended by inserting ``(before 2011)'' after ``a subsequent 
        year''.
    (b) Increasing the Applicable Resource Standard.--Section 1860D-
14(a)(3)(E) of the Social Security Act (42 U.S.C. 1395w-
114(a)(3)(E)(i)) is amended--
            (1) in the heading, by striking ``Alternative'' and 
        inserting ``Applicable'';
            (2) in clause (i)--
                    (A) in subclause (I), by striking ``and'' at the 
                end;
                    (B) in subclause (II)--
                            (i) by inserting ``(before 2011)'' after 
                        ``a subsequent year'';
                            (ii) by striking the period at the end and 
                        inserting a semicolon; and
                            (iii) by inserting before the flush 
                        sentence at the end the following new 
                        subclauses:
                                    ``(III) for 2011, $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
                                    ``(IV) for a subsequent year the 
                                dollar amounts specified in this 
                                subclause (or subclause (III)) 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.''; and
                    (C) in the flush sentence at the end, by inserting 
                ``or (IV)'' after ``subclause (II)''.
    (c) Exclusion of Pension and Retirement Benefits From Resources.--
            (1) In general.--Section 1860D-14(a)(3) of the Social 
        Security Act (42 U.S.C. 1395w-114(a)(3)), as amended by section 
        2, is amended--
                    (A) in subparagraph (E)(i), in the matter preceding 
                subclause (I), by inserting ``and the pension or 
                retirement plan exclusion provided under subparagraph 
                (I)'' after ``(G)''; and
                    (B) by adding at the end the following new 
                subparagraph:
                    ``(I) Pension and retirement benefits exclusion.--
                In determining the resources of an individual (and the 
                eligible spouse of the individual, if any) under 
                section 1613 for purposes of subparagraph (E) 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.''.
            (2) Effective date.--The amendments made by this subsection 
        shall apply to determinations made on or after January 1, 2011.
    (d) Application of Applicable Resource Standard Under Medicare 
Savings Program and Exemptions From Income and Resources.--
            (1) Application of applicable resource standard and 
        exemptions from resources.--Section 1905(p)(1)(C) of the Social 
        Security Act (42 U.S.C. 1396d(p)(1)(C)) is amended--
                    (A) by inserting ``without taking into account any 
                part of the value of any life insurance policy or any 
                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)'' 
                after ``(as so determined''; and
                    (B) by striking ``subparagraph (D)'' and all that 
                follows through ``section)'' and inserting ``section 
                1860D-14(a)(3)(E)''.
            (2) Exemption of in-kind support and maintenance.--
                    (A) In general.--Section 1905(p)(1)(B) of the 
                Social Security Act (42 U.S.C. 1396d(p)(1)(B)) is 
                amended by inserting ``and except that support and 
                maintenance furnished in kind shall not be counted as 
                income'' after ``(2)(D)''.
                    (B) Conforming amendment.--Section 1860D-
                14(a)(3)(C)(i) of the Social Security Act (42 U.S.C. 
                1395w-114(a)(3)(C)(i)) is amended by striking ``and 
                except that support and maintenance furnished in kind 
                shall not be counted as income''.
            (3) Effective date.--The amendments made by this subsection 
        shall apply to determinations made on or after January 1, 2011.
    (e) Clarification Relating to Including Retirement Benefits as 
Income.--Nothing in subparagraph (I) of section 1860D-14(a)(3) of the 
Social Security Act (42 U.S.C. 1395w-114(a)(3)), as added by subsection 
(c)(1), or section 1905(p)(1)(C) of such Act (42 U.S.C. 
1396d(p)(1)(C)), as amended by subsection (d)(1), shall be construed as 
affecting the inclusion of retirement benefits as income under section 
1612(a)(2)(B) of such Act (42 U.S.C. 1382a(a)(2)(B)).

SEC. 5. INCREASE IN INCOME LEVELS FOR ELIGIBILITY.

    (a) LIS.--
            (1) In general.--Section 1860D-14(a) of the Social Security 
        Act (42 U.S.C. 1395w-114(a)) is amended--
                    (A) in the subsection heading, by striking ``150'' 
                and inserting ``200'';
                    (B) in paragraph (1)--
                            (i) in the heading, by striking ``135'' and 
                        inserting ``150''; and
                            (ii) in the matter preceding subparagraph 
                        (A), by striking ``135'' and inserting ``150'';
                    (C) in paragraph (2)--
                            (i) in the heading, by striking ``150'' and 
                        inserting ``200''; and
                            (ii) in subparagraph (A)--
                                    (I) by striking ``135'' and 
                                inserting ``150''; and
                                    (II) by striking ``150'' and 
                                inserting ``200''; and
                    (D) in paragraph (3)(A)(ii), by striking ``150'' 
                and inserting ``200''.
            (2) Effective date.--The amendments made by this subsection 
        shall apply to determinations made on or after January 1, 2011.
    (b) MSP.--
            (1) Increase to 150 percent of fpl for qualified medicare 
        beneficiaries.--
                    (A) In general.--Section 1905(p)(2) of the Social 
                Security Act (42 U.S.C. 1396d(p)(2)) is amended--
                            (i) in subparagraph (A), by striking ``100 
                        percent'' and inserting ``150 percent'';
                            (ii) 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
                            (iii) 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.''.
                    (B) 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.''.
            (2) Expansion of specified low-income medicare beneficiary 
        (slmb) program.--
                    (A) 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--
                            (i) by adding ``and'' at the end of clause 
                        (ii);
                            (ii) 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 beginning in 2011''; and
                                    (II) by striking ``and'' at the 
                                end; and
                            (iii) by striking clause (iv).
                    (B) Revision to description.--Section 
                1902(a)(10)(E)(iii) of the Social Security Act (42 
                U.S.C. 1396b(a)(10)(E)(iii)) is amended by striking 
                ``who would be qualified medicare'' and all that 
                follows through ``but is less than'' and inserting 
                ``whose income (as determined in accordance with 
                subparagraphs (B) and (C) of section 1905(p)(1)) is 
                less than''.
                    (C) 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).''.
            (3) 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: ``, with respect to medical assistance for medicare 
        cost-sharing provided under clause (i) of section 
        1902(a)(10)(E) for individuals with incomes greater than 100 
        percent of the official poverty line described in subsection 
        (p)(2)(A) and less than or equal to 150 percent of such 
        official poverty line, and with respect to medical assistance 
        for medicare cost-sharing provided under clause (iii) of such 
        section''.
            (4) Effective date.--
                    (A) Except as provided in subparagraph (B), the 
                amendments made by this subsection 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.
                    (B) 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 subsection, 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. EFFECTIVE DATE OF MSP BENEFITS.

    (a) In General.--
            (1) Effective date of msp benefits.--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 the 
        Social Security Act (42 U.S.C. 1396a(e)(8)) is amended by 
        striking 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, 2010, but shall not result in eligibility for 
benefits for medicare cost-sharing for months before January 2010.

SEC. 7. EXPANDING SPECIAL ENROLLMENT PROCESS TO INDIVIDUALS ELIGIBLE 
              FOR AN INCOME-RELATED SUBSIDY.

    (a) In General.--Section 1860D-1(b)(1)(C) of the Social Security 
Act (42 U.S.C. 1395w-101(b)(1)(C)) is amended--
            (1) by striking ``a full-benefit dual eligible individual 
        (as defined in section 1935(c)(6))'' and inserting ``a subsidy-
        eligible individual (as defined in section 1860D-14(a)(3))''; 
        and
            (2) by striking ``1860D-14(a)(1)(A)'' and inserting 
        ``subsection (a)(1)(A) or (b)(1)(A) of section 1860D-14, as 
        applicable''
    (b) Effective Date.--The amendments made by this section shall 
apply to enrollments on or after January 1, 2010.

SEC. 8. ENHANCED COST-SHARING PROTECTIONS FOR FULL-BENEFIT DUAL 
              ELIGIBLE INDIVIDUALS AND QUALIFIED MEDICARE 
              BENEFICIARIES.

    (a) Elimination of Part D Cost-Sharing for Certain Non-
Institutionalized Full-Benefit Dual Eligible Individuals.--Section 
1860D-14(a)(1)(D)(i) of the Social Security Act (42 U.S.C. 1395w-
114(a)(1)(D)(i)) is amended--
            (1) in the heading, by striking ``Institutionalized 
        individuals.--In'' and inserting ``Elimination of cost-sharing 
        for certain full-benefit dual eligible individuals.--
                                    ``(I) Institutionalized 
                                individuals.--In''; and
            (2) by adding at the end the following new subclause:
                                    ``(II) Certain other individuals.--
                                In the case of an individual who is a 
                                full-benefit dual eligible individual 
                                who is receiving home and community 
                                based care (whether under section 1915 
                                or under a waiver under section 1115), 
                                the elimination of any beneficiary 
                                coinsurance described in section 1860D-
                                2(b)(2) (for all amounts through the 
                                total amount of expenditures at which 
                                benefits are available under section 
                                1860D-2(b)(4)).''.
    (b) Repeal of Authority for States To Pay Medicare Cost-Sharing at 
Medicaid Rates and Provision of Medical Assistance to Dual Eligibles in 
MA Plans.--
            (1) Repeal of authority for states to pay medicare cost-
        sharing at medicaid rates.--Section 1902(n) of the Social 
        Security Act (42 U.S.C. 1396a(n)) is amended--
                    (A) by striking paragraph (2);
                    (B) by redesignating paragraph (3) as paragraph 
                (2);
                    (C) in paragraph (2), as redesignated by 
                subparagraph (B)--
                            (i) in the matter preceding subparagraph 
                        (A)--
                                    (I) by striking ``In the case in 
                                which a State's payment for'' and 
                                inserting ``With respect to''; and
                                    (II) by striking ``with respect to 
                                an item or service is reduced or 
                                eliminated through the application of 
                                paragraph (2)'' and inserting ``for an 
                                item or service''; and
                            (ii) in subparagraph (A), by striking ``(if 
                        any)''; and
                    (D) by adding at the end the following new 
                paragraph:
            ``(3) Each State shall establish procedures for receiving 
        and processing claims for payment for medicare cost-sharing 
        with respect to items or services furnished to qualified 
        medicare beneficiaries by providers of services and suppliers 
        under title XVIII who are not participating providers under the 
        State plan.''.
            (2) Provision of medical assistance to dual eligibles in ma 
        plans.--Section 1902(n) of the Social Security Act (42 U.S.C. 
        1396a(n)), as amended by paragraph (1), is 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, not later than one year after 
        the date of the enactment of this paragraph and every 3 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.''.
            (3) Conforming amendments.--
                    (A) Provider agreements.--Section 1866(a)(1)(A)(ii) 
                of the Social Security Act (42 U.S.C. 
                1395cc(a)(1)(A)(ii)) is amended by striking 
                ``1902(n)(3)'' and inserting ``1902(n)(2)''.
                    (B) Nonparticipating providers.--Section 
                1848(g)(3)(A) of the Social Security Act (42 U.S.C. 
                1395w-4(g)(3)(A)) is amended by striking 
                ``1902(n)(3)(A)'' and inserting ``1902(n)(2)(A)''.
            (4) Effective date.--
                    (A) In general.--Except as provided in subparagraph 
                (B), the amendments made by this subsection shall take 
                effect on the date of enactment of this Act.
                    (B) Exception.--The amendment made by paragraph (2) 
                shall be effective and apply as if included in the 
                enactment of the Medicare Prescription Drug, 
                Improvement, and Modernization Act of 2003 (Public Law 
                108-173).

SEC. 9. TWO-WAY DEEMING BETWEEN MEDICARE SAVINGS PROGRAM AND LOW-INCOME 
              SUBSIDY PROGRAM.

    (a) Low-Income Subsidy Program.--Section 1860D-14(a)(3) of the 
Social Security Act (42 U.S.C. 1395w-104(a)(3)), as amended by section 
4, is amended by adding at the end the following new subparagraph:
                    ``(J) 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).''.
    (b) Medicare Savings Program.--Section 1905(p) of the Social 
Security Act (42 U.S.C. 1396d(p)), as amended by section 4, is 
amended--
            (1) by redesignating paragraph (8) as paragraph (9); and
            (2) 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)).''.
    (c) Effective Date.--The amendments made by this section shall 
apply to eligibility for months beginning on or after January 2010.

SEC. 10. IMPROVING LINKAGES BETWEEN HEALTH PROGRAMS AND SNAP.

    (a) Low-Income Part D Subsidy Program.--Section 1144(c) of the 
Social Security Act (42 U.S.C. 1320b-14(c)) is amended--
            (1) in paragraph (1)(C) by striking ``an application for 
        benefits under the Medicare Savings Program.'' and inserting 
        ``applications for benefits under the Medicare Savings Program 
        and the supplemental nutrition assistance program.'';
            (2) by striking paragraph (3) and inserting the following:
            ``(3) Transmittal of data to states.--
                    ``(A) In general.--Beginning on January 1, 2010, 
                with the consent of an individual completing an 
                application for benefits described in paragraph (1)(B), 
                the Commissioner shall electronically transmit data 
                from such application--
                            ``(i) to the appropriate State Medicaid 
                        agency, as determined by the Commissioner, 
                        which transmittal shall initiate an application 
                        of the individual for benefits under the 
                        Medicare Savings Program with the State 
                        Medicaid agency; and
                            ``(ii) to the appropriate State agency 
                        which administers benefits under the 
                        supplemental nutrition assistance program, as 
                        determined by the Commissioner, which 
                        transmittal shall initiate an application of 
                        the individual for benefits under the 
                        supplemental nutrition assistance program with 
                        the State agency that administers that program.
                    ``(B) Consultation regarding content, time, form, 
                frequency and manner of transmission.--In order to 
                ensure that such data transmittal provides effective 
                assistance for purposes of State adjudication of 
                applications for benefits under the Medicare Savings 
                Program and the supplemental nutrition assistance 
                program, the Commissioner shall consult with the 
                Secretary after the Secretary has consulted with the 
                States, regarding the content, form, frequency, and 
                manner in which data (on a uniform basis for all 
                States) shall be transmitted under this paragraph.'';
            (3) in paragraph (5), by adding at the end the following 
        new subparagraph:
                    ``(D) Supplemental nutrition assistance program 
                administrative costs.--The costs of the Social Security 
                Administration's work related to the supplemental 
                nutrition assistance program under this subsection 
                shall be eligible for reimbursement under section 
                11(j)(2)(C) of the Food and Nutrition Act of 2008 (7 
                U.S.C. 2020(j)(2)(C)). To the extent necessary the 
                Commissioner and the Secretary of Agriculture shall 
                revise any memoranda of understanding in effect under 
                such section.''; and
            (4) by adding at the end the following new paragraph:
            ``(8) Supplemental nutrition assistance program defined.--
        For purposes of this subsection, the term `supplemental 
        nutrition assistance program' means the program of temporary 
        benefits authorized under section 11(v) of the Food and 
        Nutrition Act of 2008 (7 U.S.C. 2020(v)).''.
    (b) Temporary Supplemental Nutrition Assistance Benefits.--Section 
11 of the Food and Nutrition Act of 2008 (7 U.S.C. 2020) is amended by 
adding at the end the following:
    ``(v) Temporary Benefits for Medicare Part D Low Income Subsidy 
Applicants.--
            ``(1) Definition of medicare part d low income subsidy 
        applicant.--In this subsection, the term `Medicare part D low 
        income subsidy applicant' means an individual, along with any 
        other family members, whose low income subsidy application 
        information has been electronically transmitted to the State 
        agency under section 1144(c)(3) of the Social Security Act (42 
        U.S.C. 1320b-14(c)(3)).
            ``(2) Provision of temporary benefits.--A State agency 
        shall provide temporary supplemental nutrition assistance 
        program benefits to a Medicare part D low income subsidy 
        applicant whose--
                    ``(A) income does not exceed 150 percent of the 
                poverty line (as determined in accordance with section 
                5(c)(1)); and
                    ``(B) financial resources do not exceed the limit 
                in effect in the State for such households under 
                section 5.
            ``(3) Determination based on medicare information.--For 
        purposes of determining eligibility under paragraph (2) and the 
        amount of temporary benefits under paragraph (5), information 
        on household members, household income, and household resources 
        from the Medicare part D low income subsidy application as 
        transmitted to the State agency under section 1144(c)(3) of the 
        Social Security Act (42 U.S.C. 1320b-14(c)(3)) shall satisfy 
        the requirements of this Act with regard to--
                    ``(A) the members of the household under section 
                3(n); and
                    ``(B) the gross income and financial resources of 
                the household under section 5.
            ``(4) Temporary benefit period.--A household shall receive 
        temporary supplemental nutrition assistance benefits under this 
        subsection for a period of not more than 2 months.
            ``(5) Temporary benefit amount.--
                    ``(A) In general.--During the temporary benefit 
                period under paragraph (4), except as provided in 
                subparagraph (B), a household shall receive a monthly 
                amount of supplemental nutrition assistance program 
                benefits calculated under section 8(a).
                    ``(B) Calculation.--In calculating benefits under 
                subparagraph (A)--
                            ``(i) the benefits shall be determined 
                        based on the gross income of the household 
                        rather than net income; and
                            ``(ii) the minimum allotment described in 
                        the proviso in section 8(a) shall be equal to 
                        40 percent of the cost of the thrifty food plan 
                        for a household containing 1 member, as 
                        determined by the Secretary under section 3, 
                        rounded to the nearest whole dollar increment.
            ``(6) Determination of future eligibility.--During the 
        temporary benefit period under paragraph (4), the State agency 
        shall provide to the household--
                    ``(A) an application to apply for benefits under 
                the other provisions of this Act; and
                    ``(B) an opportunity to complete the application 
                process by the month immediately following the 
                temporary benefit period, without a delay or suspension 
                in the benefits of the household.
            ``(7) Limitation.--This subsection shall not apply to 
        individuals who--
                    ``(A) are members of households that currently 
                receive benefits under this Act; or
                    ``(B) have received benefits under this subsection 
                in the preceding 12-month period.''.
    (c) Medicare Savings Program Applications.--
            (1) In general.--Section 1902(a) of the Social Security Act 
        (42 U.S.C. 1396a(a)) is amended--
                    (A) in paragraph (72), by striking ``and'' at the 
                end;
                    (B) in paragraph (73), by striking the period at 
                the end and inserting ``; and''; and
                    (C) by inserting after paragraph (73) the following 
                new paragraph:
            ``(74) 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 
        section 1902(a)(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.''.
            (2) Effective date.--
                    (A) In general.--Except as provided in subparagraph 
                (B), the amendments made by paragraph (1) take effect 
                on the date that is 1 year after the date of enactment 
                of this Act.
                    (B) 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 paragraph (1), 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.
            (3) Report to congress.--Not later than 2 years 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)(74) of the Social Security Act, as added by subsection 
        (c).

SEC. 11. EXPEDITING LOW-INCOME SUBSIDIES UNDER THE MEDICARE 
              PRESCRIPTION DRUG PROGRAM.

    (a) Targeted Outreach for Low-Income Subsidies.--
            (1) In general.--Section 1860D-14 of the Social Security 
        Act (42 U.S.C. 1395w-114) is amended by adding at the end the 
        following new subsection:
    ``(e) Targeted Outreach for Low-Income Subsidies.--
            ``(1) Targeted identification of subsidy-eligible 
        individuals.--
                    ``(A) In general.--The Commissioner of Social 
                Security shall provide for the identification of 
                individuals who are potentially eligible for low-income 
                assistance under this section through requests to the 
                Secretary of the Treasury in accordance with the 
                criterion established under section 6103(l)(21) of the 
                Internal Revenue Code of 1986 for information 
                indicating whether the individual involved is likely 
                eligible for such assistance.
                    ``(B) Initiation of identifications.--Not later 
                than 90 days after the date of the enactment of this 
                subsection, the Commissioner of Social Security shall 
                begin the identification of individuals through the 
                process described in subparagraph (A) and shall, by 
                such date and through such process, submit to the 
                Secretary of the Treasury requests for part D eligible 
                individuals who the Commissioner has identified as 
                potentially eligible for low-income subsidies under 
                this section before such date of enactment.
            ``(2) Notification of potentially eligible individuals.--In 
        the case of each individual identified under paragraph (1) who 
        has not otherwise applied for, or been determined eligible for, 
        benefits under this section (or who has applied for and been 
        determined ineligible for such benefits based on excess income, 
        resources, or both), the Commissioner shall transmit by mail to 
        the individual a letter including the information and 
        application required to be provided under subparagraphs (A), 
        (B), and (D) of section 1144(c)(1).
            ``(3) Follow-up communications.--If an individual to whom a 
        letter is transmitted under paragraph (2) does not 
        affirmatively respond to such letter either by making an 
        enrollment, completing an application, or declining either or 
        both, the Commissioner shall make additional attempts to 
        contact the individual to obtain such an affirmative response.
            ``(4) Use of preferred language in subsequent 
        communications.--In the case an application is completed by an 
        individual pursuant to this subsection in which a language 
        other than English is specified, the Commissioner shall provide 
        that subsequent communications under this part to the 
        individual shall be in such language as needed.
            ``(5) Construction.--Nothing in this subsection shall be 
        construed as precluding the Commissioner from taking additional 
        outreach efforts to enroll eligible individuals under this part 
        and to provide low-income subsidies to eligible individuals.
            ``(6) Maintenance of effort with respect to outreach.--In 
        no case shall the level of effort with respect to outreach to 
        and enrollment of individuals who are potentially eligible for 
        low-income assistance under this section after the date of the 
        enactment of this subsection be less than such level of effort 
        before such date of enactment until at least 90 percent of such 
        potentially eligible individuals have affirmatively responded.
            ``(7) GAO report to congress.--Not later than 2 years after 
        the date of the first submission to the Secretary of the 
        Treasury described in paragraph (1)(B), the Comptroller General 
        of the United States shall submit to Congress a report, with 
        respect to the 18-month period following the establishment of 
        the process described in paragraph (1)(A), on--
                    ``(A) the extent to which the percentage of 
                individuals who are eligible for low-income assistance 
                under this section but not enrolled under this part has 
                decreased during such period;
                    ``(B) how the Commissioner of Social Security has 
                used any savings resulting from the implementation of 
                this section and section 6103(l)(21) of the Internal 
                Revenue Code of 1986 to improve outreach to individual 
                described in subparagraph (A) to increase enrollment of 
                such individuals under this part;
                    ``(C) the effectiveness of using information from 
                the Secretary of the Treasury in accordance with 
                section 6103(l)(21) of the Internal Revenue Code of 
                1986 for purposes of indicating whether individuals are 
                eligible for low-income assistance under this section; 
                and
                    ``(D) the effectiveness of the outreach conducted 
                by the Commissioner of Social Security based on the 
                data described in subparagraph (C).''.
            (2) Conforming amendment.--Section 1144(c)(1) of the Social 
        Security Act (42 U.S.C. 1320b-14(c)(1)) is amended by inserting 
        ``(including through request to the Secretary of the Treasury 
        pursuant to section 1860D-14(e))'' before ``, the Commissioner 
        shall''.
    (b) Improvements to the Low-Income Subsidy Applications.--Section 
1860D-14(a)(3) of the Social Security Act (42 U.S.C. 1395w-114(a)(3)) 
is amended--
            (1) in subparagraph (E), by striking clauses (ii) and (iii) 
        and redesignating clause (iv) as clause (ii);
            (2) by redesignating subparagraphs (F) and (G) as 
        subparagraphs (G) and (H), respectively; and
            (3) by inserting after subparagraph (E) the following new 
        subparagraph:
                    ``(F) Simplified low-income subsidy application and 
                process.--
                            ``(i) In general.--The Secretary, jointly 
                        with the Commissioner of Social Security, 
                        shall--
                                    ``(I) develop a model, simplified 
                                application form and process consistent 
                                with clause (ii) for the determination 
                                and verification of a part D eligible 
                                individual's assets or resources under 
                                this paragraph; and
                                    ``(II) provide such form to States.
                            ``(ii) Documentation and safeguards.--Under 
                        such process--
                                    ``(I) the application form shall 
                                consist of an attestation under penalty 
                                of perjury regarding the level of 
                                assets or resources (or combined assets 
                                and resources in the case of a married 
                                part D eligible individual) and 
                                valuations of general classes of assets 
                                or resources;
                                    ``(II) such form shall not require 
                                the submittal of additional 
                                documentation regarding income or 
                                assets;
                                    ``(III) matters attested to in the 
                                application shall be subject to 
                                appropriate methods of administrative 
                                verification;
                                    ``(IV) the applicant shall be 
                                permitted to authorize another 
                                individual to act as the applicant's 
                                personal representative with respect to 
                                communications under this part and the 
                                enrollment of the applicant into a 
                                prescription drug plan (or MA-PD plan) 
                                and for low-income subsidies under this 
                                section; and
                                    ``(V) the application form 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 part.
                            ``(iii) No recovery for certain subsidies 
                        improperly paid.--If an individual in good 
                        faith and in the absence of fraud is provided 
                        low-income subsidies under this section, and if 
                        the individual is subsequently found not 
                        eligible for such subsidies, there shall be no 
                        recovery made against the individual because of 
                        such subsidies improperly paid.''.
    (c) Disclosures To Facilitate Identification of Individuals Likely 
To Be Eligible for the Low-Income Assistance Under the Medicare 
Prescription Drug Program.--
            (1) 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 to facilitate 
        identification of individuals likely to be eligible for low-
        income subsidies under medicare prescription drug program.--
                    ``(A) In general.--The Secretary, upon written 
                request from the Commissioner of Social Security, shall 
                disclose to officers and employees of the Social 
                Security Administration, with respect to any individual 
                identified by the Commissioner--
                            ``(i) whether, based on the criterion 
                        determined under subparagraph (B), such 
                        individual is likely to be eligible for low-
                        income assistance under section 1860D-14 of the 
                        Social Security Act, or
                            ``(ii) that, based on such criterion, there 
                        is insufficient information available to the 
                        Secretary to make the determination described 
                        in clause (i).
                    ``(B) Criterion.--Not later than 90 days after the 
                date of the enactment of this paragraph, the Secretary, 
                in consultation with the Commissioner of Social 
                Security, shall develop the criterion by which the 
                determination under subparagraph (A)(i) shall be made 
                (and the criterion for determining that insufficient 
                information is available to make such determination). 
                Such criterion may include analysis of information 
                available on such individual's return, the return of 
                such individual's spouse, and any information related 
                to such individual or such individual's spouse which is 
                available on any information return.''.
            (2) Procedures and recordkeeping related to disclosures.--
        Paragraph (4) of section 6103(p) of such Code is amended by 
        striking ``or (17)'' each place it appears and inserting 
        ``(17), or (21)''.
            (3) Effective date.--The amendments made by this subsection 
        shall apply to disclosures made after the date of the enactment 
        of this Act.

SEC. 12. ENHANCED OVERSIGHT AND ENFORCEMENT RELATING TO REIMBURSEMENTS 
              FOR RETROACTIVE LIS ENROLLMENT.

    (a) In General.--In the case of a retroactive LIS enrollment 
beneficiary (as defined in subsection (e)(4)) who is enrolled under a 
prescription drug plan under part D of title XVIII of the Social 
Security Act (or an MA-PD plan under part C of such title)--
            (1) the beneficiary (or any eligible third party) is 
        entitled to reimbursement by the plan for covered drug costs 
        (as defined in subsection (e)(1)) incurred by the beneficiary 
        during the retroactive coverage period of the beneficiary in 
        accordance with subsection (b) and in the case of such a 
        beneficiary described in subsection (e)(4)(A)(i), such 
        reimbursement shall be made automatically by the plan upon 
        receipt of appropriate notice the beneficiary is eligible for 
        assistance described in such subsection (e)(4)(A)(i) without 
        further information required to be filed with the plan by the 
        beneficiary;
            (2) the Secretary of Health and Human Services (in this 
        section referred to as the ``Secretary'') shall not make 
        payment to the plan--
                    (A) in the case that the beneficiary is described 
                in subsection (e)(4)(A)(i), for premium subsidies and 
                cost sharing subsidies under section 1860D-14 of the 
                Social Security Act (42 U.S.C. 1395w-114) with respect 
                to the provision of prescription drug coverage to the 
                beneficiary during such retroactive period; and
                    (B) in the case that the beneficiary is described 
                in subsection (e)(4)(A)(ii), for direct subsidies under 
                section 1860D-15(a)(1) of such Act and premium 
                subsidies and cost-sharing subsidies under section 
                1860D-14 of such Act with respect to the provision of 
                prescription drug coverage to the beneficiary during 
                such retroactive period;
        unless the plan demonstrates to the Secretary that the plan has 
        provided timely and accurate reimbursement to the beneficiary 
        (or eligible third party) in accordance with paragraph (1);
            (3) the Secretary shall not make any payment described in 
        paragraph (2) to the plan with respect to such beneficiary for 
        any month of the retroactive enrollment period during which no 
        expenses for covered part D drugs (as defined in section 1860D-
        2(e) of the Social Security Act (42 U.S.C. 1395w-102(e)) were 
        incurred by such beneficiary (or eligible third party on behalf 
        of such beneficiary); and
            (4) any payment owed the plan pursuant to this section, 
        taking into account paragraphs (2) and (3), shall be made at 
        the time the Centers for Medicare & Medicaid Services 
        reconciles payments for the entire plan year following the end 
        of the plan year, and not before such time.
    (b) Administrative Requirements Relating to Reimbursements.--
            (1) Line-item description.--Each reimbursement made by a 
        prescription drug plan or MA-PD plan under subsection (a)(1) 
        shall include a line-item description of the items for which 
        the reimbursement is made.
            (2) Timing of reimbursements.--A prescription drug plan or 
        MA-PD plan must make a reimbursement under subsection (a)(1) to 
        a retroactive LIS enrollment beneficiary, with respect to a 
        claim, not later than 30 days after--
                    (A) in the case of a beneficiary described in 
                subsection (e)(4)(A)(i), the date on which the plan 
                receives notice from the Secretary that the beneficiary 
                is eligible for assistance described in such 
                subsection; or
                    (B) in the case of a beneficiary described in 
                subsection (e)(4)(A)(ii), the date on which the 
                beneficiary files the claim with the plan.
    (c) Notice Requirements.--
            (1) By secretary of hhs and commission of the social 
        security administration.--The Secretary, jointly with the 
        Commissioner of the Social Security Administration, shall 
        ensure that each retroactive LIS enrollment beneficiary 
        receives, with any letter or notification of eligibility for a 
        low-income subsidy under section 1860D-14 of the Social 
        Security Act, a notice of their right to reimbursement 
        described in subsection (a)(1) for covered drug costs incurred 
        during the retroactive coverage period of the beneficiary. Such 
        notice shall--
                    (A) with respect to a beneficiary described in 
                subsection (e)(4)(A)(i), inform the beneficiary of the 
                beneficiary's right to automatic reimbursement as 
                described in subsection (a)(1); and
                    (B) with respect to a beneficiary described in 
                subsection (e)(4)(A)(ii), include a description of a 
                clear process that the beneficiary should follow to 
                seek such reimbursement.
            (2) By prescription drug plans.--
                    (A) In general.--Each prescription drug plan under 
                part D of title XVIII of the Social Security Act (and 
                MA-PD plan under part C of such title) shall include in 
                a notice from the plan to a retroactive LIS enrollment 
                beneficiary described in subsection (e)(4)(A)(ii) a 
                model notice developed under subparagraph (B) 
                describing the process the beneficiary must follow to 
                seek retroactive reimbursement. Such notice shall 
                include any form required by the plan to complete such 
                reimbursement and shall indicate the period of 
                retroactive coverage for which the beneficiary is 
                eligible for such reimbursement.
                    (B) Model notice.--The Secretary, jointly with the 
                Commissioner of Social Security, shall develop a model 
                notice for purposes of subparagraph (A) and shall make 
                such model notice available to all prescription drug 
                plans under part D of title XVIII of the Social 
                Security Act (and MA-PD plans under part C of such 
                title).
    (d) Public Posting To Track Payments.--
            (1) In general.--Not later than one year after the date of 
        the enactment of this Act, the Secretary shall post (and 
        annually update) on the public Internet website of the 
        Department of Health and Human Services information on the 
        total amount of payments made by the Secretary under subsection 
        (a)(2) to prescription drug plans during the most recent plan 
        year for which plan data is available.
            (2) Specific information.--Such information posted--
                    (A) in 2010 or in a subsequent year before 2016, 
                shall include information on payments made for years 
                beginning with 2006 and ending with the year for which 
                the most current information is available; and
                    (B) in 2016 or a subsequent year, shall include 
                information on payments made for at least the 10 
                previous years.
    (e) Definitions.--In this section:
            (1) Covered drug costs.--The term ``covered drug costs'' 
        means, with respect to a retroactive LIS enrollment beneficiary 
        enrolled under a prescription drug plan under part D of title 
        XVIII of the Social Security Act (or an MA-PD plan under part C 
        of such title), the amount by which--
                    (A) the costs incurred by such beneficiary during 
                the retroactive coverage period of the beneficiary for 
                covered part D drugs, premiums, and cost-sharing under 
                such title; exceeds
                    (B) such costs that would have been incurred by 
                such beneficiary during such period if the beneficiary 
                had been both enrolled in the plan and recognized by 
                such plan as qualified during such period for the low 
                income subsidy under section 1860D-14 of the Social 
                Security Act to which the individual is entitled.
            (2) Eligible third party.--The term ``eligible third 
        party'' means, with respect to a retroactive LIS enrollment 
        beneficiary, an organization or other third party that paid on 
        behalf of such beneficiary for covered drug costs incurred by 
        such beneficiary during the retroactive coverage period of such 
        beneficiary.
            (3) Retroactive coverage period.--The term ``retroactive 
        coverage period'' means--
                    (A) with respect to a retroactive LIS enrollment 
                beneficiary described in paragraph (4)(A)(i), the 
                period--
                            (i) beginning on the effective date of the 
                        assistance described in such paragraph for 
                        which the individual is eligible; and
                            (ii) ending on the date the plan 
                        effectuates the status of such individual as so 
                        eligible; and
                    (B) with respect to a retroactive LIS enrollment 
                beneficiary described in paragraph (4)(A)(ii), the 
                period--
                            (i) beginning on the date the individual is 
                        both entitled to benefits under part A, or 
                        enrolled under part B, of title XVIII of the 
                        Social Security Act and eligible for medical 
                        assistance under a State plan under title XIX 
                        of such Act; and
                            (ii) ending on the date the plan 
                        effectuates the status of such individual as a 
                        full-benefit dual eligible individual (as 
                        defined in section 1935(c)(6) of such Act).
            (4) Retroactive lis enrollment beneficiary.--
                    (A) In general.--The term ``retroactive LIS 
                enrollment beneficiary'' means an individual who--
                            (i) is enrolled in a prescription drug plan 
                        under part D of title XVIII of the Social 
                        Security Act (or an MA-PD plan under part C of 
                        such title) and subsequently becomes eligible 
                        as a full-benefit dual eligible individual (as 
                        defined in section 1935(c)(6) of such Act), an 
                        individual receiving a low-income subsidy under 
                        section 1860D-14 of such Act, an individual 
                        receiving assistance under the Medicare Savings 
                        Program implemented under clauses (i), (ii), 
                        (iii), and (iv) of section 1902(a)(10)(E) of 
                        such Act, or an individual receiving assistance 
                        under the supplemental security income program 
                        under section 1611 of such Act; or
                            (ii) subject to subparagraph (B)(i), is a 
                        full-benefit dual eligible individual (as 
                        defined in section 1935(c)(6) of such Act) who 
                        is automatically enrolled in such a plan under 
                        section 1860D-1(b)(1)(C) of such Act.
                    (B) Exception for beneficiaries enrolled in rfp 
                plan.--
                            (i) In general.--In no case shall an 
                        individual described in subparagraph (A)(ii) 
                        include an individual who is enrolled, pursuant 
                        to a RFP contract described in clause (ii), in 
                        a prescription drug plan offered by the sponsor 
                        of such plan awarded such contract.
                            (ii) RFP contract described.--The RFP 
                        contract described in this section is a 
                        contract entered into between the Secretary and 
                        a sponsor of a prescription drug plan pursuant 
                        to the Centers for Medicare & Medicaid 
                        Services' request for proposals issued on 
                        February 17, 2009, relating to Medicare part D 
                        retroactive coverage for certain low income 
                        beneficiaries, or a similar subsequent request 
                        for proposals.
    (f) GAO Report.--Not later than 24 months after the date of the 
enactment of this Act, the Comptroller General of the United States 
shall submit to Congress a report on the extent to which the provisions 
of this section improve reimbursement for covered drug costs to 
retroactive LIS enrollment beneficiaries and lower the amounts of 
payments made by the Secretary, with respect to such beneficiaries, to 
prescription drug plans under part D of title XVIII of the Social 
Security Act (and MA-PD plans under part C of such title).
    (g) Report to Congress.--In the case that an RFP contract described 
in subsection (e)(4)(B)(ii) is awarded, not later than two years after 
the effective date of such contract, the Secretary of Health and Human 
Services shall submit to Congress a report evaluating the program 
carried out through such contract.
    (h) Effective Date.--Paragraphs (2) and (3) of subsection (a) and 
subsections (b) and (c) shall apply to subsidy determinations made on 
or after the date that is 3 months after the date of the enactment of 
this Act.

SEC. 13. INTELLIGENT ASSIGNMENT IN ENROLLMENT.

    (a) In General.--Section 1860D-1(b)(1) of the Social Security Act 
(42 U.S.C. 1395w-101(b)(1), as amended by section 7(b), is amended--
            (1) in the second sentence of subparagraph (C), by striking 
        ``on a random basis among all such plans'' and inserting ``, 
        subject to subparagraph (E), in the most appropriate plan for 
        such individual''; and
            (2) by adding at the end the following new subparagraph:
                    ``(E) Intelligent assignment.--In the case of any 
                auto-enrollment under subparagraph (C), no part D 
                eligible individual described in such subparagraph 
                shall be enrolled in a prescription drug plan which 
                does not meet requirements established by the 
                Secretary.''.
    (b) Effective Date.--The amendment made by subsection (a) shall 
apply to enrollments effected on or after November 15, 2010.

SEC. 14. 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. 15. 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)), as amended by section 10, is amended--
            (1) in paragraph (73), by striking ``and'' at the end;
            (2) in paragraph (74), by striking the period at the end 
        and inserting ``; and''; and
            (3) by inserting after paragraph (74) the following new 
        paragraph:
            ``(75) 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 date that is 
        6 months after the date of 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. 16. 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 15, is amended--
                    (A) in paragraph (74), by striking ``and'' at the 
                end;
                    (B) in paragraph (75), by striking the period at 
                the end and inserting ``; and''; and
                    (C) by inserting after paragraph (75) the following 
                new paragraph:
            ``(76) 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.--
                    (A) In general.--Except as provided in subparagraph 
                (B), the amendments made by this subsection take effect 
                on the date that is 2 years after the date of enactment 
                of this Act.
                    (B) 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 subsection, 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.
    (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. 17. STATE MEDICAID AGENCY CONSIDERATION OF LOW-INCOME SUBSIDY 
              APPLICATION AND DATA TRANSMITTAL.

    (a) Technical Amendments.--
            (1) In general.--Section 1144(c)(3)(A)(i) of the Social 
        Security Act (42 U.S.C. 1320b-14(c)(3)(A)(i)), as amended by 
        section 10, is amended--
                    (A) by striking ``transmittal''; and
                    (B) by inserting ``(as specified in section 
                1935(a)(4))'' before the semicolon at the end.
            (2) Effective date.--The amendments made by this subsection 
        shall take effect as if included in the enactment of section 
        113(a) of the Medicare Improvements for Patients and Providers 
        Act of 2008 (Public Law 110-275).
    (b) Clarification of State Medicaid Agency Consideration of Low-
Income Subsidy Application.--Section 1935(a)(4) of the Social Security 
Act (42 U.S.C. 1396u-5(a)(4)), as added by section 113(b) of the 
Medicare Improvements for Patients and Providers Act of 2008 (Public 
Law 110-275), is amended--
            (1) by striking ``Program.--The State'' and inserting 
        ``Program.--
                    ``(A) In general.--The State'';
            (2) in subparagraph (A), as inserting by paragraph (1), by 
        striking the second sentence; and
            (3) by adding at the end the following new subparagraphs:
                    ``(B) For purposes of a State's obligation under 
                section 1902(a)(8) to furnish medical assistance with 
                reasonable promptness, the date of the electronic 
                transmission by the Commissioner of Social Security to 
                the State Medicaid agency of data under section 
                1144(c)(3) shall be the date of the filing of such 
                application for benefits under the Medicare Savings 
                Program.
                    ``(C) For the purpose of determining when medical 
                assistance shall be made available for medicare cost-
                sharing under this title, the State shall consider the 
                date of the application for low-income subsidies under 
                section 1860D-14 to be the date of the filing of an 
                application for benefits under the Medicare Savings 
                Program.''.
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