II 

110TH CONGRESS 

1ST SESSION S. 1108 

To amend title XVIII of the Social Security Act to provide a special enrollment period for individuals who qualify for an income-related subsidy 

under the Medicare prescription drug program and to provide funding 

for the conduct of outreach and education with respect to the premium 

and cost-sharing subsidies under such program, and for other purposes. 

IN THE SENATE OF THE UNITED STATES 

APRIL 12, 2007 

Mr. SMITH (for himself, Mr. BINGAMAN, Ms. SNOWE, Mrs. LINCOLN, and Mr. 

KERRY) 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 provide 

a special enrollment period for individuals who qualify 

for an income-related subsidy under the Medicare prescription drug program and to provide funding for the 

conduct of outreach and education with respect to the 

premium and cost-sharing subsidies under such program, 

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, 


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1 SECTION 1. SHORT TITLE. 

2 This Act may be cited as the ‘‘Medicare Part D Out3 reach and Enrollment Enhancement Act of 2007’’. 

4 SEC. 2. SPECIAL ENROLLMENT PERIOD FOR INDIVIDUALS 

5 ELIGIBLE FOR AN INCOME-RELATED SUB6 SIDY. 

7 (a) SPECIAL ENROLLMENT PERIOD.—Section 

8 1860D–1(b)(3) of the Social Security Act (42 U.S.C. 

9 1395w–101(b)(3)) is amended by adding at the end the 

10 following new subparagraph: 

11 ‘‘(F) ELIGIBILITY FOR LOW-INCOME SUB12 SIDY.— 

13 ‘‘(i) IN GENERAL.—Subject to clause 

14 (iii), in the case of an applicable individual 

15 (as defined in clause (ii)). 

16 ‘‘(ii) APPLICABLE INDIVIDUAL DE17 FINED.—For purposes of this subpara18 graph, the term ‘applicable individual’ 

19 means a part D eligible individual who is 

20 determined to be a subsidy-eligible indi21 vidual (as defined in section 1860D– 

22 14(a)(3)), including such an individual who 

23 was enrolled in a prescription drug plan or 

24 an MA–PD plan on the date of such deter25 mination. 


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1 ‘‘(iii) TIMING OF SPECIAL ENROLL2 MENT PERIOD.—The special enrollment pe3 riod established under this subparagraph 

4 shall be for a 90-day period beginning on 

5 the date the applicable individual receives 

6 notification of such determination.’’. 

7 (b) ENROLLMENT PROCESS FOR SUBSIDY-ELIGIBLE

8 INDIVIDUALS ELIGIBLE FOR SPECIAL ENROLLMENT PE9 RIOD.—Section 1860D–1(b)(1) is amended by adding at 

10 the end the following new subparagraph: 

11 ‘‘(D) SPECIAL RULE FOR SUBSIDY-ELIGI12 BLE INDIVIDUALS ELIGIBLE FOR SPECIAL EN13 ROLLMENT PERIOD.—The process established 

14 under subparagraph (A) shall include, in the 

15 case of an applicable individual (as defined in 

16 clause (ii) of paragraph (3)(F)) the following: 

17 ‘‘(i) FACILITATED ENROLLMENT.— 

18 During the 90-day period described in 

19 clause (iii) of such paragraph, a process 

20 for the facilitated enrollment of the indi21 vidual in the prescription drug plan or 

22 MA–PD plan that is most appropriate for 

23 such individual (as determined by the Sec24 retary). At the end of such 90-day period, 

25 the individual shall be enrolled in such 


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1 plan unless the individual declines enroll2 ment in the plan or in the program under 

3 this part, or chooses to enroll in another 

4 plan selected by the individual prior to the 

5 end of such 90-day period. 

6 ‘‘(ii) ONE-TIME CHANGE OF ENROLL7 MENT.—The opportunity to change enroll8 ment with a prescription drug plan or an 

9 MA–PD plan not less than once during a 

10 plan year. Nothing in the previous sen11 tence shall limit the ability of a part D eli12 gible individual who is a full-benefit dual 

13 eligible individual (as defined in section 

14 1935(c)(6)) to change enrollment under 

15 subparagraph (C)’’. 

16 (c) WAIVER OF LATE ENROLLMENT PENALTY.—Sec17 tion 1860D–13(b) of the Social Security Act (42 U.S.C. 

18 1395w–113(b)) is amended by adding at the end the fol19 lowing new paragraph: 

20 ‘‘(8) WAIVER OF PENALTY FOR SUBSIDY-ELIGI21 BLE INDIVIDUALS.—In no case shall a part D eligi22 ble individual who is determined to be a subsidy-eli23 gible individual (as defined in section 1860D– 

24 14(a)(3)) be subject to an increase in the monthly 


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1 beneficiary premium established under subsection 

2 (a).’’. 

3 (d) EFFECTIVE DATE.—The amendments made by 

4 this section shall take effect on January 1, 2008. 

5 SEC. 3. OUTREACH AND EDUCATION FOR PREMIUM AND 

6 COST-SHARING SUBSIDIES UNDER PART D. 

7 (a) ADDITIONAL FUNDING FOR OUTREACH AND AS8 SISTANCE.— 

9 (1) STATE HEALTH INSURANCE ASSISTANCE

10 PROGRAMS.—There are authorized to be appro11 priated for each of fiscal years 2008, 2009, 2010, 

12 and 2011, an amount equal to $1 multiplied by the 

13 total number of individuals entitled to benefits, or 

14 enrolled, under part A of title XVIII of the Social 

15 Security Act, or enrolled under part B of such title 

16 during the fiscal year (as determined by the Sec17 retary of Health and Human Services, based on the 

18 most recent available data before the beginning of 

19 the fiscal year) to be used to provide additional 

20 grants to State Health Insurance Assistance Pro21 grams (SHIPs) to conduct outreach and education 

22 related to the Medicare program under such title. 

23 (2) NATIONAL CENTER ON SENIOR BENEFITS

24 OUTREACH AND ENROLLMENT.— 


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1 (A) IN GENERAL.—There are appropriated 

2 $4,000,000 to the National Center on Senior 

3 Benefits Outreach and Enrollment established 

4 under section 202(a)(20)(B) of the Older Amer5 icans Act of 1965 (42 U.S.C. 3012(a)(20)(B)) 

6 to be used to provide outreach and enrollment 

7 assistance with respect to premium and cost8 sharing subsidies under the Medicare prescrip9 tion drug program under part D of title XVIII 

10 of the Social Security Act (42 U.S.C. 1395w– 

11 101 et seq.). 

12 (B) COORDINATION.—The National Center 

13 on Senior Benefits Outreach and Enrollment 

14 shall coordinate outreach and enrollment assist15 ance conducted under subparagraph (A) with 

16 activities conducted by State Health Insurance 

17 Assistance Programs (SHIPs) and other appro18 priate entities that conduct outreach and edu19 cation related to such premium and cost-shar20 ing subsidies. 

21 (b) ENCOURAGING STATES TO DIRECT SUBSIDY-EL22 IGIBLE INDIVIDUALS TO ORGANIZATIONS PROVIDING AS23 SISTANCE.— 

24 (1) IN GENERAL.—The Secretary of Health and 

25 Human Services shall encourage States to direct apVerDate Aug 31 2005 17:28 Apr 16, 2007 Jkt 059200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\S1108.IS S1108

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1 plicable individuals to appropriate organizations and 

2 entities that provide assistance with respect to— 

3 (A) applying for premium and cost-sharing 

4 subsidies under section 1860D–14 of the Social 

5 Security Act (42 U.S.C. 1395w–114); and 

6 (B) enrolling in a prescription drug plan or 

7 an MA–PD plan under part D of title XVIII of 

8 the Social Security Act (42 U.S.C. 1395w–101 

9 et seq.). 

10 (2) APPLICABLE INDIVIDUALS DEFINED.—In 

11 this subsection, the term ‘‘applicable individual’’ 

12 means an individual the State believes to be, or de13 termines to be, eligible for premium and cost-sharing 

14 subsidies under section 1860D–14 of the Social Se15 curity Act (42 U.S.C. 1395w–114). 

16 SEC. 4. SCREENING BY COMMISSIONER OF SOCIAL SECU17 RITY FOR ELIGIBILITY UNDER MEDICARE 

18 SAVINGS PROGRAMS. 

19 (a) IN GENERAL.—Section 1860D–14(a)(3)(B)(i) of 

20 the Social Security Act (42 U.S.C. 1395w– 

21 114(a)(3)(B)(i)) is amended by inserting after the first 

22 sentence the following: ‘‘As part of making an eligibility 

23 determination under the preceding sentence for an indi24 vidual, the Commissioner shall screen for the individual’s 

25 eligibility for medical assistance for any medicare costVerDate Aug 31 2005 19:28 Apr 13, 2007 Jkt 059200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\S1108.IS S1108

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1 sharing described in section 1905(p)(3) and, if the screen2 ing indicates the individual is likely eligible for any such 

3 medicare cost-sharing, transmit the pertinent information 

4 to the appropriate State Medicaid agency for the deter5 mination of eligibility and enrollment of the individual for 

6 such medicare cost-sharing under the State plan (or under 

7 a waiver of such plan).’’. 

8 (b) EFFECTIVE DATE.—The amendment made by 

9 this section shall take effect on the date of enactment of 

10 this Act. 

11 SEC. 5. ADMINISTRATION ON AGING STUDY AND REPORT 

12 ON SCREENING PROCESSES USED BY GOV13 ERNMENT NEEDS-BASED PROGRAMS. 

14 (a) STUDY.— 

15 (1) IN GENERAL.—The Assistant Secretary of 

16 the Administration on Aging (in this section referred 

17 to as the ‘‘Assistant Secretary’’) shall conduct a 

18 comprehensive study of screening processes used by 

19 government needs-based programs. 

20 (2) MATTERS STUDIED.—In conducting the 

21 study under paragraph (1), the Assistant Secretary 

22 shall— 

23 (A) assess any duplications of effort under 

24 existing screening processes used by govern25 ment needs-based programs; 


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1 (B) determine the feasibility of creating a 

2 uniform screening process for such needs-based 

3 programs; 

4 (C) determine how the Federal govern5 ment, State governments, and community-based 

6 organizations can better coordinate existing 

7 screening processes in order to facilitate the en8 rollment of seniors into need-based programs; 

9 (D) include a cost-benefit analysis with re10 spect to creating a uniform screening process or 

11 better streamlining existing screening processes; 

12 and 

13 (E) determine the feasibility of using the 

14 Internet to administer screening processes, as 

15 well as the costs and benefits of migrating to on 

16 online system. 

17 (b) REPORT.—Not later than 1 year after the date 

18 of enactment of this Act, the Assistant Secretary shall 

19 submit a report to Congress containing the results of the 

20 study conducted under subsection (a), together with rec21 ommendations— 

22 (1) to streamline and improve the effectiveness 

23 of screening processes used by government needs24 based programs; and 


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1 (2) for such legislation or administrative action 

2 as the Assistant Secretary determines appropriate. 

3 (c) AUTHORIZATION.—There are authorized to be ap4 propriated such sums as are necessary to carry out this 

5 section. 

Æ 


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