I
106TH CONGRESS
1ST SESSION
H. R. 1455
To amend title XI of the Social Security Act and the Internal Revenue
Code of 1986 to establish a mechanism to promote the provision of
Medicare cost-sharing assistance to eligible low-income Medicare bene-
ficiaries.
IN THE HOUSE OF REPRESENTATIVES
APRIL 15, 1999
Mr. MCDERMOTT (for himself, Mr. STARK, and Mr. BERRY) introduced the
following bill; which was referred to the Committee on Ways and Means,
and in addition to the Committee on Commerce, for a period to be subse-
quently 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 XI of the Social Security Act and the Internal
Revenue Code of 1986 to establish a mechanism to pro-
mote the provision of Medicare cost-sharing assistance
to eligible low-income Medicare beneficiaries.
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ‘‘QMB Improvement
Act of 1999’’.
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SEC. 2. MECHANISM PROMOTING PROVISION OF MEDICARE
COST-SHARING 
ASSISTANCE 
TO 
ELIGIBLE
LOW-INCOME MEDICARE BENEFICIARIES.
(a) IN GENERAL.—Part A of title XI of the Social
Security Act is amended by adding at the end the fol-
lowing:
‘‘PROMOTING
PROVISION
OF
MEDICARE
COST-SHARING
ASSISTANCE UNDER MEDICAID PROGRAM FOR IDEN-
TIFIED LOW-INCOME MEDICARE BENEFICIARIES
‘‘SEC. 
1147. 
(a) 
REQUIREMENT
FOR
DATA
MATCH.—
‘‘(1) REQUESTING MATCHING INFORMATION.—
The Commissioner of Social Security shall, not less
often than annually beginning with 2001, transmit
to the Secretary of the Treasury a list of the names
and TINs of Medicare beneficiaries (as defined in
section 6103(l)(15) of the Internal Revenue Code of
1986) and request that such Secretary disclose to
the Secretary of Health and Human Services the in-
formation described in subparagraph (A) of such
section.
‘‘(2) SPECIFICATION OF INCOME LEVELS.—The
Secretary shall specify—
‘‘(A) the items that will be included in de-
termination of income for purposes of applying
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this section and section 6103(l)(15)(A)(i) of the
Internal Revenue Code of 1986; and
‘‘(B) the levels of such income (based upon
a percentage of the Federal poverty guidelines)
that individuals may have and qualify for med-
ical assistance under section 1902(a)(10)(E)(i)
of the Social Security Act (relating to assist-
ance for Medicare cost-sharing benefits under
the Medicaid program).
‘‘(b) NOTICE TO INDIVIDUALS IDENTIFIED.—
‘‘(1) 
INITIAL
ELIGIBILITY.—The 
Secretary
promptly shall provide for an appropriate notice to
each individual identified under subsection (a) who
is described in section 6103(l)(15)(A)(i), of the fol-
lowing:
‘‘(A) Subject to subparagraph (B), the in-
dividual is deemed eligible for some form of
medical assistance for some Medicare cost-shar-
ing under clause (i) or (iii) of section
1902(a)(10)(E), depending on the individual’s
level of income.
‘‘(B) By accepting such assistance the in-
dividual is obligated to notify the Secretary if
the individual is not eligible for such assistance
due to—
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‘‘(i) the individual having tax-exempt
income;
‘‘(ii) the individual having countable
assets in excess of the maximum permis-
sible assets, if the individual resides in a
State that imposes an asset test for such
eligibility; or
‘‘(iii) the individual otherwise is not
eligible for such assistance.
‘‘(C) If the individual accepts such assist-
ance notwithstanding that the individual is not
eligible, the individual is liable to the State for
the amount of medical assistance provided (with
interest).
‘‘(2) CONTINUED ELIGIBILITY.—The Secretary
shall provide for an appropriate notice to each indi-
vidual identified under subsection (a) who is de-
scribed in section 6103(l)(15)(A)(ii), of the fol-
lowing: ‘Unless the individual declines coverage or
indicates otherwise, the individual will be enrolled
for the appropriate assistance with Medicare cost-
sharing under the State plan operated under title
XIX for the State in which the individual resides.’
‘‘(c) NOTICE TO STATE.—In the case of an individual
who is identified under this section and resides in a State,
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the Secretary shall provide for appropriate notice to the
State of the individual’s eligibility for medical assistance
under clause (i) or (iii) of section 1902(a)(10)(E), as the
case may be.’’.
(b) CONFORMING AMENDMENT TO MEDICAID PRO-
GRAM.—Section 1902 of such Act (42 U.S.C. 1396a) is
amended by adding at the end the following:
‘‘(aa) A State shall treat an individual who is identi-
fied under section 1147(b) as being eligible for medical
assistance under clause (i) or (ii) of subsection (a)(10)(E)
as being so eligible, until the Secretary notifies the State
otherwise, with respect to medical assistance for items and
services furnished on or after the date of the notice.’’.
(c) 
AUTHORIZATION
OF
DISCLOSURE.—Section
6103(l) of the Internal Revenue Code of 1986 (relating
to disclosure of returns and return information for pur-
poses other than tax administration) is amended by add-
ing at the end the following new paragraph:
‘‘(15) DISCLOSURE OF CERTAIN INFORMATION
IN ORDER TO QUALIFY FOR MEDICARE COST-SHAR-
ING ASSISTANCE.—
‘‘(A) IN GENERAL.—The Secretary shall,
upon written request from the Commissioner of
Social Security, disclose to the Secretary of
Health and Human Services, whether with re-
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officials of a State responsible for administra-
tion of a State plan under title XIX of the So-
cial Security Act the name, address, and TIN
of the preliminary eligibility determination.
‘‘(C) SPECIAL RULES.—
‘‘(i) 
RESTRICTIONS
ON
DISCLO-
SURE.—Information 
may 
be 
disclosed
under this paragraph only for purposes of,
and to the extent necessary in, determining
the extent to which an individual bene-
ficiary is entitled to medical assistance
under a State plan under title XIX of the
Social Security Act for some or all Medi-
care cost-sharing.
‘‘(ii) TIMELY
RESPONSES
TO
RE-
QUESTS.—Any request made under sub-
paragraph (A) shall be complied with as
soon as possible but in no event later than
60 days after the date the request was
made.’’.
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