H. R. 6331 
One Hundred Tenth Congress 
of the 
United States of America 
AT THE SECOND SESSION 
Begun and held at the City of Washington on Thursday, 
the third day of January, two thousand and eight 
An Act 
To amend titles XVIII and XIX of the Social Security Act to extend expiring 
provisions under the Medicare Program, to improve beneficiary access to preventive 
and mental health services, to enhance low-income benefit programs, and to 
maintain access to care in rural areas, including pharmacy access, and for other 
purposes. 
Be it enacted by the Senate and House of Representatives of 
the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE; TABLE OF CONTENTS. 
(a) SHORT TITLE.—This Act may be cited as the ‘‘Medicare 
Improvements for Patients and Providers Act of 2008’’. 
(b) TABLE OF CONTENTS.—The table of contents of this Act 
is as follows: 
Sec. 1. Short title; table of contents. 
TITLE I—MEDICARE 
Subtitle A—Beneficiary Improvements 
PART I—PREVENTION, MENTAL HEALTH, AND MARKETING 
Sec. 101. Improvements to coverage of preventive services. 
Sec. 102. Elimination of discriminatory copayment rates for Medicare outpatient 
psychiatric services. 
Sec. 103. Prohibitions and limitations on certain sales and marketing activities 
under Medicare Advantage plans and prescription drug plans. 
Sec. 104. Improvements to the Medigap program. 
PART II—LOW-INCOME PROGRAMS 
Sec. 111. Extension of qualifying individual (QI) program. 
Sec. 112. Application of full LIS subsidy assets test under Medicare Savings Pro-
gram. 
Sec. 113. Eliminating barriers to enrollment. 
Sec. 114. Elimination of Medicare part D late enrollment penalties paid by subsidy 
eligible individuals. 
Sec. 115. Eliminating application of estate recovery. 
Sec. 116. Exemptions from income and resources for determination of eligibility for 
low-income subsidy. 
Sec. 117. Judicial review of decisions of the Commissioner of Social Security under 
the Medicare part D low-income subsidy program. 
Sec. 118. Translation of model form. 
Sec. 119. Medicare enrollment assistance. 
Subtitle B—Provisions Relating to Part A 
Sec. 121. Expansion and extension of the Medicare Rural Hospital Flexibility Pro-
gram. 
Sec. 122. Rebasing for sole community hospitals. 
Sec. 123. Demonstration project on community health integration models in certain 
rural counties. 
Sec. 124. Extension of the reclassification of certain hospitals. 
Sec. 125. Revocation of unique deeming authority of the Joint Commission.
H. R. 6331—2 
Subtitle C—Provisions Relating to Part B 
PART I—PHYSICIANS’ SERVICES 
Sec. 131. Physician payment, efficiency, and quality improvements. 
Sec. 132. Incentives for electronic prescribing. 
Sec. 133. Expanding access to primary care services. 
Sec. 134. Extension of floor on Medicare work geographic adjustment under the 
Medicare physician fee schedule. 
Sec. 135. Imaging provisions. 
Sec. 136. Extension of treatment of certain physician pathology services under 
Medicare. 
Sec. 137. Accommodation of physicians ordered to active duty in the Armed Serv-
ices. 
Sec. 138. Adjustment for Medicare mental health services. 
Sec. 139. Improvements for Medicare anesthesia teaching programs. 
PART II—OTHER PAYMENT AND COVERAGE IMPROVEMENTS 
Sec. 141. Extension of exceptions process for Medicare therapy caps. 
Sec. 142. Extension of payment rule for brachytherapy and therapeutic radio-
pharmaceuticals. 
Sec. 143. Speech-language pathology services. 
Sec. 144. Payment and coverage improvements for patients with chronic obstructive 
pulmonary disease and other conditions. 
Sec. 145. Clinical laboratory tests. 
Sec. 146. Improved access to ambulance services. 
Sec. 147. Extension and expansion of the Medicare hold harmless provision under 
the prospective payment system for hospital outpatient department 
(HOPD) services for certain hospitals. 
Sec. 148. Clarification of payment for clinical laboratory tests furnished by critical 
access hospitals. 
Sec. 149. Adding certain entities as originating sites for payment of telehealth serv-
ices. 
Sec. 150. MedPAC study and report on improving chronic care demonstration pro-
grams. 
Sec. 151. Increase of FQHC payment limits. 
Sec. 152. Kidney disease education and awareness provisions. 
Sec. 153. Renal dialysis provisions. 
Sec. 154. Delay in and reform of Medicare DMEPOS competitive acquisition pro-
gram. 
Subtitle D—Provisions Relating to Part C 
Sec. 161. Phase-out of indirect medical education (IME). 
Sec. 162. Revisions to requirements for Medicare Advantage private fee-for-service 
plans. 
Sec. 163. Revisions to quality improvement programs. 
Sec. 164. Revisions relating to specialized Medicare Advantage plans for special 
needs individuals. 
Sec. 165. Limitation on out-of-pocket costs for dual eligibles and qualified medicare 
beneficiaries enrolled in a specialized Medicare Advantage plan for spe-
cial needs individuals. 
Sec. 166. Adjustment to the Medicare Advantage stabilization fund. 
Sec. 167. Access to Medicare reasonable cost contract plans. 
Sec. 168. MedPAC study and report on quality measures. 
Sec. 169. MedPAC study and report on Medicare Advantage payments. 
Subtitle E—Provisions Relating to Part D 
PART I—IMPROVING PHARMACY ACCESS 
Sec. 171. Prompt payment by prescription drug plans and MA–PD plans under part 
D. 
Sec. 172. Submission of claims by pharmacies located in or contracting with long- 
term care facilities. 
Sec. 173. Regular update of prescription drug pricing standard. 
PART II—OTHER PROVISIONS 
Sec. 175. Inclusion of barbiturates and benzodiazepines as covered part D drugs. 
Sec. 176. Formulary requirements with respect to certain categories or classes of 
drugs. 
Subtitle F—Other Provisions 
Sec. 181. Use of part D data.
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Sec. 182. Revision of definition of medically accepted indication for drugs. 
Sec. 183. Contract with a consensus-based entity regarding performance measure-
ment. 
Sec. 184. Cost-sharing for clinical trials. 
Sec. 185. Addressing health care disparities. 
Sec. 186. Demonstration to improve care to previously uninsured. 
Sec. 187. Office of the Inspector General report on compliance with and enforce-
ment of national standards on culturally and linguistically appropriate 
services (CLAS) in Medicare. 
Sec. 188. Medicare Improvement Funding. 
Sec. 189. Inclusion of Medicare providers and suppliers in Federal Payment Levy 
and Administrative Offset Program. 
TITLE II—MEDICAID 
Sec. 201. Extension of transitional medical assistance (TMA) and abstinence edu-
cation program. 
Sec. 202. Medicaid DSH extension. 
Sec. 203. Pharmacy reimbursement under Medicaid. 
Sec. 204. Review of administrative claim determinations. 
Sec. 205. County medicaid health insuring organizations. 
TITLE III—MISCELLANEOUS 
Sec. 301. Extension of TANF supplemental grants. 
Sec. 302. 70 percent federal matching for foster care and adoption assistance for 
the District of Columbia. 
Sec. 303. Extension of Special Diabetes Grant Programs. 
Sec. 304. IOM reports on best practices for conducting systematic reviews of clinical 
effectiveness research and for developing clinical protocols. 
TITLE I—MEDICARE 
Subtitle A—Beneficiary Improvements 
PART I—PREVENTION, MENTAL HEALTH, AND 
MARKETING 
SEC. 101. IMPROVEMENTS TO COVERAGE OF PREVENTIVE SERVICES. 
(a) COVERAGE OF ADDITIONAL PREVENTIVE SERVICES.— 
(1) COVERAGE.—Section 1861 of the Social Security Act 
(42 U.S.C. 1395x), as amended by section 114 of the Medicare, 
Medicaid, and SCHIP Extension Act of 2007 (Public Law 110– 
173), is amended— 
(A) in subsection (s)(2)— 
(i) in subparagraph (Z), by striking ‘‘and’’ after 
the semicolon at the end; 
(ii) in subparagraph (AA), by adding ‘‘and’’ after 
the semicolon at the end; and 
(iii) by adding at the end the following new 
subparagraph: 
‘‘(BB) additional preventive services (described in sub-
section (ddd)(1));’’; and 
(B) by adding at the end the following new subsection: 
‘‘Additional Preventive Services 
‘‘(ddd)(1) The term ‘additional preventive services’ means serv-
ices not otherwise described in this title that identify medical condi-
tions or risk factors and that the Secretary determines are— 
‘‘(A) reasonable and necessary for the prevention or early 
detection of an illness or disability; 
‘‘(B) recommended with a grade of A or B by the United 
States Preventive Services Task Force; and
H. R. 6331—4 
‘‘(C) appropriate for individuals entitled to benefits under 
part A or enrolled under part B. 
‘‘(2) In making determinations under paragraph (1) regarding 
the coverage of a new service, the Secretary shall use the process 
for making national coverage determinations (as defined in section 
1869(f)(1)(B)) under this title. As part of the use of such process, 
the Secretary may conduct an assessment of the relation between 
predicted outcomes and the expenditures for such service and may 
take into account the results of such assessment in making such 
determination.’’. 
(2) PAYMENT AND COINSURANCE FOR ADDITIONAL PREVEN-
TIVE SERVICES.—Section 1833(a)(1) of the Social Security Act 
(42 U.S.C. 1395l(a)(1)) is amended— 
(A) by striking ‘‘and’’ before ‘‘(V)’’; and 
(B) by inserting before the semicolon at the end the 
following: ‘‘, and (W) with respect to additional preventive 
services (as defined in section 1861(ddd)(1)), the amount 
paid shall be (i) in the case of such services which are 
clinical diagnostic laboratory tests, the amount determined 
under subparagraph (D), and (ii) in the case of all other 
such services, 80 percent of the lesser of the actual charge 
for the service or the amount determined under a fee 
schedule established by the Secretary for purposes of this 
subparagraph’’. 
(3) CONFORMING AMENDMENT REGARDING COVERAGE.—Sec-
tion 1862(a)(1)(A) of the Social Security Act (42 U.S.C. 
1395y(a)(1)(A)) is amended by inserting ‘‘or additional preven-
tive services (as described in section 1861(ddd)(1))’’ after ‘‘suc-
ceeding subparagraph’’. 
(4) RULE
OF
CONSTRUCTION.—Nothing in the provisions 
of, or amendments made by, this subsection shall be construed 
to provide coverage under title XVIII of the Social Security 
Act of items and services for the treatment of a medical condi-
tion that is not otherwise covered under such title. 
(b) REVISIONS
TO INITIAL PREVENTIVE PHYSICAL EXAMINA-
TION.— 
(1) IN GENERAL.—Section 1861(ww) of the Social Security 
Act (42 U.S.C. 1395x(ww)) is amended— 
(A) in paragraph (1)— 
(i) by inserting ‘‘body mass index,’’ after ‘‘weight’’; 
(ii) by striking ‘‘, and an electrocardiogram’’; and 
(iii) by inserting ‘‘and end-of-life planning (as 
defined in paragraph (3)) upon the agreement with 
the individual’’ after ‘‘paragraph (2)’’; 
(B) in paragraph (2), by adding at the end the following 
new subparagraphs: 
‘‘(M) An electrocardiogram. 
‘‘(N) Additional preventive services (as defined in subsection 
(ddd)(1)).’’; and 
(C) by adding at the end the following new paragraph: 
‘‘(3) For purposes of paragraph (1), the term ‘end-of-life plan-
ning’ means verbal or written information regarding— 
‘‘(A) an individual’s ability to prepare an advance directive 
in the case that an injury or illness causes the individual 
to be unable to make health care decisions; and 
‘‘(B) whether or not the physician is willing to follow the 
individual’s wishes as expressed in an advance directive.’’.
H. R. 6331—5 
(2) WAIVER OF APPLICATION OF DEDUCTIBLE.—The first sen-
tence of section 1833(b) of the Social Security Act (42 U.S.C. 
1395l(b)) is amended— 
(A) by striking ‘‘and’’ before ‘‘(8)’’; and 
(B) by inserting ‘‘, and (9) such deductible shall not 
apply with respect to an initial preventive physical exam-
ination (as defined in section 1861(ww))’’ before the period 
at the end. 
(3) EXTENSION OF ELIGIBILITY PERIOD FROM SIX MONTHS 
TO ONE YEAR.—Section 1862(a)(1)(K) of the Social Security Act 
(42 U.S.C. 1395y(a)(1)(K)) is amended by striking ‘‘6 months’’ 
and inserting ‘‘1 year’’. 
(4) TECHNICAL CORRECTION.—Section 1862(a)(1)(K) of the 
Social Security Act (42 U.S.C. 1395y(a)(1)(K)) is amended by 
striking ‘‘not later’’ and inserting ‘‘more’’. 
(c) EFFECTIVE DATE.—The amendments made by this section 
shall apply to services furnished on or after January 1, 2009. 
SEC. 102. ELIMINATION OF DISCRIMINATORY COPAYMENT RATES FOR 
MEDICARE OUTPATIENT PSYCHIATRIC SERVICES. 
Section 1833(c) of the Social Security Act (42 U.S.C. 1395l(c)) 
is amended to read as follows: 
‘‘(c)(1) Notwithstanding any other provision of this part, with 
respect to expenses incurred in a calendar year in connection with 
the treatment of mental, psychoneurotic, and personality disorders 
of an individual who is not an inpatient of a hospital at the time 
such expenses are incurred, there shall be considered as incurred 
expenses for purposes of subsections (a) and (b)— 
‘‘(A) for expenses incurred in years prior to 2010, only 
621⁄2 percent of such expenses; 
‘‘(B) for expenses incurred in 2010 or 2011, only 683⁄4 
percent of such expenses; 
‘‘(C) for expenses incurred in 2012, only 75 percent of 
such expenses; 
‘‘(D) for expenses incurred in 2013, only 811⁄4 percent of 
such expenses; and 
‘‘(E) for expenses incurred in 2014 or any subsequent cal-
endar year, 100 percent of such expenses. 
‘‘(2) For purposes of subparagraphs (A) through (D) of para-
graph (1), the term ‘treatment’ does not include brief office visits 
(as defined by the Secretary) for the sole purpose of monitoring 
or changing drug prescriptions used in the treatment of such dis-
orders or partial hospitalization services that are not directly pro-
vided by a physician.’’. 
SEC. 103. PROHIBITIONS AND LIMITATIONS ON CERTAIN SALES AND 
MARKETING ACTIVITIES UNDER MEDICARE ADVANTAGE 
PLANS AND PRESCRIPTION DRUG PLANS. 
(a) PROHIBITIONS.— 
(1) MEDICARE ADVANTAGE PROGRAM.— 
(A) IN GENERAL.—Section 1851 of the Social Security 
Act (42 U.S.C. 1395w–21) is amended— 
(i) in subsection (h)(4)— 
(I) in subparagraph (A)— 
(aa) by striking ‘‘cash or other monetary 
rebates’’ and inserting ‘‘, subject to subsection 
(j)(2)(C), cash, gifts, prizes, or other monetary 
rebates’’; and
H. R. 6331—6 
(bb) by striking ‘‘, and’’ at the end and 
inserting a semicolon; 
(II) in subparagraph (B), by striking the period 
at the end and inserting a semicolon; and 
(III) by adding at the end the following new 
subparagraph: 
‘‘(C) shall not permit a Medicare Advantage organiza-
tion (or the agents, brokers, and other third parties rep-
resenting such organization) to conduct the prohibited 
activities described in subsection (j)(1); and’’; and 
(ii) by adding at the end the following new sub-
section: 
‘‘(j) PROHIBITED ACTIVITIES DESCRIBED
AND LIMITATIONS
ON 
THE CONDUCT OF CERTAIN OTHER ACTIVITIES.— 
‘‘(1) PROHIBITED
ACTIVITIES
DESCRIBED.—The following 
prohibited activities are described in this paragraph: 
‘‘(A) UNSOLICITED
MEANS
OF
DIRECT
CONTACT.—Any 
unsolicited means of direct contact of prospective enrollees, 
including soliciting door-to-door or any outbound tele-
marketing without the prospective enrollee initiating con-
tact. 
‘‘(B) CROSS-SELLING.—The sale of other non-health 
related products (such as annuities and life insurance) 
during any sales or marketing activity or presentation con-
ducted with respect to a Medicare Advantage plan. 
‘‘(C) MEALS.—The provision of meals of any sort, 
regardless of value, to prospective enrollees at promotional 
and sales activities. 
‘‘(D) SALES AND MARKETING IN HEALTH CARE SETTINGS 
AND AT EDUCATIONAL EVENTS.—Sales and marketing activi-
ties for the enrollment of individuals in Medicare Advan-
tage plans that are conducted— 
‘‘(i) in health care settings in areas where health 
care is delivered to individuals (such as physician 
offices and pharmacies), except in the case where such 
activities are conducted in common areas in health 
care settings; and 
‘‘(ii) at educational events.’’. 
(2) MEDICARE
PRESCRIPTION
DRUG
PROGRAM.—Section 
1860D–4 of the Social Security Act (42 U.S.C. 1395w–104) 
is amended by adding at the end the following new subsection: 
‘‘(l) REQUIREMENTS WITH RESPECT TO SALES AND MARKETING 
ACTIVITIES.—The following provisions shall apply to a PDP sponsor 
(and the agents, brokers, and other third parties representing such 
sponsor) in the same manner as such provisions apply to a Medicare 
Advantage organization (and the agents, brokers, and other third 
parties representing such organization): 
‘‘(1) The prohibition under section 1851(h)(4)(C) on con-
ducting activities described in section 1851(j)(1).’’. 
(3) EFFECTIVE DATE.—The amendments made by this sub-
section shall apply to plan years beginning on or after January 
1, 2009. 
(b) LIMITATIONS.— 
(1) MEDICARE ADVANTAGE PROGRAM.—Section 1851 of the 
Social Security Act (42 U.S.C. 1395w–21), as amended by sub-
section (a)(1), is amended—
H. R. 6331—7 
(A) in subsection (h)(4), by adding at the end the fol-
lowing new subparagraph: 
‘‘(D) shall only permit a Medicare Advantage organiza-
tion (and the agents, brokers, and other third parties rep-
resenting such organization) to conduct the activities 
described in subsection (j)(2) in accordance with the limita-
tions established under such subsection.’’; and 
(B) in subsection (j), by adding at the end the following 
new paragraph: 
‘‘(2) LIMITATIONS.—The Secretary shall establish limita-
tions with respect to at least the following: 
‘‘(A) SCOPE OF MARKETING APPOINTMENTS.—The scope 
of any appointment with respect to the marketing of a 
Medicare Advantage plan. Such limitation shall require 
advance agreement with a prospective enrollee on the scope 
of the marketing appointment and documentation of such 
agreement by the Medicare Advantage organization. In 
the case where the marketing appointment is in person, 
such documentation shall be in writing. 
‘‘(B) CO-BRANDING.—The use of the name or logo of 
a co-branded network provider on Medicare Advantage plan 
membership and marketing materials. 
‘‘(C) LIMITATION OF GIFTS TO NOMINAL DOLLAR VALUE.— 
The offering of gifts and other promotional items other 
than those that are of nominal value (as determined by 
the Secretary) to prospective enrollees at promotional 
activities. 
‘‘(D) COMPENSATION.—The use of compensation other 
than as provided under guidelines established by the Sec-
retary. Such guidelines shall ensure that the use of com-
pensation creates incentives for agents and brokers to 
enroll individuals in the Medicare Advantage plan that 
is intended to best meet their health care needs. 
‘‘(E) REQUIRED
TRAINING, ANNUAL
RETRAINING, AND 
TESTING OF AGENTS, BROKERS, AND OTHER THIRD PARTIES.— 
The use by a Medicare Advantage organization of any 
individual as an agent, broker, or other third party rep-
resenting the organization that has not completed an initial 
training and testing program and does not complete an 
annual retraining and testing program.’’. 
(2) MEDICARE
PRESCRIPTION
DRUG
PROGRAM.—Section 
1860D–4(l) of the Social Security Act, as added by subsection 
(a)(2), is amended by adding at the end the following new 
paragraph: 
‘‘(2) The requirement under section 1851(h)(4)(D) to conduct 
activities described in section 1851(j)(2) in accordance with 
the limitations established under such subsection.’’. 
(3) EFFECTIVE DATE.—The amendments made by this sub-
section shall take effect on a date specified by the Secretary 
(but in no case later than November 15, 2008). 
(c) REQUIRED INCLUSION OF PLAN TYPE IN PLAN NAME.— 
(1) MEDICARE
ADVANTAGE
PROGRAM.—Section 1851(h) of 
the Social Security Act (42 U.S.C. 1395w–21(h)) is amended 
by adding at the end following new paragraph: 
‘‘(6) REQUIRED INCLUSION OF PLAN TYPE IN PLAN NAME.— 
For plan years beginning on or after January 1, 2010, a Medi-
care Advantage organization must ensure that the name of
H. R. 6331—8 
each Medicare Advantage plan offered by the Medicare Advan-
tage organization includes the plan type of the plan (using 
standard terminology developed by the Secretary).’’. 
(2) PRESCRIPTION DRUG PLANS.—Section 1860D–4(l) of the 
Social Security Act, as added by subsection (a)(2) and amended 
by subsection (b)(2), is amended by adding at the end the 
following new paragraph: 
‘‘(3) The inclusion of the plan type in the plan name under 
section 1851(h)(6).’’. 
(d) STRENGTHENING
THE
ABILITY
OF
STATES
TO
ACT
IN 
COLLABORATION WITH THE SECRETARY TO ADDRESS FRAUDULENT 
OR INAPPROPRIATE MARKETING PRACTICES.— 
(1) MEDICARE
ADVANTAGE
PROGRAM.—Section 1851(h) of 
the Social Security Act (42 U.S.C. 1395w–21(h), as amended 
by subsection (c)(1), is amended by adding at the end the 
following new paragraph: 
‘‘(7) STRENGTHENING
THE
ABILITY
OF
STATES
TO
ACT
IN 
COLLABORATION WITH THE SECRETARY TO ADDRESS FRAUDULENT 
OR INAPPROPRIATE MARKETING PRACTICES.— 
‘‘(A) APPOINTMENT
OF
AGENTS
AND
BROKERS.—Each 
Medicare Advantage organization shall— 
‘‘(i) only use agents and brokers who have been 
licensed under State law to sell Medicare Advantage 
plans offered by the Medicare Advantage organization; 
‘‘(ii) in the case where a State has a State appoint-
ment law, abide by such law; and 
‘‘(iii) report to the applicable State the termination 
of any such agent or broker, including the reasons 
for such termination (as required under applicable 
State law). 
‘‘(B) 
COMPLIANCE
WITH
STATE
INFORMATION 
REQUESTS.—Each Medicare Advantage organization shall 
comply in a timely manner with any request by a State 
for information regarding the performance of a licensed 
agent, broker, or other third party representing the Medi-
care Advantage organization as part of an investigation 
by the State into the conduct of the agent, broker, or 
other third party.’’. 
(2) PRESCRIPTION DRUG PLANS.—Section 1860D–4(l) of the 
Social Security Act, as amended by subsection (c)(2), is amended 
by adding at the end the following new paragraph: 
‘‘(4) The requirements regarding the appointment of agents 
and brokers and compliance with State information requests 
under subparagraphs (A) and (B), respectively, of section 
1851(h)(7).’’. 
(3) EFFECTIVE DATE.—The amendments made by this sub-
section shall apply to plan years beginning on or after January 
1, 2009. 
SEC. 104. IMPROVEMENTS TO THE MEDIGAP PROGRAM. 
(a) IMPLEMENTATION OF NAIC RECOMMENDATIONS.— 
(1) IN
GENERAL.—The Secretary of Health and Human 
Services (in this section referred to as the ‘‘Secretary’’) shall 
provide for implementation of the changes in the NAIC model 
law and regulations approved by the National Association of 
Insurance Commissioners in its Model #651 (‘‘Model Regulation
H. R. 6331—9 
to Implement the NAIC Medicare Supplement Insurance Min-
imum Standards Model Act’’) on March 11, 2007, as modified 
to reflect the changes made under this Act and the Genetic 
Information Nondiscrimination Act of 2008 (Public Law 110– 
233). 
(2) IMPLEMENTATION DATES.— 
(A) IN
GENERAL.—The modifications to Model #651 
required under paragraph (1) shall be completed by the 
National Association of Insurance Commissioners not later 
than October 31, 2008. Except as provided in subparagraph 
(B), each State shall have 1 year from the date the National 
Association of Insurance Commissioners adopts the revised 
NAIC model law and regulations (as changed by Model 
#651, as so modified) to conform the regulatory program 
established by the State to such revised NAIC model law 
and regulations. 
(B) EXTENSION
OF
EFFECTIVE
DATE
FOR
STATE
LAW 
AMENDMENT.—In the case of a State which the Secretary 
determines requires State legislation in order to conform 
the regulatory program established by the State to such 
revised NAIC model law and regulations, the State shall 
not be regarded as failing to comply with the requirements 
of this section solely on the basis of its failure to meet 
such 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 
enactment of this Act. For purposes of the previous sen-
tence, in the case of a State that has a 2-year legislative 
session, each year of the session is considered to be a 
separate regular session of the State legislature. 
(C) TRANSITION DATES.—No carrier may issue a new 
or revised medicare supplemental policy or certificate under 
section 1882 of the Social Security Act (42 U.S.C. 1395ss) 
that meets the requirements of such revised NAIC model 
law and regulations for coverage effective prior to June 
1, 2010. A carrier may continue to offer or issue a medicare 
supplemental policy under such section that meets the 
requirements of the NAIC model law and regulations and 
State law (as in effect prior to the adoption of such revised 
NAIC model law and regulations) prior to June 1, 2010. 
Nothing shall preclude carriers from marketing new or 
revised medicare supplemental policies or certificates that 
meet the requirements of such revised NAIC model law 
and regulations on or after the date on which the State 
conforms the regulatory program established by the State 
to such revised NAIC model law and regulations. 
(b) REQUIRED OFFERING
OF
A RANGE
OF POLICIES.—Section 
1882(o) of the Social Security Act (42 U.S.C. 1395s(o)), as amended 
by section 104(b)(3) of the Genetic Information Nondiscrimination 
Act of 2008 (Public Law 110–233), is amended by adding at the 
end the following new paragraph: 
‘‘(5) In addition to the requirement under paragraph (2), 
the issuer of the policy must make available to the individual 
at least Medicare supplemental policies with benefit packages 
classified as ‘C’ or ‘F’.’’. 
(c) CLARIFICATION.—Any health insurance policy that provides 
reimbursement for expenses incurred for items and services for
H. R. 6331—10 
which payment may be made under title XVIII of the Social Security 
Act but which are not reimbursable by reason of the applicability 
of deductibles, coinsurance, copayments or other limitations imposed 
by a Medicare Advantage plan (including a Medicare Advantage 
private fee-for-service plan) under part C of such title shall comply 
with the requirements of section 1882(o) of the such Act (42 U.S.C. 
1395ss(o)). 
PART II—LOW-INCOME PROGRAMS 
SEC. 111. EXTENSION OF QUALIFYING INDIVIDUAL (QI) PROGRAM. 
(a) EXTENSION.—Section 1902(a)(10)(E)(iv) of the Social Security 
Act (42 U.S.C. 1396a(a)(10)(E)(iv)) is amended by striking ‘‘June 
2008’’ and inserting ‘‘December 2009’’. 
(b) EXTENDING TOTAL AMOUNT AVAILABLE FOR ALLOCATION.— 
Section 1933(g) of such Act (42 U.S.C. 1396u–3(g)) is amended— 
(1) in paragraph (2)— 
(A) by striking ‘‘and’’ at the end of subparagraph (H); 
(B) in subparagraph (I)— 
(i) by striking ‘‘June 30’’ and inserting ‘‘September 
30’’; 
(ii) by striking ‘‘$200,000,000’’ and inserting 
‘‘$300,000,000’’; and 
(iii) by striking the period at the end and inserting 
a semicolon; and 
(C) by adding at the end the following new subpara-
graphs: 
‘‘(J) for the period that begins on October 1, 2008, 
and ends on December 31, 2008, the total allocation amount 
is $100,000,000; 
‘‘(K) for the period that begins on January 1, 2009, 
and ends on September 30, 2009, the total allocation 
amount is $350,000,000; and 
‘‘(L) for the period that begins on October 1, 2009, 
and ends on December 31, 2009, the total allocation amount 
is $150,000,000.’’; and 
(2) in paragraph (3), in the matter preceding subparagraph 
(A), by striking ‘‘or (H)’’ and inserting ‘‘(H), (J), or (L)’’. 
SEC. 112. APPLICATION OF FULL LIS SUBSIDY ASSETS TEST UNDER 
MEDICARE SAVINGS PROGRAM. 
Section 1905(p)(1)(C) of such Act (42 U.S.C. 1396d(p)(1)(C)) 
is amended by inserting before the period at the end the following: 
‘‘or, effective beginning with January 1, 2010, whose resources 
(as so determined) do not exceed the maximum resource level 
applied for the year under subparagraph (D) of section 1860D– 
14(a)(3) (determined without regard to the life insurance policy 
exclusion provided under subparagraph (G) of such section) 
applicable to an individual or to the individual and the individual’s 
spouse (as the case may be)’’. 
SEC. 113. ELIMINATING BARRIERS TO ENROLLMENT. 
(a) SSA ASSISTANCE WITH MEDICARE SAVINGS PROGRAM AND 
LOW-INCOME SUBSIDY PROGRAM APPLICATIONS.—Section 1144 of 
such Act (42 U.S.C. 1320b–14) is amended by adding at the end 
the following new subsection: 
‘‘(c) ASSISTANCE WITH MEDICARE SAVINGS PROGRAM AND LOW- 
INCOME SUBSIDY PROGRAM APPLICATIONS.—
H. R. 6331—11 
‘‘(1) DISTRIBUTION OF APPLICATIONS AND INFORMATION TO 
INDIVIDUALS WHO ARE POTENTIALLY ELIGIBLE FOR LOW-INCOME 
SUBSIDY
PROGRAM.—For each individual who submits an 
application for low-income subsidies under section 1860D–14, 
requests an application for such subsidies, or is otherwise 
identified as an individual who is potentially eligible for such 
subsidies, the Commissioner shall do the following: 
‘‘(A) Provide information describing the low-income 
subsidy program under section 1860D–14 and the Medicare 
Savings Program (as defined in paragraph (7)). 
‘‘(B) Provide an application for enrollment under such 
low-income subsidy program (if not already received by 
the Commissioner). 
‘‘(C) In accordance with paragraph (3), transmit data 
from such an application for purposes of initiating an 
application for benefits under the Medicare Savings Pro-
gram. 
‘‘(D) Provide information on how the individual may 
obtain assistance in completing such application and an 
application under the Medicare Savings Program, including 
information on how the individual may contact the State 
health insurance assistance program (SHIP). 
‘‘(E) Make the application described in subparagraph 
(B) and the information described in subparagraphs (A) 
and (D) available at local offices of the Social Security 
Administration. 
‘‘(2) TRAINING PERSONNEL IN EXPLAINING BENEFIT PROGRAMS 
AND ASSISTING IN COMPLETING LIS APPLICATION.—The Commis-
sioner shall provide training to those employees of the Social 
Security Administration who are involved in receiving applica-
tions for benefits described in paragraph (1)(B) in order that 
they may promote beneficiary understanding of the low-income 
subsidy program and the Medicare Savings Program in order 
to increase participation in these programs. Such employees 
shall provide assistance in completing an application described 
in paragraph (1)(B) upon request. 
‘‘(3) TRANSMITTAL
OF
DATA
TO
STATES.—Beginning on 
January 1, 2010, with the consent of an individual completing 
an application for benefits described in paragraph (1)(B), the 
Commissioner shall electronically transmit to the appropriate 
State Medicaid agency data from such application, as deter-
mined by the Commissioner, which transmittal shall initiate 
an application of the individual for benefits under the Medicare 
Savings Program with the State Medicaid agency. In order 
to ensure that such data transmittal provides effective assist-
ance for purposes of State adjudication of applications for bene-
fits under the Medicare Savings Program, the Commissioner 
shall consult with the Secretary, after the Secretary has con-
sulted with the States, regarding the content, form, frequency, 
and manner in which data (on a uniform basis for all States) 
shall be transmitted under this subparagraph. 
‘‘(4) COORDINATION
WITH
OUTREACH.—The Commissioner 
shall coordinate outreach activities under this subsection in 
connection with the low-income subsidy program and the Medi-
care Savings Program. 
‘‘(5) REIMBURSEMENT OF SOCIAL SECURITY ADMINISTRATION 
ADMINISTRATIVE COSTS.—
H. R. 6331—12 
‘‘(A) INITIAL MEDICARE SAVINGS PROGRAM COSTS; ADDI-
TIONAL LOW-INCOME SUBSIDY COSTS.— 
‘‘(i) INITIAL MEDICARE SAVINGS PROGRAM COSTS.— 
There are hereby appropriated to the Commissioner 
to carry out this subsection, out of any funds in the 
Treasury not otherwise appropriated, $24,100,000. The 
amount appropriated under ths clause shall be avail-
able on October 1, 2008, and shall remain available 
until expended. 
‘‘(ii) ADDITIONAL AMOUNT FOR LOW-INCOME SUBSIDY 
ACTIVITIES.—There are hereby appropriated to the 
Commissioner, out of any funds in the Treasury not 
otherwise appropriated, $24,800,000 for fiscal year 
2009 to carry out low-income subsidy activities under 
section 1860D–14 and the Medicare Savings Program 
(in accordance with this subsection), to remain avail-
able until expended. Such funds shall be in addition 
to the Social Security Administration’s Limitation on 
Administrative Expenditure appropriations for such 
fiscal year. 
‘‘(B) SUBSEQUENT FUNDING UNDER AGREEMENTS.— 
‘‘(i) IN GENERAL.—Effective for fiscal years begin-
ning on or after October 1, 2010, the Commissioner 
and the Secretary shall enter into an agreement which 
shall provide funding (subject to the amount appro-
priated under clause (ii)) to cover the administrative 
costs of the Commissioner’s activities under this sub-
section. Such agreement shall— 
‘‘(I) provide funds to the Commissioner for the 
full cost of the Social Security Administration’s 
work related to the Medicare Savings Program 
required under this section; 
‘‘(II) provide such funding quarterly in advance 
of the applicable quarter based on estimating 
methodology agreed to by the Commissioner and 
the Secretary; and 
‘‘(III) require an annual accounting and rec-
onciliation of the actual costs incurred and funds 
provided under this subsection. 
‘‘(ii) APPROPRIATION.—There are hereby appro-
priated to the Secretary solely for the purpose of pro-
viding payments to the Commissioner pursuant to an 
agreement specified in clause (i) that is in effect, out 
of any funds in the Treasury not otherwise appro-
priated, not more than $3,000,000 for fiscal year 2011 
and each fiscal year thereafter. 
‘‘(C) LIMITATION.—In no case shall funds from the 
Social Security Administration’s Limitation on Administra-
tive Expenses be used to carry out activities related to 
the Medicare Savings Program. For fiscal years beginning 
on or after October 1, 2010, no such activities shall be 
undertaken by the Social Security Administration unless 
the agreement specified in subparagraph (B) is in effect 
and full funding has been provided to the Commissioner 
as specified in such subparagraph. 
‘‘(6) GAO ANALYSIS AND REPORT.—
H. R. 6331—13 
‘‘(A) ANALYSIS.—The Comptroller General of the United 
States shall prepare an analysis of the impact of this 
subsection— 
‘‘(i) in increasing participation in the Medicare 
Savings Program, and 
‘‘(ii) on States and the Social Security Administra-
tion. 
‘‘(B) REPORT.—Not later than January 1, 2012, the 
Comptroller General shall submit to Congress, the Commis-
sioner, and the Secretary a report on the analysis conducted 
under subparagraph (A). 
‘‘(7) MEDICARE SAVINGS PROGRAM DEFINED.—For purposes 
of this subsection, the term ‘Medicare Savings Program’ means 
the program of medical assistance for payment of the cost 
of medicare cost-sharing under the Medicaid program pursuant 
to sections 1902(a)(10)(E) and 1933.’’. 
(b) MEDICAID AGENCY CONSIDERATION OF DATA TRANSMITTAL.— 
(1) IN GENERAL.—Section 1935(a) of such Act (42 U.S.C. 
1396u–5(a)) is amended by adding at the end the following 
new paragraph: 
‘‘(4) CONSIDERATION OF DATA TRANSMITTED BY THE SOCIAL 
SECURITY ADMINISTRATION FOR PURPOSES OF MEDICARE SAVINGS 
PROGRAM.—The State shall accept data transmitted under sec-
tion 1144(c)(3) and act on such data in the same manner 
and in accordance with the same deadlines as if the data 
constituted an initiation of an application for benefits under 
the Medicare Savings Program (as defined for purposes of such 
section) that had been submitted directly by the applicant. 
The date of the individual’s application for the low income 
subsidy program from which the data have been derived shall 
constitute the date of filing of such application for benefits 
under the Medicare Savings Program.’’. 
(2) CONFORMING
AMENDMENTS.—Section 1935(a) of such 
Act (42 U.S.C. 1396u–5(a)) is amended in the subsection 
heading by striking ‘‘AND’’ and by inserting ‘‘, AND MEDICARE 
COST-SHARING’’ after ‘‘ASSISTANCE’’. 
(c) EFFECTIVE DATE.—Except as otherwise provided, the amend-
ments made by this section shall take effect on January 1, 2010. 
SEC. 114. ELIMINATION OF MEDICARE PART D LATE ENROLLMENT 
PENALTIES PAID BY SUBSIDY ELIGIBLE INDIVIDUALS. 
(a) WAIVER OF LATE ENROLLMENT PENALTY.— 
(1) IN GENERAL.—Section 1860D–13(b) of the Social Secu-
rity Act (42 U.S.C. 1395w–113(b)) is amended by adding at 
the end the following new paragraph: 
‘‘(8) WAIVER OF PENALTY FOR SUBSIDY-ELIGIBLE INDIVID-
UALS.—In no case shall a part D eligible individual who is 
determined to be a subsidy eligible individual (as defined in 
section 1860D–14(a)(3)) be subject to an increase in the monthly 
beneficiary premium established under subsection (a).’’. 
(2) CONFORMING AMENDMENT.—Section 1860D–14(a)(1)(A) 
of the Social Security Act (42 U.S.C. 1395w–114(a)(1)(A)) is 
amended by striking ‘‘equal to’’ and all that follows through 
the period and inserting ‘‘equal to 100 percent of the amount 
described in subsection (b)(1), but not to exceed the premium 
amount specified in subsection (b)(2)(B).’’.
H. R. 6331—14 
(b) EFFECTIVE DATE.—The amendments made by this section 
shall apply to subsidies for months beginning with January 2009. 
SEC. 115. ELIMINATING APPLICATION OF ESTATE RECOVERY. 
(a) IN GENERAL.—Section 1917(b)(1)(B)(ii) of the Social Security 
Act (42 U.S.C. 1396p(b)(1)(B)(ii)) is amended by inserting ‘‘(but 
not including medical assistance for medicare cost-sharing or for 
benefits described in section 1902(a)(10)(E))’’ before the period at 
the end. 
(b) EFFECTIVE DATE.—The amendment made by subsection (a) 
shall take effect as of January 1, 2010. 
SEC. 116. EXEMPTIONS FROM INCOME AND RESOURCES FOR DETER-
MINATION OF ELIGIBILITY FOR LOW-INCOME SUBSIDY. 
(a) IN GENERAL.—Section 1860D–14(a)(3) of the Social Security 
Act (42 U.S.C. 1395w–114(a)(3)) is amended— 
(1) in subparagraph (C)(i), by inserting ‘‘and except that 
support and maintenance furnished in kind shall not be counted 
as income’’ after ‘‘section 1902(r)(2)’’; 
(2) in subparagraph (D), in the matter before clause (i), 
by inserting ‘‘subject to the life insurance policy exclusion pro-
vided under subparagraph (G)’’ before ‘‘)’’; 
(3) in subparagraph (E)(i), in the matter before subclause 
(I), by inserting ‘‘subject to the life insurance policy exclusion 
provided under subparagraph (G)’’ before ‘‘)’’; and 
(4) by adding at the end the following new subparagraph: 
‘‘(G) LIFE
INSURANCE
POLICY
EXCLUSION.—In deter-
mining the resources of an individual (and the eligible 
spouse of the individual, if any) under section 1613 for 
purposes of subparagraphs (D) and (E) no part of the 
value of any life insurance policy shall be taken into 
account.’’. 
(b) EFFECTIVE DATE.—The amendments made by this section 
shall take effect with respect to applications filed on or after 
January 1, 2010. 
SEC. 117. JUDICIAL REVIEW OF DECISIONS OF THE COMMISSIONER 
OF SOCIAL SECURITY UNDER THE MEDICARE PART D LOW- 
INCOME SUBSIDY PROGRAM. 
(a) IN GENERAL.—Section 1860D–14(a)(3)(B)(iv) of the Social 
Security Act (42 U.S.C. 1395w–114(a)(3)(B)(iv)) is amended— 
(1) in subclause (I), by striking ‘‘and’’ at the end; 
(2) in subclause (II), by striking the period at the end 
and inserting ‘‘; and’’; and 
(3) by adding at the end the following new subclause: 
‘‘(III) judicial review of the final decision of 
the Commissioner made after a hearing shall be 
available to the same extent, and with the same 
limitations, as provided in subsections (g) and (h) 
of section 205.’’. 
(b) EFFECTIVE DATE.—The amendments made by subsection 
(a) shall take effect as if included in the enactment of section 
101 of the Medicare Prescription Drug, Improvement, and Mod-
ernization Act of 2003. 
SEC. 118. TRANSLATION OF MODEL FORM. 
(a) IN GENERAL.—Section 1905(p)(5)(A) of the Social Security 
Act (42 U.S.C. 1396d(p)(5)(A)) is amended by adding at the end
H. R. 6331—15 
the following: ‘‘The Secretary shall provide for the translation of 
such application form into at least the 10 languages (other than 
English) that are most often used by individuals applying for hos-
pital insurance benefits under section 226 or 226A and shall make 
the translated forms available to the States and to the Commis-
sioner of Social Security.’’. 
(b) EFFECTIVE DATE.—The amendment made by subsection (a) 
shall take effect on January 1, 2010. 
SEC. 119. MEDICARE ENROLLMENT ASSISTANCE. 
(a) ADDITIONAL FUNDING FOR STATE HEALTH INSURANCE ASSIST-
ANCE PROGRAMS.— 
(1) GRANTS.— 
(A) IN GENERAL.—The Secretary of Health and Human 
Services (in this section referred to as the ‘‘Secretary’’) 
shall use amounts made available under subparagraph (B) 
to make grants to States for State health insurance assist-
ance programs receiving assistance under section 4360 of 
the Omnibus Budget Reconciliation Act of 1990. 
(B) FUNDING.—For purposes of making grants under 
this subsection, the Secretary shall provide for the transfer, 
from the Federal Hospital Insurance Trust Fund under 
section 1817 of the Social Security Act (42 U.S.C. 1395i) 
and the Federal Supplementary Medical Insurance Trust 
Fund under section 1841 of such Act (42 U.S.C. 1395t), 
in the same proportion as the Secretary determines under 
section 1853(f) of such Act (42 U.S.C. 1395w–23(f)), of 
$7,500,000 to the Centers for Medicare & Medicaid Services 
Program Management Account for fiscal year 2009, to 
remain available until expended. 
(2) AMOUNT OF GRANTS.—The amount of a grant to a State 
under this subsection from the total amount made available 
under paragraph (1) shall be equal to the sum of the amount 
allocated to the State under paragraph (3)(A) and the amount 
allocated to the State under subparagraph (3)(B). 
(3) ALLOCATION TO STATES.— 
(A) ALLOCATION BASED ON PERCENTAGE OF LOW-INCOME 
BENEFICIARIES.—The amount allocated to a State under 
this subparagraph from 2⁄3 of the total amount made avail-
able under paragraph (1) shall be based on the number 
of individuals who meet the requirement under subsection 
(a)(3)(A)(ii) of section 1860D–14 of the Social Security Act 
(42 U.S.C. 1395w–114) but who have not enrolled to receive 
a subsidy under such section 1860D–14 relative to the 
total number of individuals who meet the requirement 
under such subsection (a)(3)(A)(ii) in each State, as esti-
mated by the Secretary. 
(B) ALLOCATION BASED ON PERCENTAGE OF RURAL BENE-
FICIARIES.—The amount allocated to a State under this 
subparagraph from 1⁄3 of the total amount made available 
under paragraph (1) shall be based on the number of part 
D eligible individuals (as defined in section 1860D– 
1(a)(3)(A) of such Act (42 U.S.C. 1395w–101(a)(3)(A))) 
residing in a rural area relative to the total number of 
such individuals in each State, as estimated by the Sec-
retary.
H. R. 6331—16 
(4) PORTION
OF
GRANT
BASED
ON
PERCENTAGE
OF
LOW- 
INCOME BENEFICIARIES TO BE USED TO PROVIDE OUTREACH TO 
INDIVIDUALS WHO MAY BE SUBSIDY ELIGIBLE INDIVIDUALS OR 
ELIGIBLE FOR THE MEDICARE SAVINGS PROGRAM.—Each grant 
awarded under this subsection with respect to amounts allo-
cated under paragraph (3)(A) shall be used to provide outreach 
to individuals who may be subsidy eligible individuals (as 
defined in section 1860D–14(a)(3)(A) of the Social Security Act 
(42 U.S.C. 1395w–114(a)(3)(A)) or eligible for the Medicare 
Savings Program (as defined in subsection (f)). 
(b) ADDITIONAL FUNDING
FOR AREA AGENCIES
ON AGING.— 
(1) GRANTS.— 
(A) IN GENERAL.—The Secretary, acting through the 
Assistant Secretary for Aging, shall make grants to States 
for area agencies on aging (as defined in section 102 of 
the Older Americans Act of 1965 (42 U.S.C. 3002)) and 
Native American programs carried out under the Older 
Americans Act of 1965 (42 U.S.C. 3001 et seq.). 
(B) FUNDING.—For purposes of making grants under 
this subsection, the Secretary shall provide for the transfer, 
from the Federal Hospital Insurance Trust Fund under 
section 1817 of the Social Security Act (42 U.S.C. 1395i) 
and the Federal Supplementary Medical Insurance Trust 
Fund under section 1841 of such Act (42 U.S.C. 1395t), 
in the same proportion as the Secretary determines under 
section 1853(f) of such Act (42 U.S.C. 1395w–23(f)), of 
$7,500,000 to the Administration on Aging for fiscal year 
2009, to remain available until expended. 
(2) AMOUNT OF GRANT AND ALLOCATION TO STATES BASED 
ON PERCENTAGE OF LOW-INCOME AND RURAL BENEFICIARIES.— 
The amount of a grant to a State under this subsection from 
the total amount made available under paragraph (1) shall 
be determined in the same manner as the amount of a grant 
to a State under subsection (a), from the total amount made 
available under paragraph (1) of such subsection, is determined 
under paragraph (2) and subparagraphs (A) and (B) of para-
graph (3) of such subsection. 
(3) REQUIRED USE OF FUNDS.— 
(A) ALL
FUNDS.—Subject to subparagraph (B), each 
grant awarded under this subsection shall be used to pro-
vide outreach to eligible Medicare beneficiaries regarding 
the benefits available under title XVIII of the Social Secu-
rity Act. 
(B) OUTREACH TO INDIVIDUALS WHO MAY BE SUBSIDY 
ELIGIBLE
INDIVIDUALS
OR
ELIGIBLE
FOR
THE
MEDICARE 
SAVINGS PROGRAM.—Subsection (a)(4) shall apply to each 
grant awarded under this subsection in the same manner 
as it applies to a grant under subsection (a). 
(c) ADDITIONAL FUNDING FOR AGING AND DISABILITY RESOURCE 
CENTERS.— 
(1) GRANTS.— 
(A) IN
GENERAL.—The Secretary shall make grants 
to Aging and Disability Resource Centers under the Aging 
and Disability Resource Center grant program that are 
established centers under such program on the date of 
the enactment of this Act.
H. R. 6331—17 
(B) FUNDING.—For purposes of making grants under 
this subsection, the Secretary shall provide for the transfer, 
from the Federal Hospital Insurance Trust Fund under 
section 1817 of the Social Security Act (42 U.S.C. 1395i) 
and the Federal Supplementary Medical Insurance Trust 
Fund under section 1841 of such Act (42 U.S.C. 1395t), 
in the same proportion as the Secretary determines under 
section 1853(f) of such Act (42 U.S.C. 1395w–23(f)), of 
$5,000,000 to the Administration on Aging for fiscal year 
2009, to remain available until expended. 
(2) REQUIRED USE OF FUNDS.—Each grant awarded under 
this subsection shall be used to provide outreach to individuals 
regarding the benefits available under the Medicare prescrip-
tion drug benefit under part D of title XVIII of the Social 
Security Act and under the Medicare Savings Program. 
(d) COORDINATION OF EFFORTS TO INFORM OLDER AMERICANS 
ABOUT BENEFITS AVAILABLE UNDER FEDERAL
AND STATE PRO-
GRAMS.— 
(1) IN GENERAL.—The Secretary, acting through the Assist-
ant Secretary for Aging, in cooperation with related Federal 
agency partners, shall make a grant to, or enter into a contract 
with, a qualified, experienced entity under which the entity 
shall— 
(A) maintain and update web-based decision support 
tools, and integrated, person-centered systems, designed 
to inform older individuals (as defined in section 102 of 
the Older Americans Act of 1965 (42 U.S.C. 3002)) about 
the full range of benefits for which the individuals may 
be eligible under Federal and State programs; 
(B) utilize cost-effective strategies to find older individ-
uals with the greatest economic need (as defined in such 
section 102) and inform the individuals of the programs; 
(C) develop and maintain an information clearinghouse 
on best practices and the most cost-effective methods for 
finding older individuals with greatest economic need and 
informing the individuals of the programs; and 
(D) provide, in collaboration with related Federal 
agency partners administering the Federal programs, 
training and technical assistance on the most effective out-
reach, screening, and follow-up strategies for the Federal 
and State programs. 
(2) FUNDING.—For purposes of making a grant or entering 
into a contract under paragraph (1), the Secretary shall provide 
for the transfer, from the Federal Hospital Insurance Trust 
Fund under section 1817 of the Social Security Act (42 U.S.C. 
1395i) and the Federal Supplementary Medical Insurance Trust 
Fund under section 1841 of such Act (42 U.S.C. 1395t), in 
the same proportion as the Secretary determines under section 
1853(f) of such Act (42 U.S.C. 1395w–23(f)), of $5,000,000 to 
the Administration on Aging for fiscal year 2009, to remain 
available until expended. 
(e) REPROGRAMMING FUNDS FROM MEDICARE, MEDICAID, AND 
SCHIP EXTENSION ACT OF 2007.—The Secretary shall only use 
the $5,000,000 in funds allocated to make grants to States for 
Area Agencies on Aging and Aging Disability and Resource Centers 
for the period of fiscal years 2008 through 2009 under section 
118 of the Medicare, Medicaid, and SCHIP Extension Act of 2007
H. R. 6331—32 
(F) in paragraph (6), by striking subparagraph (C) 
and inserting the following: 
‘‘(C) REPORTING PERIOD.— 
‘‘(i) IN GENERAL.—Subject to clauses (ii) and (iii), 
the term ‘reporting period’ means— 
‘‘(I) for 2007, the period beginning on July 
1, 2007, and ending on December 31, 2007; and 
‘‘(II) for 2008, 2009, 2010, and 2011, the entire 
year. 
‘‘(ii) AUTHORITY TO REVISE REPORTING PERIOD.— 
For years after 2009, the Secretary may revise the 
reporting period under clause (i) if the Secretary deter-
mines such revision is appropriate, produces valid 
results on measures reported, and is consistent with 
the goals of maximizing scientific validity and reducing 
administrative burden. If the Secretary revises such 
period pursuant to the preceding sentence, the term 
‘reporting period’ shall mean such revised period. 
‘‘(iii) REFERENCE.—Any reference in this subsection 
to a reporting period with respect to the application 
of subsection (a)(5) shall be deemed a reference to 
the reporting period under subparagraph (D)(iii) of 
such subsection.’’. 
(4) INCLUSION
OF
QUALIFIED
AUDIOLOGISTS
AS
ELIGIBLE 
PROFESSIONALS.— 
(A) IN GENERAL.—Section 1848(k)(3)(B) of the Social 
Security Act (42 U.S.C. 1395w–4(k)(3)(B)), is amended by 
adding at the end the following new clause: 
‘‘(iv) Beginning with 2009, a qualified audiologist 
(as defined in section 1861(ll)(3)(B)).’’. 
(B) NO CHANGE IN BILLING.—Nothing in the amend-
ment made by subparagraph (A) shall be construed to 
change the way in which billing for audiology services 
(as defined in section 1861(ll)(2) of the Social Security 
Act (42 U.S.C. 1395x(ll)(2))) occurs under title XVIII of 
such Act as of July 1, 2008. 
(5) CONFORMING
AMENDMENTS.—Section 1848(m) of the 
Social Security Act, as added and amended by paragraphs 
(2) and (3), is amended— 
(A) in paragraph (5)— 
(i) in subparagraph (A)— 
(I) by striking ‘‘section 1848(k) of the Social 
Security Act, as added by subsection (b),’’ and 
inserting ‘‘subsection (k)’’; and 
(II) by striking ‘‘such section’’ and inserting 
‘‘such subsection’’; 
(ii) in subparagraph (B), by striking ‘‘of the Social 
Security Act (42 U.S.C. 1395l)’’; 
(iii) in subparagraph (E), in the matter preceding 
clause (i), by striking ‘‘1869 or 1878 of the Social Secu-
rity Act or otherwise’’ and inserting ‘‘1869, section 
1878, or otherwise’’; and 
(iv) in subparagraph (F)— 
(I) by striking ‘‘paragraph (2)(B) of section 
1848(k) of the Social Security Act (42 U.S.C. 
1395w–4(k))’’ and inserting ‘‘subsection (k)(2)(B)’’; 
and