Prescription Coverage Now Act of 2006 - Amends part D (Voluntary Prescription Drug Benefit Program) of title XVIII (Medicare) of the Social Security Act to direct the Secretary of Health and Human Service to provide for an expedited process for the qualification for low-income assistance through a request to the Secretary of the Treasury for tax return and other information sufficient to identify: (1) whether the individual involved is likely eligible for subsidies; and (2) the amount of premium and cost-sharing subsidies for which they would qualify based on such information.
Increases the maximum permissible resource level for subsidy eligibility.
Waives the late enrollment penalty for subsidy-eligible individuals for the first 24 months of non-enrollment.
[Congressional Bills 109th Congress]
[From the U.S. Government Publishing Office]
[H.R. 5969 Introduced in House (IH)]
109th CONGRESS
2d Session
H. R. 5969
To amend part D of title XVIII of the Social Security Act to assist
low-income individuals in obtaining subsidized prescription drug
coverage under the Medicare prescription drug program by expediting the
application and qualification process, by increasing the maximum
permissible resource level for eligibility for such subsidies, and by
waiving any late enrollment penalty for the first 24 uncovered months.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
July 28, 2006
Mr. Doggett (for himself, Mr. Rangel, Mr. Stark, Mr. Hoyer, Mr.
Clyburn, Mr. Larson of Connecticut, Mr. McDermott, Mr. Lewis of
Georgia, Mr. Neal of Massachusetts, Mr. McNulty, Mr. Becerra, Mrs.
Jones of Ohio, Mr. Emanuel, Mr. Abercrombie, Mr. Ackerman, Mr. Allen,
Mr. Andrews, Mr. Baca, Ms. Baldwin, Mr. Berman, Mr. Berry, Mr. Bishop
of Georgia, Mr. Bishop of New York, Ms. Corrine Brown of Florida, Mr.
Brown of Ohio, Mr. Butterfield, Mrs. Capps, Mr. Capuano, Mr. Cardoza,
Ms. Carson, Mrs. Christensen, Mr. Clay, Mr. Cleaver, Mr. Conyers, Mr.
Costello, Mr. Crowley, Mr. Cuellar, Mr. Cummings, Mr. Davis of Alabama,
Mr. Davis of Illinois, Ms. DeGette, Mr. Delahunt, Ms. DeLauro, Mr.
Dicks, Mr. Doyle, Mr. Edwards, Mr. Engel, Mr. Farr, Mr. Fattah, Mr.
Filner, Mr. Frank of Massachusetts, Mr. Gonzalez, Mr. Gordon, Mr. Al
Green of Texas, Mr. Gene Green of Texas, Mr. Grijalva, Mr. Gutierrez,
Ms. Harman, Mr. Hastings of Florida, Mr. Higgins, Mr. Hinchey, Mr.
Hinojosa, Mr. Honda, Mr. Inslee, Mr. Israel, Mr. Jackson of Illinois,
Ms. Jackson-Lee of Texas, Ms. Eddie Bernice Johnson of Texas, Ms.
Kaptur, Mr. Kennedy of Rhode Island, Mr. Kildee, Ms. Kilpatrick of
Michigan, Mr. Kucinich, Mr. Langevin, Ms. Lee, Mrs. Lowey, Mrs.
Maloney, Ms. Matsui, Ms. McCollum of Minnesota, Mr. McGovern, Ms.
McKinney, Mr. Meehan, Mr. Meek of Florida, Mr. Meeks of New York, Ms.
Millender-McDonald, Mr. Miller of North Carolina, Mr. George Miller of
California, Mr. Mollohan, Ms. Moore of Wisconsin, Mr. Moran of
Virginia, Mr. Nadler, Mrs. Napolitano, Ms. Norton, Mr. Oberstar, Mr.
Olver, Mr. Ortiz, Mr. Owens, Mr. Pallone, Mr. Pascrell, Mr. Pastor, Mr.
Payne, Mr. Price of North Carolina, Mr. Reyes, Ms. Roybal-Allard, Mr.
Rush, Mr. Ryan of Ohio, Ms. Linda T. Sanchez of California, Ms. Loretta
Sanchez of California, Mr. Sanders, Ms. Schakowsky, Ms. Schwartz of
Pennsylvania, Mr. Scott of Virginia, Mr. Scott of Georgia, Mr. Serrano,
Ms. Slaughter, Ms. Solis, Mr. Thompson of Mississippi, Mr. Tierney, Mr.
Towns, Mr. Udall of New Mexico, Mr. Van Hollen, Ms. Velazquez, Ms.
Wasserman Schultz, Ms. Waters, Ms. Watson, Mr. Watt, Mr. Waxman, Mr.
Weiner, Mr. Wexler, Ms. Woolsey, Mr. Wu, and Mr. Wynn) 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 part D of title XVIII of the Social Security Act to assist
low-income individuals in obtaining subsidized prescription drug
coverage under the Medicare prescription drug program by expediting the
application and qualification process, by increasing the maximum
permissible resource level for eligibility for such subsidies, and by
waiving any late enrollment penalty for the first 24 uncovered months.
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 ``Prescription Coverage Now Act of
2006''.
SEC. 2. EXPEDITING LOW-INCOME SUBSIDIES UNDER THE MEDICARE PRESCRIPTION
DRUG PROGRAM.
(a) In General.--Section 1860D-14 of the Social Security Act (42
U.S.C. 1395w-114) is amended by adding at the end the following new
subsection:
``(e) Expedited Application and Eligibility Process.--
``(1) Expedited process.--
``(A) In general.--The Secretary shall provide for
an expedited process under this subsection for the
qualification for low-income assistance under this
section through a request by the Secretary to the
Secretary of the Treasury as provided in subparagraphs
(B) and (C) for information sufficient to identify
whether the individual involved is likely eligible for
subsidies under this section based on such information
and the amount of premium and cost-sharing subsidies
for which they would qualify based on such information.
Such process shall be conducted in cooperation with the
Commissioner of Social Security.
``(B) Opt in for newly eligible individuals.--Not
later than 60 days after the date of the enactment of
this subsection, the Secretary shall ensure that, as
part of the Medicare enrollment process, enrolling
individuals--
``(i) receive information describing the
low-income subsidy provided under this section;
and
``(ii) are provided the opportunity to opt-
in to the expedited process described in this
subsection by giving consent for the Secretary
to screen the beneficiary for eligibility for
such subsidy through a request to the Secretary
of the Treasury under section 6103(l)(7) of the
Internal Revenue Code of 1986.
``(C) Transition for currently eligible
individuals.--In the case of any part D eligible
individual to which subparagraph (B) did not apply at
the time of such individual's enrollment, the Secretary
shall, as soon as practicable after implementation of
subparagraph (B), request in writing that the Secretary
of the Treasury disclose, pursuant to section
6103(l)(21) of the Internal Revenue Code of 1986,
whether such individual has either filed no income tax
return or whether such individual's income tax return
indicates likely eligibility for the low-income subsidy
provided under this section.
``(2) Notification of potentially eligible individuals.--
Under such process, in the case of each individual identified
under paragraph (1) who has not otherwise applied for, or been
determined eligible for, benefits under this section (or who
has applied for and been determined ineligible for such
benefits based only on excess resources), the Secretary shall
send them a letter (using basic, uncomplicated language)
containing the following:
``(A) Eligibility.--A statement that, based on the
information obtained under paragraph (1), the
individual is likely eligible for low-income subsidies
under this section.
``(B) Amount of subsidies.--A description of the
amount of premium and cost-sharing subsidies under this
section for which the individual would likely be
eligible based on such information.
``(C) Enrollment opportunity.--In case the
individual is not enrolled in a prescription drug plan
or MA-PD plan--
``(i) a statement that--
``(I) the individual has the
opportunity to enroll in a prescription
drug plan or MA-PD plan for benefits
under this part, but is not required to
be so enrolled; and
``(II) if the individual has
creditable prescription drug coverage,
the individual need not so enroll;
``(ii) a list of the prescription drug
plans and MA-PD plans in which the individual
is eligible to enroll;
``(iii) an enrollment form that may be used
to enroll in such a plan by mail and that
provides that if the individual wishes to
enroll but does not designate a plan, the
Secretary is authorized to enroll the
individual in such a prescription drug plan
selected by the Secretary; and
``(iv) a statement that the individual may
also enroll online or by telephone, but, in
order to qualify for low-income subsidies, the
individual must complete the attestation
described in subparagraph (D) or otherwise
apply for such subsidies.
``(D) Attestation.--A one-page application form
that provides for a signed attestation, under penalty
of law, as to the amount of income and assets of the
individual and constitutes an application for the low-
income subsidies described in subparagraph (B). Such
form--
``(i) shall not require the submittal of
additional documentation regarding income or
assets;
``(ii) shall permit the appointment of a
personal representative described in paragraph
(6); and
``(iii) may provide for the specification
of a language (other than English) that is
preferred for subsequent communications with
respect to the individual under this part.
``(E) Information on ship.--Information on how the
individual may contact the State Health Insurance
Assistance Program (SHIP) for the State in which the
individual is located in order to obtain assistance
regarding enrollment and benefits under this part.
If a State is doing its own outreach to low-income seniors
regarding enrollment and low-income subsidies under this part,
such process shall be coordinated with the State's outreach
effort.
``(3) Follow-up communications.--If the individual does not
respond to the letter described in paragraph (2) either by
making an enrollment described in paragraph (2)(C), completing
an attestation described in paragraph (2)(D), or declining
either or both, the Secretary shall make additional attempts to
contact the individual to obtain such an affirmative response.
``(4) Hold-harmless.--Under such process, if an individual
in good faith and the absence of fraud executes an attestation
described in paragraph (2)(D) and is provided low-income
subsidies under this section on the basis of such attestation,
if the individual is subsequently found not eligible for such
subsidies, there shall be no recovery made against the
individual because of such subsidies improperly paid.
``(5) Use of authorized representative.--Under such
process, with proper authorization (which may be part of the
attestation form described in paragraph (2)(D)), an individual
may authorize another individual to act as the individual's
personal representative with respect to communications under
this part and the enrollment of the individual under a
prescription drug plan (or MA-PD plan) and for low-income
subsidies under this section.
``(6) Use of preferred language in subsequent
communications.--In the case an attestation described in
paragraph (2)(D) is completed and in which a language other
than English is specified under clause (iii) of such paragraph,
the Secretary shall provide that subsequent communications to
the individual under this part shall be in such language.
``(7) Construction.--Nothing in this subsection shall be
construed as precluding the Secretary from taking additional
outreach efforts to enroll eligible individuals under this part
and to provide low-income subsidies to eligible individuals.''.
(b) Transitional Disclosure of Return Information for Purposes of
Providing Low-Income Subsidies Under Medicare.--
(1) In general.--Subsection (l) of section 6103 of the
Internal Revenue Code of 1986 is amended by adding at the end
the following new paragraph:
``(21) Transitional disclosure of return information for
purposes of providing low-income subsidies under medicare.--
``(A) In general.--The Secretary, upon written
request from the Secretary of Health and Human Services
under section 1860D-14(e)(1) of the Social Security Act
for an individual described in subparagraph (C) of such
section, shall disclose to officers and employees of
the Department of Health and Human Services and the
Social Security Administration with respect to a
taxpayer for the applicable year--
``(i)(I) whether the adjusted gross income,
as modified in accordance with specifications
of the Secretary of Health and Human Services
for purposes of carrying out such section, of
such taxpayer and, if applicable, such
taxpayer's spouse, for the applicable year,
exceeds the amounts specified by the Secretary
of Health and Human Services as indicating
likely eligibility for the low-income subsidy
provided under section 1860D-14 of such Act,
``(II) whether the return was a joint
return, and
``(III) the applicable year, or
``(ii) if applicable, the fact that there
is no return filed for such taxpayer for the
applicable year.
``(B) Definition of applicable year.--For the
purposes of this paragraph, the term `applicable year'
means the most recent taxable year for which
information is available in the Internal Revenue
Service's taxpayer data information systems, or, if
there is no return filed for such taxpayer for such
year, the prior taxable year.
``(C) Restriction on use of disclosed
information.--Return information disclosed under this
paragraph may be used only for the purposes of
identifying eligible individuals for, and
administering--
``(i) low-income subsidies under section
1860D-14 of the Social Security Act, and
``(ii) the Medicare Savings Program
implemented under clauses (i), (iii), and (iv)
of section 1902(a)(10)(E) of such Act.
``(D) Termination.--Return information may not be
disclosed under this paragraph after the date that is
one year after the date of the enactment of this
paragraph.''.
(2) Confidentiality.--Paragraph (3) of section 6103(a) of
such Code is amended by striking ``or (20)'' and inserting
``(20), or (21)''.
(3) Procedures and recordkeeping related to disclosures.--
Paragraph (4) of section 6103(p) of such Code is amended by
striking ``or (20)'' each place it appears and inserting
``(20), or (21)''.
(4) Unauthorized disclosure or inspection.--Paragraph (2)
of section 7213(a) of such Code is amended by striking ``or
(20)'' and inserting ``(20), or (21)''.
SEC. 3. INCREASE IN PERMITTED RESOURCES TO OBTAIN LOW-INCOME SUBSIDIES.
(a) Increase in Resource Limits.--Subparagraph (E) of section
1860D-14(a)(3) of the Social Security Act (42 U.S.C. 1395ww-114(a)(3))
is amended--
(1) in subclause (I), by striking ``for 2006'' and
inserting ``for months in 2006 before the first day of the
first month beginning after the date of the enactment of the
Prescription Drug Now Act of 2006'' and by striking ``and'' at
the end;
(2) by redesignating subclause (II) as subclause (III);
(3) by inserting after subclause (I) the following new
subclause:
``(II) for months in 2006 beginning
with the first month that begins after
the date of the enactment of the
Prescription Drug Now Act of 2006,
$50,000 (or $100,000 in the case of the
combined value of the individual's
assets or resources and the assets or
resources of the individual's spouse);
and''; and
(4) in the last sentence, by striking ``subclause (II)''
and inserting ``subclause (III)''.
(b) Not Counting Value of Life Insurance as Resource.--Such section
is further amended--
(1) in subparagraphs (D) and (E), by inserting ``, except
as provided in subparagraph (G)'' after ``supplemental security
income program''; and
(2) by adding at the end the following new subparagraph:
``(G) Exclusion of life insurance in resources.--
For purposes of subparagraphs (D) and (E), the value of
a life insurance policy shall not be counted as a
resource for months beginning after the date of the
enactment of this subparagraph.''.
SEC. 4. WAIVER OF LATE ENROLLMENT PENALTY FOR SUBSIDY ELIGIBLE
INDIVIDUALS FOR FIRST 24 MONTHS OF NON-ENROLLMENT.
Section 1860D-13(b)(3)(B) of the Social Security Act (42 U.S.C.
1395w-113(b)(3)(B)) is amended by inserting before the period at the
end the following: ``, except that in the case of a subsidy eligible
individual (as defined in section 1860D-14(a)(3)(A)) the first 24
uncovered months shall not be counted''.
<all>
Introduced in House
Introduced in House
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.
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.
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.
Referred to the Subcommittee on Health, for a period to be subsequently determined by the Chairman .
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