I
105TH CONGRESS
2D SESSION
H. R. 4836
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
OCTOBER 14, 1998
Mr. MCDERMOTT (for himself, Mr. STARK, and Mr. MILLER of California) in-
troduced 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 subsequently determined by the Speaker, in each case for consider-
ation 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 1998’’.
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 follow-
ing:
‘‘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
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 medi-
cal 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—
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-
spect to any Medicare beneficiary (as defined in
paragraph (12)(E)(i)) identified by the Com-
missioner—
‘‘(i) there has not been filed an in-
come tax return for the most recent period
for which the Secretary has information; or
there has been such a return filed and the
amount of the gross income (or the sum of
such elements of gross income as the Sec-
retary of Health and Human Services may
specify) is below such level (or levels) as
such Secretary may specify to carry out
section 1147(b) of the Social Security Act,
treating the number of dependents as the
size of the family involved; and
‘‘(ii) whether, for such an individual
who qualified for Medicare cost-sharing as-
sistance described in section 1147 at any
time in the previous year, the individual is
still described in clause (i).
‘‘(B) DISCLOSURE BY HEALTH CARE FI-
NANCING
ADMINISTRATION.—With respect to
information disclosed under subparagraph (A),
the Administrator of the Health Care Financing
Administration may disclose to the appropriate
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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