I 

111TH CONGRESS 

1ST SESSION H. R. 2716 

To amend title XIX of the Social Security Act to provide financial stability 

for seniors and people with disabilities through improvements in the 

Medicare Savings Program. 

IN THE HOUSE OF REPRESENTATIVES 

JUNE 4, 2009 

Mr. BECERRA (for himself and Mr. DOGGETT) introduced the following bill; 

which was referred to the Committee on Energy and Commerce, and in 

addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such 

provisions as fall within the jurisdiction of the committee concerned 

A BILL 

To amend title XIX of the Social Security Act to provide 

financial stability for seniors and people with disabilities 

through improvements in the Medicare Savings Program. 

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; TABLE OF CONTENTS. 

4 (a) SHORT TITLE.—This Act may be cited as the 

5 ‘‘Medicare Savings Program Improvement Act of 2009’’. 

6 (b) TABLE OF CONTENTS.—The table of contents of 

7 this Act is as follows: 

Sec. 1. Short title; table of contents. 


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Sec. 2. Increase in income levels for eligibility. 

Sec. 3. Modification of resource standards. 

Sec. 4. Eligibility for other programs. 

Sec. 5. Effective date of MSP benefits. 

Sec. 6. Treatment of qualified Medicare beneficiaries, specified low-income 

Medicare beneficiaries, and other dual eligibles as medicare 

beneficiaries. 

Sec. 7. Monitoring and enforcement of limitation on beneficiary liability. 

Sec. 8. Medicaid treatment of certain Medicare providers. 

Sec. 9. State provision of medical assistance to dual eligibles in MA plans. 

Sec. 10. Medicare enrollment assistance. 

Sec. 11. Medicaid agency consideration of low-income subsidy application and 

data transmittal. 

Sec. 12. QMB buy-in of part A and part B premiums. 

Sec. 13. Increasing availability of MSP applications through availability on the 

Internet and designation of preferred language. 

Sec. 14. Medicare savings program applications. 

Sec. 15. Repeal of payment limitation. 

1 SEC. 2. INCREASE IN INCOME LEVELS FOR ELIGIBILITY. 

2 (a) INCREASE TO 150 PERCENT OF FPL FOR QUALI3 FIED MEDICARE BENEFICIARIES.— 

4 (1) IN GENERAL.—Section 1905(p)(2) of the 

5 Social Security Act (42 U.S.C. 1396d(p)(2)) is 

6 amended— 

7 (A) in subparagraph (A), by striking ‘‘100 

8 percent’’ and inserting ‘‘150 percent’’; 

9 (B) in subparagraph (B)— 

10 (i) by striking ‘‘and’’ at the end of 

11 clause (ii); 

12 (ii) by striking the period at the end 

13 of clause (iii) and inserting ‘‘, and’’; and 

14 (iii) by adding at the end the fol15 lowing: 

16 ‘‘(iv) January 1, 2011, is 150 per17 cent.’’; and 


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1 (C) in subparagraph (C)— 

2 (i) by striking ‘‘and’’ at the end of 

3 clause (iii); 

4 (ii) by striking the period at the end 

5 of clause (iv) and inserting ‘‘, and’’; and 

6 (iii) by adding at the end the fol7 lowing: 

8 ‘‘(v) January 1, 2011, is 150 per9 cent.’’. 

10 (2) APPLICATION OF INCOME TEST BASED ON

11 FAMILY SIZE.—Section 1905(p)(2)(A) of such Act 

12 (42 U.S.C. 1396d(p)(2)(A)) is amended by adding 

13 at the end the following: ‘‘For purposes of this sub14 paragraph, family size means the applicant, the 

15 spouse (if any) of the applicant if living in the same 

16 household as the applicant, and the number of indi17 viduals who are related to the applicant (or appli18 cants), who are living in the same household as the 

19 applicant (or applicants), and who are dependent on 

20 the applicant (or the applicant’s spouse) for at least 

21 one-half of their financial support.’’. 

22 (3) NOT COUNTING IN-KIND SUPPORT AND

23 MAINTENANCE AS INCOME.—Section 1905(p)(2)(D) 

24 of such Act (42 U.S.C. 1396d(p)(2)(D)) is amended 

25 by adding at the end the following new clause: 


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1 ‘‘(iii) In determining income under 

2 this subsection, support and maintenance 

3 furnished in kind shall not be counted as 

4 income.’’. 

5 (b) EXPANSION OF SPECIFIED LOW-INCOME MEDI6 CARE BENEFICIARY (SLMB) PROGRAM.— 

7 (1) ELIGIBILITY OF INDIVIDUALS WITH IN8 COMES BELOW 200 PERCENT OF FPL.—Section 

9 1902(a)(10)(E) of the Social Security Act (42 

10 U.S.C. 1396b(a)(10)(E)) is amended— 

11 (A) by adding ‘‘and’’ at the end of clause 

12 (ii); 

13 (B) in clause (iii)— 

14 (i) by striking ‘‘and 120 percent in 

15 1995 and years thereafter’’ and inserting 

16 ‘‘, or 120 percent in 1995 and any suc17 ceeding year before 2011, or 200 percent 

18 in 2011 and years thereafter’’; and 

19 (ii) by striking ‘‘and’’ at the end; and 

20 (C) by striking clause (iv). 

21 (2) REFERENCES.—Section 1905(p)(1) of such 

22 Act (42 U.S.C. 1396d(p)(1)) is amended by adding 

23 at and below subparagraph (C) the following: ‘‘The 

24 term ‘specified low-income medicare beneficiary’ 


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1 means an individual described in section 

2 1902(a)(13)(iii).’’. 

3 (c) PROVIDING 100 PERCENT FEDERAL FINANC4 ING.—The third sentence of section 1905(b) of such Act 

5 (42 U.S.C. 1396d(b)) is amended by inserting before the 

6 period at the end the following: ‘‘and with respect to med7 ical assistance for Medicare cost-sharing provided under 

8 section 1902(a)(10)(E)(iii) and under section 

9 1902(a)(10)(E)(i) with respect to individuals with income 

10 (as determined in accordance with subsection (p)(1)(B)) 

11 is greater than 100 percent of the official income poverty 

12 line applicable to a family of the size involved’’. 

13 (d) EFFECTIVE DATE.— 

14 (1) Except as provided in paragraph (2), the 

15 amendments made by this section shall take effect 

16 on January 1, 2011, and, with respect to title XIX 

17 of the Social Security Act, shall apply to calendar 

18 quarters beginning on or after January 1, 2011. 

19 (2) In the case of a State plan for medical as20 sistance under title XIX of the Social Security Act 

21 which the Secretary of Health and Human Services 

22 determines requires State legislation (other than leg23 islation appropriating funds) in order for the plan to 

24 meet the additional requirements imposed by the 

25 amendments made by this section, the State plan 


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1 shall not be regarded as failing to comply with the 

2 requirements of such title solely on the basis of its 

3 failure to meet these additional requirements before 

4 the first day of the first calendar quarter beginning 

5 after the close of the first regular session of the 

6 State legislature that begins after the date of the en7 actment of this Act. For purposes of the previous 

8 sentence, in the case of a State that has a 2-year 

9 legislative session, each year of such session shall be 

10 deemed to be a separate regular session of the State 

11 legislature. 

12 SEC. 3. MODIFICATION OF RESOURCE STANDARDS. 

13 (a) IN GENERAL.—Section 1905(p) of the Social Se14 curity Act (42 U.S.C. 1396d(p)) is amended— 

15 (1) in paragraph (1), by amending subpara16 graph (C) to read as follows: 

17 ‘‘(C) whose resources (as determined under 

18 section 1613 for purposes of the supplemental 

19 income security program, except as provided in 

20 paragraph (6)(B)) do not exceed the amount 

21 described in paragraph (6)(A).’’; 

22 (2) by redesignating paragraph (6) as para23 graph (7); and 

24 (3) by inserting after paragraph (5) the fol25 lowing: 


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1 ‘‘(6)(A) The resource level specified in this subpara2 graph for— 

3 ‘‘(i) for 2011, is $27,500 (or $55,000 in the 

4 case of the combined value of the individual’s assets 

5 or resources and the assets or resources of the indi6 vidual’s spouse); and 

7 ‘‘(ii) for a subsequent year is the applicable re8 source level specified in this subparagraph for the 

9 previous year increased by the annual percentage in10 crease in the consumer price index (all items; U.S. 

11 city average) as of September of such previous year. 

12 Any dollar amount established under clause (ii) that is not 

13 a multiple of $10 shall be rounded to the nearest multiple 

14 of $10. 

15 ‘‘(B) In determining the resources of an individual 

16 (and their eligible spouse, if any) under section 1613 for 

17 purposes of paragraph (1)(C) (relating to qualified Medi18 care beneficiaries) or section 1902(a)(10)(E)(iii) (relating 

19 to specified low-income medicare beneficiaries), the fol20 lowing additional exclusions shall apply: 

21 ‘‘(i) No part of the value of any life insurance 

22 policy shall be taken into account. 

23 ‘‘(ii) No balance in, or benefits received under, 

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1 tion 3 of the Employee Retirement Income Security 

2 Act of 1974) shall be taken into account’’. 

3 (b) EFFECTIVE DATE.— 

4 (1) Except as provided in paragraph (2), the 

5 amendments made by this section shall apply to cal6 endar quarters beginning on or after January 1, 

7 2011. 

8 (2) In the case of a State plan for medical as9 sistance under title XIX of the Social Security Act 

10 which the Secretary of Health and Human Services 

11 determines requires State legislation (other than leg12 islation appropriating funds) in order for the plan to 

13 meet the additional requirements imposed by the 

14 amendments made by this section, the State plan 

15 shall not be regarded as failing to comply with the 

16 requirements of such title solely on the basis of its 

17 failure to meet these additional requirements before 

18 the first day of the first calendar quarter beginning 

19 after the close of the first regular session of the 

20 State legislature that begins after the date of the en21 actment of this Act. For purposes of the previous 

22 sentence, in the case of a State that has a 2-year 

23 legislative session, each year of such session shall be 

24 deemed to be a separate regular session of the State 

25 legislature. 


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1 SEC. 4. ELIGIBILITY FOR OTHER PROGRAMS. 

2 (a) IN GENERAL.—Section 1905(p) of the Social Se3 curity Act (42 U.S.C. 1396d(p)), as amended by section 

4 2(a), is amended— 

5 (1) by redesignating paragraph (7) as para6 graph (8); and 

7 (2) by inserting after paragraph (6) the fol8 lowing new paragraph: 

9 ‘‘(7) Notwithstanding any other provision of 

10 law, any medical assistance for some or all medicare 

11 cost-sharing under this title shall not be considered 

12 income or resources in determining eligibility for, or 

13 the amount of assistance or benefits provided under, 

14 any other public benefit provided under Federal law 

15 or the law of any State or political subdivision there16 of.’’. 

17 (b) EFFECTIVE DATE.—The amendments made by 

18 subsection (a) shall apply to eligibility for benefits on or 

19 after January 1, 2010. 

20 SEC. 5. EFFECTIVE DATE OF MSP BENEFITS. 

21 (a) PROVIDING FOR 3 MONTHS RETROACTIVE ELIGI22 BILITY.— 

23 (1) IN GENERAL.— Section 1905(a) of the So24 cial Security Act (42 U.S.C. 1396d(a)) is amended, 

25 in the matter preceding paragraph (1), by striking 

26 ‘‘assistance or, in the case of medicare cost-sharing’’ 


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1 and all that follows through ‘‘beneficiary)’’ and in2 serting ‘‘assistance)’’. 

3 (2) CONFORMING AMENDMENTS.—(A) Section 

4 1902(e)(8) of such Act (42 U.S.C. 1396a(e)(8)) is 

5 amended— 

6 (i) by striking the first sentence; and 

7 (ii) by striking ‘‘such determination’’. 

8 (B) Section 1848(g)(3) of such Act (42 U.S.C. 

9 1395w–4(g)(3)) is amended by adding at the end 

10 the following new subparagraph: 

11 ‘‘(C) TREATMENT OF RETROACTIVE ELIGI12 BILITY.—In the case of an individual who is de13 termined to be eligible for medical assistance 

14 described in subparagraph (A) retroactively, the 

15 Secretary shall provide a process whereby 

16 claims which are submitted for services fur17 nished during the period of retroactive eligi18 bility and during a month in which the indi19 vidual otherwise would have been eligible for 

20 such assistance and which were not submitted 

21 in accordance with such subparagraph are re22 submitted and re-processed in accordance with 

23 such subparagraph.’’. 

24 (b) EFFECTIVE DATE.—The amendments made by 

25 this section shall take effect on January 1, 2010, but shall 


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1 not result in eligibility for benefits for medicare cost-shar2 ing for months before January 2010. 

3 SEC. 6. TREATMENT OF QUALIFIED MEDICARE BENE4 FICIARIES, SPECIFIED LOW-INCOME MEDI5 CARE BENEFICIARIES, AND OTHER DUAL ELI6 GIBLES AS MEDICARE BENEFICIARIES. 

7 (a) IN GENERAL.—Section 1862 of the Social Secu8 rity Act (42 U.S.C. 1395y) is amended by adding at the 

9 end the following new subsection: 

10 ‘‘(n) TREATMENT OF QUALIFIED MEDICARE BENE11 FICIARIES (QMBS), SPECIFIED LOW-INCOME MEDICARE

12 BENEFICIARIES (SLMBS), AND OTHER DUAL ELIGI13 BLES.—Nothing in this title shall be construed as author14 izing a provider of services or supplier to discriminate 

15 (through a private contractual arrangement or otherwise) 

16 against an individual who is otherwise entitled to services 

17 under this title on the basis that the individual is a quali18 fied medicare beneficiary (as defined in section 

19 1905(p)(1)), a specified low-income medicare beneficiary, 

20 or is otherwise eligible for medical assistance for medicare 

21 cost-sharing or other benefits under title XIX.’’. 

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

23 subsection (a) shall apply to items and services furnished 

24 on or after the date of the enactment of this Act. 


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1 SEC. 7. MONITORING AND ENFORCEMENT OF LIMITATION 

2 ON BENEFICIARY LIABILITY. 

3 (a) IN GENERAL.—Section 1902(n) of the Social Se4 curity Act (42 U.S.C. 1396b(n)) is amended— 

5 (1) by striking paragraph (2); and 

6 (2) in paragraph (3)— 

7 (A) by striking ‘‘In the case in which’’ and 

8 all that follows through ‘‘ the application of 

9 paragraph (2)’’ and inserting ‘‘With respect to 

10 an item or service’’; 

11 (B) in subparagraph (A), by striking ‘‘(if 

12 any)’’; and 

13 (C) by redesignating such paragraph as 

14 paragraph (2). 

15 (b) CONFORMING AMENDMENT.—Section 1905(p)(2) 

16 of such Act (42 U.S.C. 1396d(p)(2)) is amended by strik17 ing ‘‘(subject to section 1902(n))’’. 

18 (c) EFFECTIVE DATE.—The amendments made by 

19 this section shall apply to items and services furnished on 

20 or after January 1, 2011. 

21 SEC. 8. MEDICAID TREATMENT OF CERTAIN MEDICARE 

22 PROVIDERS. 

23 (a) IN GENERAL.—Section 1902(n) of the Social Se24 curity Act (42 U.S.C. 1396a(n)) is amended by adding 

25 at the end the following new paragraph: 


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1 ‘‘(3) A State plan shall not deny a claim from a pro2 vider or supplier with respect to medicare cost-sharing de3 scribed in subparagraph (B), (C), or (D) of section 

4 1905(p)(3) for an item or service which is eligible for pay5 ment under title XVIII on the basis that the provider or 

6 supplier does not have a provider agreement in effect 

7 under this title or does not otherwise serve all individuals 

8 entitled to medical assistance under this title. The State 

9 shall create a mechanism through which provider or sup10 pliers that do not otherwise have provider agreements with 

11 the State can bill the State for medicare cost-sharing for 

12 qualified medicare beneficiaries.’’. 

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

14 subsection (a) shall apply to items and services furnished 

15 on or after the date of the enactment of this Act. 

16 SEC. 9. STATE PROVISION OF MEDICAL ASSISTANCE TO 

17 DUAL ELIGIBLES IN MA PLANS. 

18 (a) IN GENERAL.—Section 1902(n) of the Social Se19 curity Act (42 U.S.C. 1396b(n)), as amended by section 

20 8(a), is further amended by adding at the end the fol21 lowing new paragraph: 

22 ‘‘(4)(A) Each State shall— 

23 ‘‘(i) identify those individuals who are eligible 

24 for medical assistance for medicare cost-sharing and 


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1 who are enrolled with a Medicare Advantage plan 

2 under part C of title XVIII; and 

3 ‘‘(ii) for the individuals so identified, provide 

4 for payment of medical assistance for the medicare 

5 cost-sharing (including cost-sharing under a Medi6 care Advantage plan) to which they are entitled. 

7 ‘‘(B)(i) The Inspector General of the Department of 

8 Health and Human Services shall examine whether States 

9 are providing for medical assistance for Medicare cost10 sharing for individuals enrolled in Medicare Advantage 

11 plans in accordance with this title. The Inspector General 

12 shall submit to the Secretary, not later than one year after 

13 the date of the enactment of this paragraph, a report on 

14 such examination and a finding as to whether States are 

15 failing to provide such medical assistance. 

16 ‘‘(ii) If a report under clause (i) includes a finding 

17 that States are failing to provide such medical assistance, 

18 not later than 60 days after the date of receiving such 

19 report the Secretary shall submit to Congress a report 

20 that includes a plan of action on how to enforce such re21 quirement.’’. 

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

23 subsection (a) shall be effective as if included in the enact24 ment of the Medicare Prescription Drug, Improvement, 

25 and Modernization Act of 2003 (Public Law 108–173). 


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1 SEC. 10. MEDICARE ENROLLMENT ASSISTANCE. 

2 (a) ADDITIONAL FUNDING FOR STATE HEALTH IN3 SURANCE ASSISTANCE PROGRAMS.— 

4 (1) GRANTS.— 

5 (A) IN GENERAL.—The Secretary of 

6 Health and Human Services (in this section re7 ferred to as the ‘‘Secretary’’) shall use amounts 

8 made available under subparagraph (B) to 

9 make grants to States for State health insur10 ance assistance programs receiving assistance 

11 under section 4360 of the Omnibus Budget 

12 Reconciliation Act of 1990. 

13 (B) FUNDING.—For purposes of making 

14 grants under this subsection, the Secretary 

15 shall provide for the transfer, from the Federal 

16 Hospital Insurance Trust Fund under section 

17 1817 of the Social Security Act (42 U.S.C. 

18 1395i) and the Federal Supplementary Medical 

19 Insurance Trust Fund under section 1841 of 

20 such Act (42 U.S.C. 1395t), in the same pro21 portion as the Secretary determines under sec22 tion 1853(f) of such Act (42 U.S.C. 1395w– 

23 23(f)), of $14,000,000 to the Centers for Medi24 care & Medicaid Services Program Management 

25 Account for fiscal year 2011, to remain avail26 able until expended. 


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1 (2) AMOUNT OF GRANTS.—The amount of a 

2 grant to a State under this subsection from the total 

3 amount made available under paragraph (1) shall be 

4 equal to the sum of the amount allocated to the 

5 State under paragraph (3)(A) and the amount allo6 cated to the State under subparagraph (3)(B). 

7 (3) ALLOCATION TO STATES.— 

8 (A) ALLOCATION BASED ON PERCENTAGE

9 OF LOW-INCOME BENEFICIARIES.—The amount 

10 allocated to a State under this subparagraph 

from 2 11 ⁄3 of the total amount made available 

12 under paragraph (1) shall be based on the num13 ber of individuals who meet the requirement 

14 under subsection (a)(3)(A)(ii) of section 

15 1860D–14 of the Social Security Act (42 

16 U.S.C. 1395w–114) but who have not enrolled 

17 to receive a subsidy under such section 1860D– 

18 14 relative to the total number of individuals 

19 who meet the requirement under such sub20 section (a)(3)(A)(ii) in each State, as estimated 

21 by the Secretary. 

22 (B) ALLOCATION BASED ON PERCENTAGE

23 OF RURAL BENEFICIARIES.—The amount allo24 cated to a State under this subparagraph from 

1 25 ⁄3 of the total amount made available under 


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1 paragraph (1) shall be based on the number of 

2 part D eligible individuals (as defined in section 

3 1860D–1(a)(3)(A) of such Act (42 U.S.C. 

4 1395w–101(a)(3)(A))) residing in a rural area 

5 relative to the total number of such individuals 

6 in each State, as estimated by the Secretary. 

7 (4) PORTION OF GRANT BASED ON PERCENT8 AGE OF LOW-INCOME BENEFICIARIES TO BE USED

9 TO PROVIDE OUTREACH TO INDIVIDUALS WHO MAY

10 BE SUBSIDY ELIGIBLE INDIVIDUALS OR ELIGIBLE

11 FOR THE MEDICARE SAVINGS PROGRAM.—Each 

12 grant awarded under this subsection with respect to 

13 amounts allocated under paragraph (3)(A) shall be 

14 used to provide outreach to individuals who may be 

15 subsidy eligible individuals (as defined in section 

16 1860D–14(a)(3)(A) of the Social Security Act (42 

17 U.S.C. 1395w–114(a)(3)(A)) or eligible for the 

18 Medicare Savings Program (as defined in subsection 

19 (f)). 

20 (b) ADDITIONAL FUNDING FOR AREA AGENCIES ON

21 AGING.— 

22 (1) GRANTS.— 

23 (A) IN GENERAL.—The Secretary, acting 

24 through the Assistant Secretary for Aging, shall 

25 make grants to States for area agencies on 


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1 aging (as defined in section 102 of the Older 

2 Americans Act of 1965 (42 U.S.C. 3002)) and 

3 Native American programs carried out under 

4 the Older Americans Act of 1965 (42 U.S.C. 

5 3001 et seq.). 

6 (B) FUNDING.—For purposes of making 

7 grants under this subsection, the Secretary 

8 shall provide for the transfer, from the Federal 

9 Hospital Insurance Trust Fund under section 

10 1817 of the Social Security Act (42 U.S.C. 

11 1395i) and the Federal Supplementary Medical 

12 Insurance Trust Fund under section 1841 of 

13 such Act (42 U.S.C. 1395t), in the same pro14 portion as the Secretary determines under sec15 tion 1853(f) of such Act (42 U.S.C. 1395w– 

16 23(f)), of $10,000,000 to the Administration on 

17 Aging for fiscal year 2011, to remain available 

18 until expended. 

19 (2) AMOUNT OF GRANT AND ALLOCATION TO

20 STATES BASED ON PERCENTAGE OF LOW-INCOME

21 AND RURAL BENEFICIARIES.—The amount of a 

22 grant to a State under this subsection from the total 

23 amount made available under paragraph (1) shall be 

24 determined in the same manner as the amount of a 

25 grant to a State under subsection (a), from the total 


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1 amount made available under paragraph (1) of such 

2 subsection, is determined under paragraph (2) and 

3 subparagraphs (A) and (B) of paragraph (3) of such 

4 subsection. 

5 (3) REQUIRED USE OF FUNDS.— 

6 (A) ALL FUNDS.—Subject to subparagraph 

7 (B), each grant awarded under this subsection 

8 shall be used to provide outreach to eligible 

9 Medicare beneficiaries regarding the benefits 

10 available under title XVIII of the Social Secu11 rity Act. 

12 (B) OUTREACH TO INDIVIDUALS WHO MAY

13 BE SUBSIDY ELIGIBLE INDIVIDUALS OR ELIGI14 BLE FOR THE MEDICARE SAVINGS PROGRAM.— 

15 Subsection (a)(4) shall apply to each grant 

16 awarded under this subsection in the same 

17 manner as it applies to a grant under sub18 section (a). 

19 (c) ADDITIONAL FUNDING FOR AGING AND DIS20 ABILITY RESOURCE CENTERS.— 

21 (1) GRANTS.— 

22 (A) IN GENERAL.—The Secretary shall 

23 make grants to Aging and Disability Resource 

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1 lished centers under such program on the date 

2 of the enactment of this Act. 

3 (B) FUNDING.—For purposes of making 

4 grants under this subsection, the Secretary 

5 shall provide for the transfer, from the Federal 

6 Hospital Insurance Trust Fund under section 

7 1817 of the Social Security Act (42 U.S.C. 

8 1395i) and the Federal Supplementary Medical 

9 Insurance Trust Fund under section 1841 of 

10 such Act (42 U.S.C. 1395t), in the same pro11 portion as the Secretary determines under sec12 tion 1853(f) of such Act (42 U.S.C. 1395w– 

13 23(f)), of $10,000,000 to the Administration on 

14 Aging for fiscal year 2011, to remain available 

15 until expended. 

16 (2) REQUIRED USE OF FUNDS.—Each grant 

17 awarded under this subsection shall be used to pro18 vide outreach to individuals regarding the benefits 

19 available under the Medicare prescription drug ben20 efit under part D of title XVIII of the Social Secu21 rity Act and under the Medicare Savings Program. 

22 (d) COORDINATION OF EFFORTS TO INFORM OLDER

23 AMERICANS ABOUT BENEFITS AVAILABLE UNDER FED24 ERAL AND STATE PROGRAMS.— 


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1 (1) IN GENERAL.—The Secretary, acting 

2 through the Assistant Secretary for Aging, in co3 operation with related Federal agency partners, shall 

4 make a grant to, or enter into a contract with, a 

5 qualified, experienced entity under which the entity 

6 shall— 

7 (A) maintain and update web-based deci8 sion support tools, and integrated, person-cen9 tered systems, designed to inform older individ10 uals (as defined in section 102 of the Older 

11 Americans Act of 1965 (42 U.S.C. 3002)) 

12 about the full range of benefits for which the 

13 individuals may be eligible under Federal and 

14 State programs; 

15 (B) utilize cost-effective strategies to find 

16 older individuals with the greatest economic 

17 need (as defined in such section 102) and in18 form the individuals of the programs; 

19 (C) develop and maintain an information 

20 clearinghouse on best practices and the most 

21 cost-effective methods for finding older individ22 uals with greatest economic need and informing 

23 the individuals of the programs; and 

24 (D) provide, in collaboration with related 

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1 eral programs, training and technical assistance 

2 on the most effective outreach, screening, and 

3 follow-up strategies for the Federal and State 

4 programs. 

5 (2) FUNDING.—For purposes of making a 

6 grant or entering into a contract under paragraph 

7 (1), the Secretary shall provide for the transfer, 

8 from the Federal Hospital Insurance Trust Fund 

9 under section 1817 of the Social Security Act (42 

10 U.S.C. 1395i) and the Federal Supplementary Med11 ical Insurance Trust Fund under section 1841 of 

12 such Act (42 U.S.C. 1395t), in the same proportion 

13 as the Secretary determines under section 1853(f) of 

14 such Act (42 U.S.C. 1395w–23(f)), of $10,000,000 

15 to the Administration on Aging for fiscal year 2011, 

16 to remain available until expended. 

17 (e) MEDICARE SAVINGS PROGRAM DEFINED.—For 

18 purposes of this section, the term ‘‘Medicare Savings Pro19 gram’’ means the program of medical assistance for pay20 ment of the cost of medicare cost-sharing under the Med21 icaid program pursuant to sections 1902(a)(10)(E) and 

22 1933 of the Social Security Act (42 U.S.C. 

23 1396a(a)(10)(E), 1396u–3). 


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1 SEC. 11. MEDICAID AGENCY CONSIDERATION OF LOW-IN2 COME SUBSIDY APPLICATION AND DATA 

3 TRANSMITTAL. 

4 (a) CONFORMING AMENDMENT TO SECTION 1144.— 

5 The first sentence of section 1144(c)(3) of the Social Se6 curity Act (42 U.S.C. 1320b–14(c)(3)), as added by sec7 tion 113(a) of Public Law 110–275, is amended— 

8 (1) by striking ‘‘transmittal’’; and 

9 (2) by inserting ‘‘as specified in section 

10 1935(a)(4)’’ before the period at the end. 

11 (b) CLARIFYING AMENDMENT TO SECTION 1935.— 

12 Section 1935(a)(4) of the Social Security Act (42 U.S.C. 

13 1396u–5(a)(4)), as added by section 113(b) of Public Law 

14 110–275, is amended by striking the last sentence and in15 serting the following: ‘‘For the purpose of a State’s obliga16 tion under section 1902(a)(8) to furnish medical assist17 ance with reasonable promptness, the date of the elec18 tronic transmission of low income subsidy program data, 

19 as described in section 1144(c), from the Commissioner 

20 of Social Security to the State Medicaid Agency, shall con21 stitute the date of filing of such application for benefits 

22 under the Medicare Savings Program. For the purpose of 

23 determining when such medical assistance will be made 

24 available, the State shall consider the date of the individ25 ual’s application for the low income subsidy program to 


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1 constitute the date of filing of an application for benefits 

2 under the Medicare Savings Program.’’. 

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

4 this section are effective as if they had been included in 

5 the enactment of section 113(b) of Public Law 110–275. 

6 (d) OIG STUDY.—The Inspector General of the De7 partment of Health and Human Services shall examine the 

8 extent to which States are complying with the require9 ment, under amendments made by the Medicare Improve10 ments for Patients and Providers Act of 2008 (Public Law 

11 110–275), that they initiate an application for Medicare 

12 Savings Program from data of the Social Security Admin13 istration suggesting eligibility. 

14 SEC. 12. QMB BUY-IN OF PART A AND PART B PREMIUMS. 

15 (a) REQUIREMENT.—Section 1902(a) of the Social 

16 Security Act (42 U.S.C. 1396a(a)) is amended— 

17 (1) in paragraph (72), by striking ‘‘and’’ at the 

18 end; 

19 (2) in paragraph (73), by striking the period at 

20 the end and inserting ‘‘; and’’; and 

21 (3) by inserting after paragraph (73) the fol22 lowing new paragraph: 

23 ‘‘(74) provide that the State enters into a modi24 fication of an agreement under section 1818(g).’’. 

25 (b) EFFECTIVE DATE.— 


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1 (1) IN GENERAL.—Except as provided in para2 graph (2), the amendments made by this section 

3 take effect on the first day of the first calendar 

4 quarter beginning 6 months after the date of the en5 actment of this Act. 

6 (2) EXTENSION OF EFFECTIVE DATE FOR

7 STATE LAW AMENDMENT.—In the case of a State 

8 plan under title XIX of the Social Security Act (42 

9 U.S.C. 1396 et seq.) which the Secretary of Health 

10 and Human Services determines requires State legis11 lation in order for the plan to meet the additional 

12 requirements imposed by the amendments made by 

13 this section, the State plan shall not be regarded as 

14 failing to comply with the requirements of such title 

15 solely on the basis of its failure to meet these addi16 tional requirements before the first day of the first 

17 calendar quarter beginning after the close of the 

18 first regular session of the State legislature that be19 gins after the date of enactment of this Act. For 

20 purposes of the previous sentence, in the case of a 

21 State that has a 2-year legislative session, each year 

22 of the session is considered to be a separate regular 

23 session of the State legislature. 


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1 SEC. 13. INCREASING AVAILABILITY OF MSP APPLICATIONS 

2 THROUGH AVAILABILITY ON THE INTERNET 

3 AND DESIGNATION OF PREFERRED LAN4 GUAGE. 

5 (a) REQUIREMENT FOR STATES.— 

6 (1) IN GENERAL.—Section 1902(a) of the So7 cial Security Act (42 U.S.C. 1396a(a)), as amended 

8 by section 12, is amended— 

9 (A) in paragraph (73), by striking ‘‘and’’at 

10 the end; 

11 (B) in paragraph (74), by striking the pe12 riod at the end and inserting ‘‘; and’’; and 

13 (C) by inserting after paragraph (74) the 

14 following new paragraph: 

15 ‘‘(75) provide— 

16 ‘‘(A) that the application for medical as17 sistance for Medicare cost-sharing under this 

18 title used by the State allows an individual to 

19 specify a preferred language for subsequent 

20 communication and, in the case in which a lan21 guage other than English is specified, provide 

22 that subsequent communications under this title 

23 to the individual shall be in such language; and 

24 ‘‘(B) that the State makes such application 

25 available through an Internet website and proVerDate Nov 24 2008 23:11 Jun 09, 2009 Jkt 079200 PO 00000 Frm 00026 Fmt 6652 Sfmt 6201 E:\BILLS\H2716.IH H2716

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1 vides for such application to be completed on 

2 such website.’’. 

3 (2) EFFECTIVE DATE.—The amendments made 

4 by this subsection take effect on and after the first 

5 day of the first calendar quarter beginning 2 years 

6 after the date of the enactment of this Act. 

7 (b) REQUIREMENT FOR THE SECRETARY.—Section 

8 1905(p)(5) of the Social Security Act (42 U.S.C. 

9 1396d(p)(5)) is amended by adding at the end the fol10 lowing new sentence: ‘‘Such form shall allow an individual 

11 to specify a preferred language for subsequent commu12 nication.’’ 

13 SEC. 14. MEDICARE SAVINGS PROGRAM APPLICATIONS. 

14 (a) IN GENERAL.—Section 1902(a) of the Social Se15 curity Act (42 U.S.C. 1396a(a)), as amended by sections 

16 12 and 13, is further amended— 

17 (1) in paragraph (74), by striking ‘‘and’’at the 

18 end; 

19 (2) in paragraph (75), by striking the period at 

20 the end and inserting ‘‘; and’’; and 

21 (3) by inserting after paragraph (75) the fol22 lowing new paragraph: 

23 ‘‘(76) provide that the State coordinates with 

24 the State agency that administers benefits under the 

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1 lished under the Food and Nutrition Act of 2008 (7 

2 U.S.C. 2011 et seq.) to ensure that individuals ap3 plying for medical assistance provided under para4 graph (10)(E), as described in sections 1905(p) and 

5 1933, have the opportunity to apply for, establish 

6 eligibility for, and, if eligible, receive supplemental 

7 nutrition assistance program benefits.’’. 

8 (b) EFFECTIVE DATE.— 

9 (1) IN GENERAL.—Except as provided in para10 graph (2), the amendments made by subsection (a) 

11 take effect on the first day of the first calendar 

12 quarter beginning 6 months after the date of the en13 actment of this Act. 

14 (2) EXTENSION OF EFFECTIVE DATE FOR

15 STATE LAW AMENDMENT.—In the case of a State 

16 plan under title XIX of the Social Security Act (42 

17 U.S.C. 1396 et seq.) which the Secretary of Health 

18 and Human Services determines requires State legis19 lation in order for the plan to meet the additional 

20 requirements imposed by the amendments made by 

21 subsection (a), the State plan shall not be regarded 

22 as failing to comply with the requirements of such 

23 title solely on the basis of its failure to meet these 

24 additional requirements before the first day of the 

25 first calendar quarter beginning after the close of 


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1 the first regular session of the State legislature that 

2 begins after the date of enactment of this Act. For 

3 purposes of the previous sentence, in the case of a 

4 State that has a 2-year legislative session, each year 

5 of the session is considered to be a separate regular 

6 session of the State legislature. 

7 (c) REPORT TO CONGRESS.—Not later than 1 year 

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

9 Health and Human Services shall submit to Congress a 

10 report on the process each State uses to meet the require11 ments under section 1902(a)(76) of the Social Security 

12 Act, as added by subsection (a). 

13 SEC. 15. REPEAL OF PAYMENT LIMITATION. 

14 (a) IN GENERAL.—Section 1902(n) of the Social Se15 curity Act (42 U.S.C. 1396a(n)) is amended— 

16 (1) by striking paragraphs (2) and (3); and 

17 (2) in paragraph (1)— 

18 (A) by striking ‘‘(n)(1)’’ and inserting 

19 ‘‘(n)’’; and 

20 (B) by striking ‘‘may provide’’ and insert21 ing ‘‘shall provide’’. 

22 (b) CONFORMING AMENDMENTS.—(1) Section 

23 1902(a)(10) of such Act is amended, in the subclause 

24 (VIII) following subparagraph (G), by striking ‘‘sub25 section (n) and’’. 


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1 (2) Section 1905(p)(2) of such Act (42 U.S.C. 

2 1396d(p)(2)) is amended by striking ‘‘(subject to section 

3 1902(n))’’. 

4 (c) EFFECTIVE DATE.—The amendments made by 

5 this section shall apply to items and services furnished on 

6 or after January 1, 2010. 

Æ 


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