Title: BENES Act of 2020
Policy area: Health

Summary:
Beneficiary Enrollment Notification and Eligibility Simplification Act of 2019 or the BENES Act of 2019
This bill makes a series of changes to, and requires additional notifications regarding, the Medicare enrollment process.
Specifically, the bill changes the Medicare general enrollment period to October 15-December 31, and requires coverage to begin on the first day of the month following enrollment. (Currently, the general enrollment period is January 1-March 31, and coverage begins July 1.) The bill also generally requires coverage to begin on the first day of the month following enrollment for individuals who enroll in the latter months of their initial enrollment period. (Currently, the longer an individual waits to enroll, the more delayed the effective date of coverage.)
The bill also requires Social Security account statements for individuals ages 60 to 64 to include information about Medicare eligibility, late enrollment penalties, coordination of benefits, and special enrollment populations (e.g., veterans).

[Congressional Bills 116th Congress]
[From the U.S. Government Publishing Office]
[H.R. 2477 Introduced in House (IH)]

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116th CONGRESS
  1st Session
                                H. R. 2477

 To amend title XVIII of the Social Security Act to establish a system 
to notify individuals approaching Medicare eligibility, to simplify and 
 modernize the eligibility enrollment process, and for other purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                              May 2, 2019

Mr. Ruiz (for himself, Mrs. Walorski, Mr. Schneider, and Mr. Bilirakis) 
 introduced the following bill; which was referred to the Committee on 
    Ways and Means, and in addition to the Committee on Energy and 
Commerce, for a period to be subsequently 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 XVIII of the Social Security Act to establish a system 
to notify individuals approaching Medicare eligibility, to simplify and 
 modernize the eligibility enrollment process, 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.

    This Act may be cited as the ``Beneficiary Enrollment Notification 
and Eligibility Simplification Act of 2019'' or the ``BENES Act of 
2019''.

SEC. 2. BENEFICIARY ENROLLMENT NOTIFICATION AND ELIGIBILITY 
              SIMPLIFICATION.

    (a) Eligibility and Enrollment Notices.--
            (1) As part of social security account statement for 
        individuals age 60 to 65.--Section 1143(a) of the Social 
        Security Act (42 U.S.C. 1320b-13(a)) is amended by adding at 
        the end the following new paragraph:
            ``(4) Medicare eligibility information.--
                    ``(A) In general.--In the case of statements 
                provided on or after the date that is 2 years after the 
                date of the enactment of this Act to individuals who 
                have attained 60 years of age but have not attained 65 
                years of age, the statement shall also include a notice 
                containing the information described in subparagraph 
                (B).
                    ``(B) Contents of notice.--The notice required 
                under subparagraph (A) shall contain information on 
                (including a clear, simple explanation of)--
                            ``(i) eligibility for benefits under the 
                        Medicare program under title XVIII, and in 
                        particular benefits under part B of such title;
                            ``(ii) the possibility of a late enrollment 
                        penalty for failure to timely enroll (including 
                        the process for requesting relief under section 
                        1837(h) in plain language);
                            ``(iii) the need for coordination of 
                        benefits under such part B (including primary 
                        and secondary coverage scenarios) imposed under 
                        title XVIII; and
                            ``(iv) populations, such as veterans, for 
                        whom there are special considerations with 
                        respect to enrollment under this title.
                    ``(C) Development of notice.--
                            ``(i) In general.--The Secretary, in 
                        consultation with representatives of each of 
                        the groups described in subparagraph (D)(i), 
                        and in coordination with the Commissioner of 
                        Social Security, shall develop the notice to be 
                        provided pursuant to subparagraph (A).
                            ``(ii) Notice improvement.--The Secretary, 
                        not less than once every two years, shall--
                                    ``(I) review the content of the 
                                notice to be provided under 
                                subparagraph (A); and
                                    ``(II) update and revise such 
                                notice as the Secretary deems 
                                appropriate.
                    ``(D) Groups for consultation.--
                            ``(i) In general.--For purposes of 
                        subparagraph (C), the groups described in this 
                        clause include the following:
                                    ``(I) Individuals who are more than 
                                60 years of age.
                                    ``(II) Veterans.
                                    ``(III) Individuals with 
                                disabilities.
                                    ``(IV) Individuals with end stage 
                                renal disease.
                                    ``(V) Low-income individuals and 
                                families.
                                    ``(VI) Employers (including human 
                                resources professionals).
                                    ``(VII) States (including 
                                representatives of State-run Health 
                                Insurance Exchanges, Medicaid offices, 
                                and Departments of Insurance).
                                    ``(VIII) State Health Insurance 
                                Assistance Programs.
                                    ``(IX) Health insurers.
                                    ``(X) Health insurance agents and 
                                brokers.
                                    ``(XI) Such other groups as 
                                specified by the Secretary.
                            ``(ii) Nonapplication of faca.--The Federal 
                        Advisory Committee Act shall not apply to 
                        consultations made pursuant to subparagraph (C) 
                        with groups described in clause (i).
                    ``(E) Posting of notice on websites.--The 
                Commissioner of Social Security and the Secretary shall 
                each ensure that the notice being used under 
                subparagraph (A) is posted in a prominent location on 
                their respective Department Internet website.''.
            (2) Individuals in medicare waiting period.--Title XI of 
        the Social Security Act is amended by inserting after section 
        1144 the following new section:

    ``medicare enrollment notification and eligibility notices for 
                 individuals in medicare waiting period

                               ``Notices

    ``Sec. 1144A. (a)
            ``(1) In General.--The Commissioner of Social Security, in 
        coordination with the Secretary, shall distribute the notice 
        developed and used by the Commissioner under section 1143(a)(4) 
        to individuals in the Medicare waiting period under section 
        226(b) of this Act.
            ``(2) Authority to Modify Notice.--The Secretary, in 
        coordination with the Commissioner of Social Security, may 
        modify the notice to be distributed under paragraph (1) as 
        necessary to take into account the population receiving the 
        notice.
            ``(3) Posting of Notice on Websites.--The Commissioner of 
        Social Security and the Secretary shall each ensure that the 
        notice being distributed under paragraph (1) is posted in a 
        prominent location on their respective Department Internet 
        website.

                                ``Timing

    ``(b) Beginning two years after the date of the enactment of this 
section, a notice required under subsection (a)(1) shall be mailed to 
an individual no less than two times in accordance with the following:
            ``(1) The notice shall be provided to such individual no 
        later than 3 months prior to the date of such individual's 
        enrollment period as provided under section 1837.
            ``(2) The notice shall subsequently be provided to such 
        individual no later than one month prior to such date.''.
    (b) Beneficiary Medicare Part B Enrollment Periods and Effective 
Date of Coverage.--
            (1) Effective dates.--Section 1838(a) of the Social 
        Security Act (42 U.S.C. 1395q(a)) is amended--
                    (A) by amending paragraph (2) to read as follows:
            ``(2)(A) in the case of an individual who enrolls pursuant 
        to subsection (d) of section 1837 before the month in which he 
        first satisfies paragraph (1) or (2) of section 1836, the first 
        day of such month;
            ``(B) in the case of an individual not described in 
        subparagraph (A) who first satisfies such paragraph in a month 
        beginning before January 2021 and who enrolls--
                    ``(i) pursuant to such subsection (d) in such month 
                in which he first satisfies such paragraph, the first 
                day of the month following the month in which he so 
                enrolls;
                    ``(ii) pursuant to such subsection (d) in the month 
                following such month in which he first satisfies such 
                paragraph, the first day of the second month following 
                the month in which he so enrolls; or
                    ``(iii) pursuant to such subsection (d) more than 
                one month following such month in which he satisfies 
                such paragraph, the first day of the third month 
                following the month in which he so enrolls;
            ``(C) in the case of an individual not described in 
        subparagraph (A) who first satisfies such paragraph in a month 
        beginning on or after January 1, 2021, and who enrolls pursuant 
        to such subsection (d) in such month in which he first 
        satisfies such paragraph or in any subsequent month of his 
        initial enrollment period, the first day of the month following 
        the month in which he so enrolls;
            ``(D) in the case of an individual not described in 
        subparagraph (A) who enrolls pursuant to subsection (e) of 
        section 1837 in a month beginning before October 15, 2020, the 
        July 1 following the month in which he so enrolls; or
            ``(E) in the case of an individual not described in 
        subparagraph (A) who enrolls pursuant to subsection (e) of 
        section 1837 in a month beginning on or after October 15, 2020, 
        the first day of the month following the month in which he so 
        enrolls.''; and
                    (B) by amending paragraph (3) to read as follows:
            ``(3)(A) in the case of an individual who is deemed to have 
        enrolled on or before the last day of the third month of his 
        initial enrollment period, the first day of the month in which 
        he first meets the applicable requirements of section 1836 or 
        July 1, 1973, whichever is later;
            ``(B) in the case of an individual who is deemed to have 
        enrolled on or after the first day of the fourth month of his 
        initial enrollment period beginning before January 1, 2021, as 
        prescribed under subparagraphs (B)(i), (B)(ii), (B)(iii), and 
        (D) of paragraph (2) of this subsection; or
            ``(C) in the case of an individual who is deemed to have 
        enrolled on or after the first day of the fourth month of his 
        initial enrollment period beginning on or after January 1, 
        2021, as prescribed under paragraph (2)(C) of this 
        subsection.''.
            (2) General and special enrollment periods.--Section 
        1837(e) of the Social Security Act (42 U.S.C. 1395p(e)) is 
        amended to read as follows:
    ``(e) Enrollment Periods.--
            ``(1) For coverage during years before 2022.--There shall 
        be a general enrollment period during the period beginning on 
        January 1 and ending on March 31 of each year before 2022.
            ``(2) For coverage during years beginning with 2022.--For 
        coverage during years beginning with 2022 and each subsequent 
        year, there shall be a general enrollment period beginning on 
        October 15 of the previous year through December 31 of such 
        previous year.
            ``(3) Exceptional circumstances.--The Secretary may 
        establish a special enrollment period in the case that an 
        individual meets such exceptional conditions as the Secretary 
        may provide.''.
            (3) Technical correction.--
                    (A) In general.--Section 1839(b) of the Social 
                Security Act (42 U.S.C. 1395r(b)) is amended by 
                striking ``close of the enrollment period'' each place 
                it appears and inserting ``close of the month''.
                    (B) Effective date.--The amendment made by 
                subparagraph (A) shall take effect on November 1, 2021.
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