endar years 2008 through 2012 to carry out ac-
tivities described in subparagraph (B). 
(B) ACTIVITIES DESCRIBED.—The activi-
ties described in this subparagraph are the fol-
lowing: 
(i) Activities under section 4360 of 
the Omnibus Budget Reconciliation Act of 
1990 for the purpose of outreach to low-in-
come Medicare beneficiaries to assist in ap-
plying for and obtaining benefits under the 
Medicare Savings Program (under title 
XIX of the Social Security Act) and the 
low-income subsidy program under section 
1860D–14 of such Act. 
(ii) Activities of the National Center 
on Senior Benefits Outreach and Enroll-
ment 
(as 
described 
in 
section 
202(a)(20)(B) of the Older Americans Act 
of 1965 (42 U.S.C. 3012(a)(20)(B)). 
(iii) Similar activities carried out by 
other qualified agencies designated by the 
Secretary of Health and Human Services. 
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SEC. 9. TREATMENT OF QUALIFIED MEDICARE BENE-
FICIARIES, SPECIFIED LOW-INCOME MEDI-
CARE BENEFICIARIES, AND OTHER DUAL ELI-
GIBLES AS MEDICARE BENEFICIARIES. 
(a) IN GENERAL.—Section 1862 of the Social Secu-
rity Act (42 U.S.C. 1395y) is amended by adding at the 
end the following new subsection: 
‘‘(n) TREATMENT OF QUALIFIED MEDICARE BENE-
FICIARIES (QMBS), SPECIFIED LOW-INCOME MEDICARE 
BENEFICIARIES (SLMBS), AND OTHER DUAL ELIGI-
BLES.—Nothing in this title shall be construed as author-
izing a provider of services or supplier to discriminate 
(through a private contractual arrangement or otherwise) 
against an individual who is otherwise entitled to services 
under this title on the basis that the individual is a quali-
fied 
medicare 
beneficiary 
(as 
defined 
in 
section 
1905(p)(1)), a specified low-income medicare beneficiary, 
or is otherwise eligible for medical assistance for medicare 
cost-sharing or other benefits under title XIX.’’. 
(b) EFFECTIVE DATE.—The amendment made by 
subsection (a) shall apply to items and services furnished 
on or after the date of the enactment of this Act. 
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SEC. 10. MEDICAID TREATMENT OF CERTAIN MEDICARE 
PROVIDERS. 
(a) IN GENERAL.—Section 1902(n) of the Social Se-
curity Act (42 U.S.C. 1396a(n)) is amended by adding 
at the end the following new paragraph: 
‘‘(4) A State plan shall not deny a claim from 
a provider or supplier with respect to medicare cost- 
sharing described in subparagraph (B), (C), or (D) 
of section 1905(p)(3) for an item or service which is 
eligible for payment under title XVIII on the basis 
that the provider or supplier does not have a pro-
vider agreement in effect under this title or does not 
otherwise serve all individuals entitled to medical as-
sistance under this title.’’. 
(b) EFFECTIVE DATE.—The amendment made by 
subsection (a) shall apply to items and services furnished 
on or after the date of the enactment of this Act. 
SEC. 11. MONITORING AND ENFORCEMENT OF LIMITATION 
ON BENEFICIARY LIABILITY. 
Section 1902(n) of the Social Security Act (42 U.S.C. 
1396b(n)), as amended by section 9(a), is further amend-
ed by adding at the end the following new paragraph: 
‘‘(5)(A) The Inspector General of the Depart-
ment of Health and Human Services shall examine, 
not later than one year after the date of the enact-
ment of this paragraph and every three years there-
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after, whether providers have attempted to make 
qualified 
medicare 
beneficiaries 
liable 
for 
deductibles, coinsurance, and co-payments in viola-
tion of paragraph (3)(B). The Inspector General 
shall submit to the Secretary a report on such exam-
ination and a finding as to whether qualified medi-
care beneficiaries have been held liable in violation 
of such paragraph. 
‘‘(B) If a report under subparagraph (A) in-
cludes a finding that qualified medicare beneficiaries 
have been held liable in violation of such paragraph, 
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 en-
force provisions of such paragraph.’’. 
SEC. 12. STATE PROVISION OF MEDICAL ASSISTANCE TO 
DUAL ELIGIBLES IN MA PLANS. 
(a) IN GENERAL.—Section 1902(n) of the Social Se-
curity Act (42 U.S.C. 1396b(n)), as amended by section 
10, is further amended by adding at the end the following 
new paragraph: 
‘‘(6)(A) Each State shall— 
‘‘(i) identify those individuals who are eli-
gible for medical assistance for medicare cost- 
sharing and who are enrolled with a Medicare 
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Advantage plan under part C of title XVIII; 
and 
‘‘(ii) for the individuals so identified, pro-
vide 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 Depart-
ment of Health and Human Services shall examine, 
not later than one year after the date of the enact-
ment of this paragraph and every three years there-
after, whether States are providing for medical as-
sistance for medicare cost-sharing for individuals en-
rolled 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 find-
ing 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.’’. 
(b) EFFECTIVE DATE.— 
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(1) Except as provided in paragraph (2), the 
amendment made by subsection (a) shall apply to 
calendar quarters beginning on or after the date of 
the enactment of this Act. 
(2) In the case of a State plan for medical as-
sistance under title XIX of the Social Security Act 
which the Secretary of Health and Human Services 
determines requires State legislation (other than leg-
islation appropriating funds) in order for the plan to 
meet the additional requirements imposed by the 
amendment made by subsection (a), 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 en-
actment 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. 
Æ 
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