Enrollment REFORM Act

II 116TH CONGRESS 1ST SESSION S. 1928 To amend title XVIII of the Social Security Act to improve the enrollment of retiring individuals in the Medicare program. IN THE SENATE OF THE UNITED STATES JUNE 20, 2019 Mr. PORTMAN (for himself and Mr. CASEY) 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 improve the enrollment of retiring individuals in the Medicare program. 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 ‘‘Enrollment Reshaping 4 Entry For Older, Retiring Members Act’’ or the ‘‘Enroll- 5 ment REFORM Act’’. 6 VerDate Sep 11 2014 22:40 Jun 25, 2019 Jkt 089200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\S1928.IS S1928 tkelley on DSKBCP9HB2PROD with BILLS 2 •S 1928 IS SEC. 2. COORDINATION OF MEDICARE BENEFITS WITH 1 OTHER HEALTH CARE INSURANCE. 2 (a) IN GENERAL.—Section 1862(b)(1)(A) of the So- 3 cial Security Act (42 U.S.C. 1395y(b)(1)(A)) is amended 4 by adding at the end the following new clause: 5 ‘‘(vi) COORDINATION OF BENEFITS 6 WITH OTHER HEALTH CARE INSURANCE.— 7 Notwithstanding any other provision of 8 law, in the event that an individual is en- 9 rolled in an employer group health plan 10 (including a multiemployer or multiple em- 11 ployer group health plan) by virtue of cur- 12 rent employment status with an employer 13 that does not have 20 or more individuals 14 in current employment status for each 15 working day in each of 20 or more cal- 16 endar weeks in the current calendar year 17 and the preceding calendar year and the 18 individual is eligible but not enrolled in 19 coverage under part B, such employer 20 group health plan shall not reduce benefits 21 under the plan with respect to the indi- 22 vidual on the basis that the individual 23 could have been enrolled in coverage under 24 part B. Nothing in the preceding sentence 25 shall require such employer group health 26 VerDate Sep 11 2014 22:40 Jun 25, 2019 Jkt 089200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\S1928.IS S1928 tkelley on DSKBCP9HB2PROD with BILLS 3 •S 1928 IS plan to provide coverage to an individual 1 who elects to enroll in coverage under part 2 B or to prohibit such plan from termi- 3 nating such coverage or reducing benefits 4 if such individual makes such election.’’. 5 (b) EFFECTIVE DATE.—The amendment made by 6 subsection (a) shall apply to items and services furnished 7 on or after the date of the enactment of this Act. 8 SEC. 3. LIMITATION ON DOCUMENTATION AN INDIVIDUAL 9 IS REQUIRED TO PROVIDE IN ORDER TO 10 DEMONSTRATE EMPLOYMENT-BASED 11 HEALTH INSURANCE FOR PURPOSES OF 12 AVOIDING THE PART B LATE ENROLLMENT 13 PENALTY. 14 (a) IN GENERAL.—Section 1839 of the Social Secu- 15 rity Act (42 U.S.C. 1395r) is amended— 16 (1) in subsection (b), in the second sentence, by 17 striking ‘‘For purposes’’ and inserting ‘‘Subject to 18 subsection (j), for purposes’’; and 19 (2) by adding at the end the following new sub- 20 section: 21 ‘‘(j) LIMITATION ON DOCUMENTATION AN INDI- 22 VIDUAL IS REQUIRED TO PROVIDE IN ORDER TO DEM- 23 ONSTRATE EMPLOYMENT-BASED HEALTH INSURANCE 24 VerDate Sep 11 2014 22:40 Jun 25, 2019 Jkt 089200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\S1928.IS S1928 tkelley on DSKBCP9HB2PROD with BILLS 4 •S 1928 IS FOR PURPOSES OF AVOIDING THE LATE ENROLLMENT 1 PENALTY.— 2 ‘‘(1) LIMITATION.—Subject to paragraph (2), 3 for purposes of demonstrating enrollment in a group 4 health plan or a large group health plan for a period 5 of time under the second sentence of subsection (b), 6 the Secretary may not require an individual to pro- 7 vide documentation of such enrollment for more 8 than the 36-month period immediately preceding the 9 close of the enrollment period in which the individual 10 enrolled (or reenrolled). 11 ‘‘(2) LIMITATION NOT APPLICABLE IF INDI- 12 VIDUAL IS UNABLE TO PROVIDE DOCUMENTATION 13 FOR ENTIRE 36-MONTH PERIOD.—In the case where 14 an individual is unable to provide documentation of 15 enrollment described in paragraph (1) for the entire 16 preceding 36-month period described in such para- 17 graph, the limitation under paragraph (1) shall not 18 apply. 19 ‘‘(3) INDIVIDUAL CAN PROVIDE ADDITIONAL 20 DOCUMENTATION.—Nothing in this subsection shall 21 preclude an individual from providing the Secretary 22 with documentation of enrollment for periods prior 23 to the preceding 36-month period described in para- 24 graph (1), including in the case where the limitation 25 VerDate Sep 11 2014 22:40 Jun 25, 2019 Jkt 089200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\S1928.IS S1928 tkelley on DSKBCP9HB2PROD with BILLS 5 •S 1928 IS under paragraph (1) does not apply because of the 1 application of paragraph (2).’’. 2 (b) EFFECTIVE DATE.—The amendment made by 3 subsection (a) shall apply to calculations of premiums 4 under such section 1839 made on or after the date of the 5 enactment of this Act. 6 Æ VerDate Sep 11 2014 22:40 Jun 25, 2019 Jkt 089200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6301 E:\BILLS\S1928.IS S1928 tkelley on DSKBCP9HB2PROD with BILLS