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108th CONGRESS
2d Session
H. R. 4437
To amend part D of title XVIII of the Social Security Act to provide
for low-income beneficiaries in the Medicare savings programs automatic
enrollment and eligibility for low-income subsidies under the Medicare
transitional and permanent prescription drug programs.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
May 20, 2004
Mr. Dingell (for himself, Mr. Rangel, Mr. Waxman, Mr. Stark, Mr. Brown
of Ohio, Ms. Pelosi, Mr. Markey, Mr. Towns, Mr. Pallone, Mr. Rush, Mr.
Stupak, Mr. Engel, Mr. Wynn, Ms. McCarthy of Missouri, Mr. Strickland,
Mrs. Capps, Mr. John, Mr. Allen, Mr. Davis of Florida, Mr. Becerra, Mr.
McNulty, Mr. Doggett, Mr. Matsui, Mr. Sandlin, and Mr. Deutsch)
introduced the following bill; which was referred to the Committee on
Energy and Commerce, and in addition to the Committee on Ways and
Means, 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 part D of title XVIII of the Social Security Act to provide
for low-income beneficiaries in the Medicare savings programs automatic
enrollment and eligibility for low-income subsidies under the Medicare
transitional and permanent prescription drug programs.
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 ``Medicare Prescription Drug Low-
Income Assistance Act of 2004''.
SEC. 2. ASSURANCE OF ASSISTANCE FOR LOW-INCOME BENEFICIARIES IN
MEDICARE SAVINGS PROGRAMS UNDER MEDICARE PRESCRIPTION
DRUG DISCOUNT CARD AND TRANSITIONAL ASSISTANCE PROGRAM.
(a) Automatic Enrollment.--
(1) In general.--Section 1860D-31(c)(1) of the Social
Security Act (42 U.S.C. 1395w-141(c)(1)) is amended by adding
at the end the following new subparagraph:
``(F) Automatic enrollment of certain low-income
beneficiaries in medicare savings programs.--
``(i) Notice of eligibility.--Not later
than 45 days after the date an individual
described in clause (ii) is first eligible to
enroll in an endorsed discount card program
under this section, each State or the Secretary
(at the option of each State) shall mail to
each individual described in clause (ii), a
notice stating the following:
``(I) Such individual is eligible
to enroll in an endorsed discount card
program and to receive transitional
assistance under subsection (g).
``(II) If such individual does not
enroll before 30 days after the date of
the notice, such individual will be
automatically enrolled in an endorsed
discount card program selected by the
Secretary unless the individual
notifies the Secretary that such
individual does not wish to be so
enrolled.
``(III) If such individual is
automatically enrolled in an endorsed
discount card program selected by the
Secretary, the individual may enroll in
another endorsed discount card program
selected by the individual during the
60-day period beginning on the date of
such automatic enrollment.
``(IV) If the individual is
enrolled in an endorsed discount card
program during 2004, the individual
will be permitted to change enrollment
under subsection (c)(1)(C)(ii) for
2005.
``(V) There is no obligation to use
the endorsed discount card program or
transitional assistance when purchasing
prescription drugs.
``(ii) Individuals benefiting from
automatic enrollment.--An individual described
in this clause is a discount card eligible
individual who--
``(I) is a recipient of
supplemental security income benefits
under title XVI, or is determined to be
eligible for medical assistance under
title XIX solely by reason of clause
(i), (iii), or (iv) of section
1902(a)(10)(E); and
``(II) has not enrolled in an
endorsed discount card program as of
the date that is 30 days after the date
the individual is first eligible to
enroll in such a program.
``(iii) Automatic enrollment.--The
Secretary shall enroll each individual
described in clause (ii), who has not enrolled
in an endorsed discount card program or
provided notice to the Secretary under clause
(iv) as of the end of the 30-day period
beginning on the date of the notice to the
individual under clause (i), in an endorsed
discount card program selected by the Secretary
that serves residents of the State in which the
individual resides.
``(iv) Opt-out.--Clause (iii) shall not
apply to an individual if the individual
notifies the Secretary before the end of the
30-day period described in such clause that the
individual does not wish to be automatically
enrolled under such clause.
``(v) 60-day grace period to change card
program.--The Secretary shall permit each
individual who is automatically enrolled under
clause (iii) to elect, during the 60-day period
that begins on the date the individual is so
enrolled, to enroll in a different endorsed
discount card program selected by such
individual. Such a change shall be treated as
an exceptional case for purposes of
subparagraph (C)(iii).''.
(b) Provision of Transitional Assistance.--
(1) In general.--Section 1860D-31(b) of such Act (42 U.S.C.
1395w-141(b)) is amended by adding at the end the following new
paragraph:
``(5) Special rule for certain low-income beneficiaries in
medicare savings programs.--
``(A) In general.--Except as provided in
subparagraph (C), individuals described in subsection
(c)(1)(F)(ii) shall be treated as transitional
assistance eligible individuals.
``(B) Special transitional assistance eligible
individuals.--Except as provided in subparagraph (C),
such individuals who are recipients of supplemental
security income benefits under title XVI or determined
to be eligible for medical assistance under title XIX
solely by reason of clause (i), (iii), or (iv) of
section 1902(a)(10)(E) shall be treated as special
transitional assistance eligible individuals.
``(C) Application of disqualification for
individuals with prescription drug coverage.--The
Secretary shall not apply subparagraphs (A) and (B) in
the case of an individual if the Secretary finds that
there is reason to believe that the individual is
described in paragraph (2)(B) (relating to individuals
with certain prescription drug coverage).''.
(2) Waiver of self-certification and verification.--Section
1860D-31(f) of such Act (42 U.S.C. 1395w-141(f)) is amended by
adding at the end the following new paragraph:
``(5) Special rule for certain low-income beneficiaries in
medicare savings programs.--The provisions of paragraphs (2)
and (3) shall not apply to individuals who are treated as
transitional assistance eligible individuals under subsection
(b)(5).''.
(c) Effective Date.--The amendments made by this section shall take
effect as if included in the enactment of section 101 of the Medicare
Prescription Drug, Improvement, and Modernization Act of 2003 (Public
Law 108-173; 117 Stat. 2071).
SEC. 3. ASSURANCE OF ASSISTANCE FOR LOW-INCOME BENEFICIARIES IN
MEDICARE SAVINGS PROGRAMS UNDER QUALIFIED PRESCRIPTION
DRUG COVERAGE.
(a) Automatic Enrollment.--Section 1860D-1(b)(1)(C) of the Social
Security Act (42 U.S.C. 1395w-101(b)(1)(C)) is amended--
(1) by designating the matter beginning with ``The process
established'' as a clause (i) with the heading ``In general.--
'' and an appropriate indentation;
(2) by striking ``a full-benefit dual eligible individual
(as defined in section 1935(c)(6)) who has failed to enroll in
a prescription drug plan or an MA-PD plan'' and inserting
``described in clause (ii)''; and
(3) by adding at the end the following new clauses:
``(ii) Individuals covered.--An individual
described in this clause is an individual who--
``(I) is a full-benefit dual
eligible individual (as defined in
section 1935(c)(6)), is a recipient of
supplemental security income benefits
under title XVI, or is determined to be
eligible for medical assistance under
title XIX solely by reason of clause
(i), (iii), or (iv) of section
1902(a)(10)(E); and
``(II) has failed to enroll in a
prescription drug plan or an MA-PD
plan.
``(iii) Application of notice, opt-out, and
grace period in change in enrollment
provisions.--In carrying out this subparagraph,
the Secretary shall provide for the application
of notice and change in enrollment provisions
with respect to enrollment in prescription drug
plans and MA-PD plans similar to those provided
under clauses (i), (iv), and (v) of section
1860D-31(c)(1)(F) with respect to enrollment in
endorsed discount card programs.''.
(b) Provision of Premium and Cost-Sharing Subsidies.--Section
1860D-14(a)(3)(B)(v) of such Act (42 U.S.C. 1395w-114(a)(3)(B)(v)) is
amended to read as follows:
``(v) Treatment of medicaid beneficiaries
and low-income beneficiaries in medicare
savings programs.--Subject to subparagraph (F),
the Secretary shall provide that the following
individuals who are part D eligible individuals
shall be treated as being determined to be
subsidy eligible individuals described in
paragraph (1):
``(I) Full-benefit dual eligible
individuals (as defined in section
1935(c)(6)).
``(II) Individuals who are
recipients of supplemental security
income benefits under title XVI.
``(III) Individuals who are
determined to be eligible for medical
assistance under title XIX solely by
reason of clause (i), (iii), or (iv) of
section 1902(a)(10)(E).''.
(c) Effective Date.--The amendments made by this section shall take
effect as if included in the enactment of section 101 of the Medicare
Prescription Drug, Improvement, and Modernization Act of 2003 (Public
Law 108-173; 117 Stat. 2071).
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