Medicare Early Access Act of 1998

TABLE OF CONTENTS:

Title I: Access to Medicare Benefits for Individuals 62-to-

65 Years of Age

Title II: Access to Medicare Benefits for Displaced Workers

55-to-62 Years of Age

Title III: COBRA Protection for Early Retirees

Subtitle A: Amendments to the Employee Retirement

Income Security Act of 1974

Subtitle B: Amendments to the Public Health Service Act

Subtitle C: Amendments to the Internal Revenue Code of

1986

Title IV: Financing

Medicare Early Access Act of 1998 - Title I: Access to Medicare Benefits for Individuals 62-to-65 Years of Age - Amends title XVIII (Medicare) of the Social Security Act (SSA) to add a new part D (Purchase of Medicare Benefits by Certain Individuals Age 62-to-65 Years of Age). Makes eligible to enroll in Medicare during a specified period individuals between the ages of 62 and 65 who: (1) are not eligible for coverage under group health plans or Federal health insurance; but (2) would be Medicare-eligible if age 65. Requires prior notification of each individual seeking to enroll of the deferred monthly premium amount for which the individual will be liable upon attaining age 65.

(Sec. 101) Directs the Secretary of Health and Human Services to determine rates for: (1) the base monthly premium; (2) the base annual premium for individuals age 62 or older; and (3) the deferred premium for such individuals.

Limits the maximum annual premium in a premium area to assure participation in all areas of the country. Directs the Secretary to provide for payment and collection of the base monthly premium. Makes the enrollee liable for the deferred monthly premium payment. Requires collection of both premiums in the same manner as for the payment of monthly premiums under Medicare part B (Supplementary Medical Insurance).

Creates in the Treasury the Medicare Early Access Trust Fund (Trust Fund) to hold collected premiums as well as the savings from new fraud and abuse initiatives under the Medicare Fraud and Overpayment Act of 1998 which are transferred to it out of the Medicare trust funds.

Directs: (1) the Trust Fund's Board of Trustees to report annually to the Congress on the need for adjustments in the new program in order to maintain its financial solvency; and (2) the Comptroller General to report periodically to the Congress on the adequacy of program financing along with appropriate recommendations to accomplish such end.

Requires: (1) individuals enrolled under the new part D program to be treated for Medicare purposes as though they were entitled to benefits under Medicare part A (Hospital Insurance) and enrolled under Medicare part B; and (2) new part D program benefits to be payable under Medicare to such individuals in the same manner as if they were so entitled and enrolled.

Provides that the new part D program shall not be treated as Medicare for purposes of the Medicaid program under SSA title XIX, including the provision of Medicare cost-sharing assistance, nor for purposes of COBRA continuation requirements of the Public Health Service Act.

Title II: Access to Medicare Benefits for Displaced Workers 55-to-62 Years of Age - Amends SSA title XVIII part D to rename the newly established part D program the Purchase of Medicare Benefits by Certain Individuals Age 55-to-65 Years of Age. Provides for part D coverage for certain displaced workers and spouses between the ages of 55 and 62 under arrangements similar to those in title I. Directs the Secretary to provide for continued enrollment of displaced workers who attain 62 years of age.

Title III: COBRA Protection for Early Retirees - Subtitle A: Amendments to the Employee Retirement Income Security Act of 1974 - Amends the Employee Retirement Income Security Act of 1974 to extend specified group health plan insurance continuation coverage under COBRA (Consolidated Omnibus Budget Reconciliation Act of 1985) to qualified retirees and their dependents, in cases of substantial reduction or termination of a retiree group health plan. Sets forth a special rule for certain dependents in case of termination or substantial reduction of retiree health coverage. Permits an increased level of premiums in the case of an individual provided continuation coverage by reason of the qualifying event.

Subtitle B: Amendments to the Public Health Service Act - Amends the Public Health Service Act to extend specified group health plan insurance continuation coverage under COBRA to qualified retirees and their dependents, in cases of substantial reduction or termination of a retiree group health plan. Sets forth a special rule for certain dependents in case of termination or substantial reduction of retiree health coverage. Permits an increased level of premiums in the case of an individual provided continuation coverage by reason of the qualifying event.

Subtitle C: Amendments to the Internal Revenue Code of 1986 - Amends the Internal Revenue Code to extend specified group health plan insurance continuation coverage under COBRA to qualified retirees and their dependents, in cases of substantial reduction or termination of a retiree group health plan. Sets forth a special rule for certain dependents in case of termination or substantial reduction of retiree health coverage. Permits an increased level of premiums in the case of an individual provided continuation coverage by reason of the qualifying event.

Title IV: Financing - Requires any increase in payments under the Medicare program that results from the enactment of this Act to be offset by reductions in Medicare payments pursuant to the anti-fraud and -abuse provisions of the Medicare Fraud and Overpayment Act of 1998.