II 

113TH CONGRESS 

1ST SESSION S. 324 

To amend part B of the title XVIII of the Social Security Act to apply 

deemed enrollment to residents of Puerto Rico and to provide a special 

enrollment period and a reduction in the late enrollment penalties for 

certain residents of Puerto Rico. 

IN THE SENATE OF THE UNITED STATES 

FEBRUARY 14, 2013 

Mr. SCHUMER introduced the following bill; which was read twice and referred 

to the Committee on Finance 

A BILL 

To amend part B of the title XVIII of the Social Security 

Act to apply deemed enrollment to residents of Puerto 

Rico and to provide a special enrollment period and 

a reduction in the late enrollment penalties for certain 

residents of Puerto Rico. 

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

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Puerto Rico Medicare 

5 Part B Equity Act of 2013’’. 


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1 SEC. 2. APPLICATION OF PART B DEEMED ENROLLMENT 

2 PROCESS TO RESIDENTS OF PUERTO RICO; 

3 SPECIAL ENROLLMENT PERIOD AND LIMIT 

4 ON LATE ENROLLMENT PENALTIES. 

5 (a) APPLICATION OF PART B DEEMED ENROLLMENT

6 PROCESS TO RESIDENTS OF PUERTO RICO.—Section 

7 1837(f)(3) of the Social Security Act (42 U.S.C. 

8 1395p(f)(3)) is amended by striking ‘‘, exclusive of Puerto 

9 Rico’’. 

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

11 subsection (a) shall apply to individuals whose initial en12 rollment period under section 1837(d) of the Social Secu13 rity Act begins on or after the first day of the effective 

14 month, specified by the Secretary of Health and Human 

15 Services under section 1839(j)(1)(C) of such Act, as added 

16 by subsection (c)(2). 

17 (c) TRANSITION PROVIDING SPECIAL ENROLLMENT

18 PERIOD AND LIMIT ON LATE ENROLLMENT PENALTIES

19 FOR CERTAIN MEDICARE BENEFICIARIES.—Section 1839 

20 of the Social Security Act (42 U.S.C. 1395r) is amend21 ed— 

22 (1) in the first sentence of subsection (b), by in23 serting ‘‘subject to section 1839(j)(2),’’ after ‘‘sub24 section (i)(4) or (l) of section 1837,’’; and 

25 (2) by adding at the end the following new sub26 section: 


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1 ‘‘(j) SPECIAL RULES FOR CERTAIN RESIDENTS OF

2 PUERTO RICO.— 

3 ‘‘(1) SPECIAL ENROLLMENT PERIOD, COVERAGE

4 PERIOD FOR RESIDENTS WHO ARE ELIGIBLE BUT

5 NOT ENROLLED.— 

6 ‘‘(A) IN GENERAL.—In the case of a tran7 sition individual (as defined in paragraph (3)) 

8 who is not enrolled under this part as of the 

9 day before the first day of the effective month 

10 (as defined in subparagraph (C)), the Secretary 

11 shall provide for a special enrollment period 

12 under section 1837 of 7 months beginning with 

13 such effective month during which the indi14 vidual may be enrolled under this part. 

15 ‘‘(B) COVERAGE PERIOD.—In the case of 

16 such an individual who enrolls during such spe17 cial enrollment period, the coverage period 

18 under section 1838 shall begin on the first day 

19 of the second month after the month in which 

20 the individual enrolls. 

21 ‘‘(C) EFFECTIVE MONTH DEFINED.—In 

22 this section, the term ‘effective month’ means a 

23 month, not earlier than October 2014 and not 

24 later than January 2015, specified by the Sec25 retary. 


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1 ‘‘(2) REDUCTION IN LATE ENROLLMENT PEN2 ALTIES FOR CURRENT ENROLLEES AND INDIVID3 UALS ENROLLING DURING TRANSITION.— 

4 ‘‘(A) IN GENERAL.—In the case of a tran5 sition individual who is enrolled under this part 

6 as of the day before the first day of the effec7 tive month or who enrolls under this part on or 

8 after the date of the enactment of this sub9 section but before the end of the special enroll10 ment period under paragraph (1)(A), the 

11 amount of the late enrollment penalty imposed 

12 under section 1839(b) shall be recalculated by 

13 reducing the penalty to 15 percent of the pen14 alty otherwise established. 

15 ‘‘(B) APPLICATION.—Subparagraph (A) 

16 shall be applied in the case of a transition indi17 vidual who— 

18 ‘‘(i) is enrolled under this part as of 

19 the month before the effective month, for 

20 premiums for months beginning with such 

21 effective month; or 

22 ‘‘(ii) enrolls under this part on or 

23 after the date of the enactment of this Act 

24 and before the end of the special enroll25 ment period under paragraph (1)(A), for 


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1 premiums for months during the coverage 

2 period under this part which occur during 

3 or after the effective month. 

4 ‘‘(C) LOSS OF REDUCTION IF INDIVIDUAL

5 TERMINATES ENROLLMENT.—Subparagraph 

6 (A) shall not apply to a transition individual if 

7 the individual terminates enrollment under this 

8 part after the end of the special enrollment pe9 riod under paragraph (1). 

10 ‘‘(3) TRANSITION INDIVIDUAL DEFINED.—In 

11 this section, the term ‘transition individual’ means 

12 an individual who resides in Puerto Rico and who 

13 would have been deemed enrolled under this part 

14 pursuant to section 1837(f) before the first day of 

15 the effective month but for the fact that the indi16 vidual was a resident of Puerto Rico, regardless of 

17 whether the individual is enrolled under this part as 

18 of such first day.’’. 

Æ 


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