constitute the date of filing of an application for benefits 
under the Medicare Savings Program.’’. 
(c) EFFECTIVE DATE.—The amendments made by 
this section are effective as if they had been included in 
the enactment of section 113(b) of Public Law 110–275. 
(d) OIG STUDY.—The Inspector General of the De-
partment of Health and Human Services shall examine the 
extent to which States are complying with the require-
ment, under amendments made by the Medicare Improve-
ments for Patients and Providers Act of 2008 (Public Law 
110–275), that they initiate an application for Medicare 
Savings Program from data of the Social Security Admin-
istration suggesting eligibility. 
SEC. 12. QMB BUY-IN OF PART A AND PART B PREMIUMS. 
(a) REQUIREMENT.—Section 1902(a) of the Social 
Security Act (42 U.S.C. 1396a(a)) is amended— 
(1) in paragraph (72), by striking ‘‘and’’ at the 
end; 
(2) in paragraph (73), by striking the period at 
the end and inserting ‘‘; and’’; and 
(3) by inserting after paragraph (73) the fol-
lowing new paragraph: 
‘‘(74) provide that the State enters into a modi-
fication of an agreement under section 1818(g).’’. 
(b) EFFECTIVE DATE.— 
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(1) IN GENERAL.—Except as provided in para-
graph (2), the amendments made by this section 
take effect on the first day of the first calendar 
quarter beginning 6 months after the date of the en-
actment of this Act. 
(2) EXTENSION
OF
EFFECTIVE
DATE
FOR 
STATE LAW AMENDMENT.—In the case of a State 
plan under title XIX of the Social Security Act (42 
U.S.C. 1396 et seq.) which the Secretary of Health 
and Human Services determines requires State legis-
lation in order for the plan to meet the additional 
requirements imposed by the amendments made by 
this section, 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 addi-
tional requirements before the first day of the first 
calendar quarter beginning after the close of the 
first regular session of the State legislature that be-
gins after the date of enactment 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 the session is considered to be a separate regular 
session of the State legislature. 
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SEC. 13. INCREASING AVAILABILITY OF MSP APPLICATIONS 
THROUGH AVAILABILITY ON THE INTERNET 
AND 
DESIGNATION 
OF 
PREFERRED 
LAN-
GUAGE. 
(a) REQUIREMENT FOR STATES.— 
(1) IN GENERAL.—Section 1902(a) of the So-
cial Security Act (42 U.S.C. 1396a(a)), as amended 
by section 12, is amended— 
(A) in paragraph (73), by striking ‘‘and’’at 
the end; 
(B) in paragraph (74), by striking the pe-
riod at the end and inserting ‘‘; and’’; and 
(C) by inserting after paragraph (74) the 
following new paragraph: 
‘‘(75) provide— 
‘‘(A) that the application for medical as-
sistance for Medicare cost-sharing under this 
title used by the State allows an individual to 
specify a preferred language for subsequent 
communication and, in the case in which a lan-
guage other than English is specified, provide 
that subsequent communications under this title 
to the individual shall be in such language; and 
‘‘(B) that the State makes such application 
available through an Internet website and pro-
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vides for such application to be completed on 
such website.’’. 
(2) EFFECTIVE DATE.—The amendments made 
by this subsection take effect on and after the first 
day of the first calendar quarter beginning 2 years 
after the date of the enactment of this Act. 
(b) REQUIREMENT FOR THE SECRETARY.—Section 
1905(p)(5) of the Social Security Act (42 U.S.C. 
1396d(p)(5)) is amended by adding at the end the fol-
lowing new sentence: ‘‘Such form shall allow an individual 
to specify a preferred language for subsequent commu-
nication.’’ 
SEC. 14. MEDICARE SAVINGS PROGRAM APPLICATIONS. 
(a) IN GENERAL.—Section 1902(a) of the Social Se-
curity Act (42 U.S.C. 1396a(a)), as amended by sections 
12 and 13, is further amended— 
(1) in paragraph (74), by striking ‘‘and’’at the 
end; 
(2) in paragraph (75), by striking the period at 
the end and inserting ‘‘; and’’; and 
(3) by inserting after paragraph (75) the fol-
lowing new paragraph: 
‘‘(76) provide that the State coordinates with 
the State agency that administers benefits under the 
supplemental nutrition assistance program estab-
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lished under the Food and Nutrition Act of 2008 (7 
U.S.C. 2011 et seq.) to ensure that individuals ap-
plying for medical assistance provided under para-
graph (10)(E), as described in sections 1905(p) and 
1933, have the opportunity to apply for, establish 
eligibility for, and, if eligible, receive supplemental 
nutrition assistance program benefits.’’. 
(b) EFFECTIVE DATE.— 
(1) IN GENERAL.—Except as provided in para-
graph (2), the amendments made by subsection (a) 
take effect on the first day of the first calendar 
quarter beginning 6 months after the date of the en-
actment of this Act. 
(2) EXTENSION
OF
EFFECTIVE
DATE
FOR 
STATE LAW AMENDMENT.—In the case of a State 
plan under title XIX of the Social Security Act (42 
U.S.C. 1396 et seq.) which the Secretary of Health 
and Human Services determines requires State legis-
lation in order for the plan to meet the additional 
requirements imposed by the amendments 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 
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the first regular session of the State legislature that 
begins after the date of enactment 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 the session is considered to be a separate regular 
session of the State legislature. 
(c) REPORT TO CONGRESS.—Not later than 1 year 
after the date of enactment of this Act, the Secretary of 
Health and Human Services shall submit to Congress a 
report on the process each State uses to meet the require-
ments under section 1902(a)(76) of the Social Security 
Act, as added by subsection (a). 
SEC. 15. REPEAL OF PAYMENT LIMITATION. 
(a) IN GENERAL.—Section 1902(n) of the Social Se-
curity Act (42 U.S.C. 1396a(n)) is amended— 
(1) by striking paragraphs (2) and (3); and 
(2) in paragraph (1)— 
(A) by striking ‘‘(n)(1)’’ and inserting 
‘‘(n)’’; and 
(B) by striking ‘‘may provide’’ and insert-
ing ‘‘shall provide’’. 
(b) 
CONFORMING
AMENDMENTS.—(1) 
Section 
1902(a)(10) of such Act is amended, in the subclause 
(VIII) following subparagraph (G), by striking ‘‘sub-
section (n) and’’. 
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(2) Section 1905(p)(2) of such Act (42 U.S.C. 
1396d(p)(2)) is amended by striking ‘‘(subject to section 
1902(n))’’. 
(c) EFFECTIVE DATE.—The amendments made by 
this section shall apply to items and services furnished on 
or after January 1, 2010. 
Æ 
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