BENES Act of 2019

II 116TH CONGRESS 1ST SESSION S. 1280 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 SENATE OF THE UNITED STATES MAY 2, 2019 Mr. CASEY (for himself, Mr. YOUNG, Ms. STABENOW, Ms. COLLINS, Mr. PORTMAN, and Mr. COONS) introduced the following bill; which was read twice and referred to the Committee on Finance A BILL To amend title XVIII of the Social Security Act to establish a system to notify individuals approaching Medicare eligi- bility, to simplify and modernize the eligibility enrollment process, and for other purposes. Be it enacted by the Senate and House of Representa- 1 tives of the United States of America in Congress assembled, 2 SECTION 1. SHORT TITLE. 3 This Act may be cited as the ‘‘Beneficiary Enrollment 4 Notification and Eligibility Simplification Act of 2019’’ or 5 the ‘‘BENES Act of 2019’’. 6 VerDate Sep 11 2014 04:19 May 04, 2019 Jkt 089200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\S1280.IS S1280 kjohnson on DSK79L0C42 with BILLS 2 •S 1280 IS SEC. 2. BENEFICIARY ENROLLMENT NOTIFICATION AND 1 ELIGIBILITY SIMPLIFICATION. 2 (a) ELIGIBILITY AND ENROLLMENT NOTICES.— 3 (1) AS PART OF SOCIAL SECURITY ACCOUNT 4 STATEMENT FOR INDIVIDUALS AGE 60 TO 65.—Sec- 5 tion 1143(a) of the Social Security Act (42 U.S.C. 6 1320b–13(a)) is amended by adding at the end the 7 following new paragraph: 8 ‘‘(4) MEDICARE ELIGIBILITY INFORMATION.— 9 ‘‘(A) IN GENERAL.—In the case of state- 10 ments provided on or after the date that is 2 11 years after the date of the enactment of this 12 Act to individuals who have attained 60 years 13 of age but have not attained 65 years of age, 14 the statement shall also include a notice con- 15 taining the information described in subpara- 16 graph (B). 17 ‘‘(B) CONTENTS OF NOTICE.—The notice 18 required under subparagraph (A) shall contain 19 information on (including a clear, simple expla- 20 nation of)— 21 ‘‘(i) eligibility for benefits under the 22 Medicare program under title XVIII, and 23 in particular benefits under part B of such 24 title; 25 VerDate Sep 11 2014 04:19 May 04, 2019 Jkt 089200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\S1280.IS S1280 kjohnson on DSK79L0C42 with BILLS 3 •S 1280 IS ‘‘(ii) the possibility of a late enroll- 1 ment penalty for failure to timely enroll 2 (including the process for requesting relief 3 under section 1837(h) in plain language); 4 ‘‘(iii) the need for coordination of ben- 5 efits under such part B (including primary 6 and secondary coverage scenarios) imposed 7 under title XVIII; and 8 ‘‘(iv) populations, such as veterans, 9 for whom there are special considerations 10 with respect to enrollment under this title. 11 ‘‘(C) DEVELOPMENT OF NOTICE.— 12 ‘‘(i) IN GENERAL.—The Secretary, in 13 consultation with representatives of each of 14 the groups described in subparagraph 15 (D)(i), and in coordination with the Com- 16 missioner of Social Security, shall develop 17 the notice to be provided pursuant to sub- 18 paragraph (A). 19 ‘‘(ii) NOTICE IMPROVEMENT.—The 20 Secretary, not less than once every two 21 years, shall— 22 ‘‘(I) review the content of the no- 23 tice to be provided under subpara- 24 graph (A); and 25 VerDate Sep 11 2014 04:19 May 04, 2019 Jkt 089200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\S1280.IS S1280 kjohnson on DSK79L0C42 with BILLS 4 •S 1280 IS ‘‘(II) update and revise such no- 1 tice as the Secretary deems appro- 2 priate. 3 ‘‘(D) GROUPS FOR CONSULTATION.— 4 ‘‘(i) IN GENERAL.—For purposes of 5 subparagraph (C), the groups described in 6 this clause include the following: 7 ‘‘(I) Individuals who are more 8 than 60 years of age. 9 ‘‘(II) Veterans. 10 ‘‘(III) Individuals with disabil- 11 ities. 12 ‘‘(IV) Individuals with end stage 13 renal disease. 14 ‘‘(V) Low-income individuals and 15 families. 16 ‘‘(VI) Employers (including 17 human resources professionals). 18 ‘‘(VII) States (including rep- 19 resentatives of State-run Health In- 20 surance Exchanges, Medicaid offices, 21 and Departments of Insurance). 22 ‘‘(VIII) State Health Insurance 23 Assistance Programs. 24 ‘‘(IX) Health insurers. 25 VerDate Sep 11 2014 04:19 May 04, 2019 Jkt 089200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\S1280.IS S1280 kjohnson on DSK79L0C42 with BILLS 5 •S 1280 IS ‘‘(X) Health insurance agents 1 and brokers. 2 ‘‘(XI) Such other groups as spec- 3 ified by the Secretary. 4 ‘‘(ii) NONAPPLICATION OF FACA.— 5 The Federal Advisory Committee Act shall 6 not apply to consultations made pursuant 7 to subparagraph (C) with groups described 8 in clause (i). 9 ‘‘(E) POSTING OF NOTICE ON WEBSITES.— 10 The Commissioner of Social Security and the 11 Secretary shall each ensure that the notice 12 being used under subparagraph (A) is posted in 13 a prominent location on their respective Depart- 14 ment Internet website.’’. 15 (2) INDIVIDUALS IN MEDICARE WAITING PE- 16 RIOD.—Title XI of the Social Security Act is amend- 17 ed by inserting after section 1144 the following new 18 section: 19 ‘‘MEDICARE ENROLLMENT NOTIFICATION AND ELIGI- 20 BILITY NOTICES FOR INDIVIDUALS IN MEDICARE 21 WAITING PERIOD 22 ‘‘SEC. 1144A. (a) NOTICES.— 23 ‘‘(1) IN GENERAL.—The Commissioner of So- 24 cial Security, in coordination with the Secretary, 25 shall distribute the notice developed and used by the 26 VerDate Sep 11 2014 04:19 May 04, 2019 Jkt 089200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\S1280.IS S1280 kjohnson on DSK79L0C42 with BILLS 6 •S 1280 IS Commissioner under section 1143(a)(4) to individ- 1 uals in the Medicare waiting period under section 2 226(b) of this Act. 3 ‘‘(2) AUTHORITY TO MODIFY NOTICE.—The 4 Secretary, in coordination with the Commissioner of 5 Social Security, may modify the notice to be distrib- 6 uted under paragraph (1) as necessary to take into 7 account the population receiving the notice. 8 ‘‘(3) POSTING OF NOTICE ON WEBSITES.—The 9 Commissioner of Social Security and the Secretary 10 shall each ensure that the notice being distributed 11 under paragraph (1) is posted in a prominent loca- 12 tion on their respective Department Internet 13 website. 14 ‘‘(b) TIMING.—Beginning two years after the date of 15 the enactment of this section, a notice required under sub- 16 section (a)(1) shall be mailed to an individual no less than 17 two times in accordance with the following: 18 ‘‘(1) The notice shall be provided to such indi- 19 vidual no later than 3 months prior to the date of 20 such individual’s enrollment period as provided 21 under section 1837. 22 ‘‘(2) The notice shall subsequently be provided 23 to such individual no later than one month prior to 24 such date.’’. 25 VerDate Sep 11 2014 04:19 May 04, 2019 Jkt 089200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\S1280.IS S1280 kjohnson on DSK79L0C42 with BILLS 7 •S 1280 IS (b) BENEFICIARY MEDICARE PART B ENROLLMENT 1 PERIODS AND EFFECTIVE DATE OF COVERAGE.— 2 (1) EFFECTIVE DATES.—Section 1838(a) of the 3 Social Security Act (42 U.S.C. 1395q(a)) is amend- 4 ed— 5 (A) by amending paragraph (2) to read as 6 follows: 7 ‘‘(2)(A) in the case of an individual who enrolls 8 pursuant to subsection (d) of section 1837 before 9 the month in which he first satisfies paragraph (1) 10 or (2) of section 1836, the first day of such month, 11 ‘‘(B) in the case of an individual not described 12 in subparagraph (A) who first satisfies such para- 13 graph in a month beginning before January 2021 14 and who enrolls— 15 ‘‘(i) pursuant to such subsection (d) in 16 such month in which he first satisfies such 17 paragraph, the first day of the month following 18 the month in which he so enrolls, 19 ‘‘(ii) pursuant to such subsection (d) in the 20 month following such month in which he first 21 satisfies such paragraph, the first day of the 22 second month following the month in which he 23 so enrolls, or 24 VerDate Sep 11 2014 04:19 May 04, 2019 Jkt 089200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\S1280.IS S1280 kjohnson on DSK79L0C42 with BILLS 8 •S 1280 IS ‘‘(iii) pursuant to such subsection (d) more 1 than one month following such month in which 2 he satisfies such paragraph, the first day of the 3 third month following the month in which he so 4 enrolls, 5 ‘‘(C) in the case of an individual not described 6 in subparagraph (A) who first satisfies such para- 7 graph in a month beginning on or after January 1, 8 2021, and who enrolls pursuant to such subsection 9 (d) in such month in which he first satisfies such 10 paragraph or in any subsequent month of his initial 11 enrollment period, the first day of the month fol- 12 lowing the month in which he so enrolls, 13 ‘‘(D) in the case of an individual not described 14 in subparagraph (A) who enrolls pursuant to sub- 15 section (e) of section 1837 in a month beginning be- 16 fore October 15, 2020, the July 1 following the 17 month in which he so enrolls, or 18 ‘‘(E) in the case of an individual not described 19 in subparagraph (A) who enrolls pursuant to sub- 20 section (e) of section 1837 in a month beginning on 21 or after October 15, 2020, the first day of the 22 month following the month in which he so enrolls.’’; 23 and 24 VerDate Sep 11 2014 04:19 May 04, 2019 Jkt 089200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\S1280.IS S1280 kjohnson on DSK79L0C42 with BILLS 9 •S 1280 IS (B) by amending paragraph (3) to read as 1 follows: 2 ‘‘(3)(A) in the case of an individual who is 3 deemed to have enrolled on or before the last day of 4 the third month of his initial enrollment period, the 5 first day of the month in which he first meets the 6 applicable requirements of section 1836 or July 1, 7 1973, whichever is later, 8 ‘‘(B) in the case of an individual who is deemed 9 to have enrolled on or after the first day of the 10 fourth month of his initial enrollment period begin- 11 ning before January 1, 2021, as prescribed under 12 subparagraphs (B)(i), (B)(ii), (B)(iii), and (D) of 13 paragraph (2) of this subsection, or 14 ‘‘(C) in the case of an individual who is deemed 15 to have enrolled on or after the first day of the 16 fourth month of his initial enrollment period begin- 17 ning on or after January 1, 2021, as prescribed 18 under paragraph (2)(C) of this subsection.’’. 19 (2) GENERAL AND SPECIAL ENROLLMENT PERI- 20 ODS.—Section 1837(e) of the Social Security Act 21 (42 U.S.C. 1395p(e)) is amended to read as follows: 22 ‘‘(e) ENROLLMENT PERIODS.— 23 ‘‘(1) FOR COVERAGE DURING YEARS BEFORE 24 2022.—There shall be a general enrollment period 25 VerDate Sep 11 2014 04:19 May 04, 2019 Jkt 089200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\S1280.IS S1280 kjohnson on DSK79L0C42 with BILLS 10 •S 1280 IS during the period beginning on January 1 and end- 1 ing on March 31 of each year before 2022. 2 ‘‘(2) FOR COVERAGE DURING YEARS BEGINNING 3 WITH 2022.—For coverage during years beginning 4 with 2022 and each subsequent year, there shall be 5 a general enrollment period beginning on October 15 6 of the previous year through December 31 of such 7 previous year. 8 ‘‘(3) EXCEPTIONAL CIRCUMSTANCES.—The 9 Secretary may establish a special enrollment period 10 in the case that an individual meets such exceptional 11 conditions as the Secretary may provide.’’. 12 (3) TECHNICAL CORRECTION.— 13 (A) IN GENERAL.—Section 1839(b) of the 14 Social Security Act (42 U.S.C. 1395r(b)) is 15 amended by striking ‘‘close of the enrollment 16 period’’ each place it appears and inserting 17 ‘‘close of the month’’. 18 (B) EFFECTIVE DATE.—The amendment 19 made by subparagraph (A) shall take effect on 20 November 1, 2021. 21 Æ VerDate Sep 11 2014 04:19 May 04, 2019 Jkt 089200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6301 E:\BILLS\S1280.IS S1280 kjohnson on DSK79L0C42 with BILLS