BENES 2.0 Act

II 118TH CONGRESS 1ST SESSION S. 1687 To amend title XVIII of the Social Security Act to establish a system to notify individuals approaching Medicare eligibility. IN THE SENATE OF THE UNITED STATES MAY 18, 2023 Mr. CASEY (for himself, Mr. YOUNG, Ms. STABENOW, Ms. COLLINS, Ms. SINEMA, Mr. SCOTT of South Carolina, Mr. BROWN, Mr. SULLIVAN, Ms. SMITH, and Mr. BRAUN) 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. 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 2.0 Act’’ or the 5 ‘‘BENES 2.0 Act’’. 6 SEC. 2. BENEFICIARY ENROLLMENT NOTIFICATION AND 7 ELIGIBILITY SIMPLIFICATION. 8 (a) ELIGIBILITY AND ENROLLMENT NOTICES.— 9 VerDate Sep 11 2014 03:35 Jun 02, 2023 Jkt 039200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\S1687.IS S1687 kjohnson on DSK79L0C42PROD with BILLS 2 •S 1687 IS (1) AS PART OF SOCIAL SECURITY ACCOUNT 1 STATEMENT FOR INDIVIDUALS ATTAINING AGES 60 2 TO 65.— 3 (A) IN GENERAL.—Section 1143(a) of the 4 Social Security Act (42 U.S.C. 1320b–13(a)) is 5 amended by adding at the end the following 6 new paragraph: 7 ‘‘(4) MEDICARE ELIGIBILITY INFORMATION.— 8 ‘‘(A) IN GENERAL.—In the case of state- 9 ments provided on or after the date that is 2 10 years after the date of the enactment of this 11 paragraph to individuals who are attaining ages 12 60, 61, 62, 63, 64, and 65, the statement shall 13 also include a notice containing the information 14 described in subparagraph (B). 15 ‘‘(B) CONTENTS OF NOTICE.—The notice 16 required under subparagraph (A) shall include 17 a clear, simple explanation of— 18 ‘‘(i) eligibility for benefits under the 19 Medicare program under title XVIII, and 20 in particular benefits under part B of such 21 title; 22 ‘‘(ii) the reasons a late enrollment 23 penalty for failure to timely enroll could be 24 assessed and how such late enrollment pen- 25 VerDate Sep 11 2014 02:59 Jun 03, 2023 Jkt 039200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\S1687.IS S1687 kjohnson on DSK79L0C42PROD with BILLS 3 •S 1687 IS alty is calculated, in particular for benefits 1 under such part B; 2 ‘‘(iii) the availability of relief from 3 such late enrollment penalty and retro- 4 active enrollment under section 1837(h) 5 (including as such section is applied under 6 sections 1818(c) and 1818A(c)(3)), with 7 examples of circumstances under which 8 such relief may be granted and examples of 9 circumstances under which such relief 10 would not be granted; 11 ‘‘(iv) coordination of benefits (includ- 12 ing primary and secondary coverage sce- 13 narios) pursuant to section 1862(b), in 14 particular for benefits under such part B; 15 ‘‘(v) enrollment, eligibility, and coordi- 16 nation of benefits under title XVIII with 17 respect to populations, for whom there are 18 special considerations, such as residents of 19 Puerto Rico and veterans; and 20 ‘‘(vi) online resources and toll-free 21 telephone numbers of the Social Security 22 Administration and the Centers for Medi- 23 care & Medicaid Services (including 1– 24 800–MEDICARE and the national toll-free 25 VerDate Sep 11 2014 03:35 Jun 02, 2023 Jkt 039200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\S1687.IS S1687 kjohnson on DSK79L0C42PROD with BILLS 4 •S 1687 IS number of the Social Security Administra- 1 tion) that provide information on eligibility 2 for benefits under the Medicare program 3 under title XVIII. 4 ‘‘(C) DEVELOPMENT OF NOTICE.— 5 ‘‘(i) IN GENERAL.—The Secretary, in 6 coordination with the Commissioner of So- 7 cial Security, and taking into consideration 8 information collected pursuant to clause 9 (ii), shall, not later than 12 months after 10 the last day of the period for the request 11 of information described in clause (ii), de- 12 velop the notice to be provided pursuant to 13 subparagraph (A). 14 ‘‘(ii) REQUEST FOR INFORMATION.— 15 Not later than 6 months after the date of 16 the enactment of this paragraph, the Sec- 17 retary shall request written information, 18 including recommendations, from stake- 19 holders (including the groups described in 20 subparagraph (D)) on the information to 21 be included in the notice. 22 ‘‘(iii) NOTICE IMPROVEMENT.—Begin- 23 ning 4 years after the date of the enact- 24 ment of this paragraph, and not less than 25 VerDate Sep 11 2014 03:35 Jun 02, 2023 Jkt 039200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\S1687.IS S1687 kjohnson on DSK79L0C42PROD with BILLS 5 •S 1687 IS once every 2 years thereafter, the Sec- 1 retary, in coordination with the Commis- 2 sioner of Social Security, shall— 3 ‘‘(I) review the content of the no- 4 tice to be provided under subpara- 5 graph (A); 6 ‘‘(II) request written information, 7 including recommendations, on such 8 notice through a request for informa- 9 tion process as described in clause (ii); 10 and 11 ‘‘(III) update and revise such no- 12 tice as the Secretary deems appro- 13 priate. 14 ‘‘(D) GROUPS.—For purposes of subpara- 15 graph (C)(ii), the groups described in this sub- 16 paragraph include the following: 17 ‘‘(i) Individuals who are 60 years of 18 age or older. 19 ‘‘(ii) Veterans. 20 ‘‘(iii) Individuals with disabilities. 21 ‘‘(iv) Individuals with end stage renal 22 disease. 23 ‘‘(v) Low-income individuals and fami- 24 lies. 25 VerDate Sep 11 2014 03:35 Jun 02, 2023 Jkt 039200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\S1687.IS S1687 kjohnson on DSK79L0C42PROD with BILLS 6 •S 1687 IS ‘‘(vi) Employers (including human re- 1 sources professionals). 2 ‘‘(vii) States (including representa- 3 tives of State-run Health Insurance Ex- 4 changes, Medicaid offices, and Depart- 5 ments of Insurance). 6 ‘‘(viii) State Health Insurance Assist- 7 ance Programs. 8 ‘‘(ix) Health insurers. 9 ‘‘(x) Health insurance agents and bro- 10 kers. 11 ‘‘(xi) Such other groups as specified 12 by the Secretary. 13 ‘‘(E) POSTING OF NOTICE ON WEBSITES.— 14 The Commissioner of Social Security and the 15 Secretary shall post the notice required under 16 subparagraph (A) on the public internet website 17 of the Social Security Administration and on 18 Medicare.gov (or a successor website), respec- 19 tively. 20 ‘‘(F) NO EFFECT ON OBLIGATION TO MAIL 21 STATEMENTS.—Nothing in this paragraph shall 22 be construed to relieve the Commissioner of So- 23 cial Security from any requirement under sub- 24 section (c), including the requirement to mail a 25 VerDate Sep 11 2014 03:35 Jun 02, 2023 Jkt 039200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\S1687.IS S1687 kjohnson on DSK79L0C42PROD with BILLS 7 •S 1687 IS statement on an annual basis to each eligible 1 individual who is not receiving benefits under 2 title II and for whom a mailing address can be 3 determined through such methods as the Com- 4 missioner determines to be appropriate.’’. 5 (B) TIMING OF STATEMENTS.—Section 6 1143(c)(2) of the Social Security Act (42 7 U.S.C. 1320b–13(c)(2)) is amended by adding 8 at the end the following new sentence: ‘‘With 9 respect to statements provided to individuals 10 who are attaining age 65, as described in sub- 11 section (a)(4), such statements shall be mailed 12 not earlier than 6 months and not later than 3 13 months before the individual attains such age.’’. 14 (2) SOCIAL SECURITY BENEFICIARIES.—Title 15 XI of the Social Security Act (42 U.S.C. 1301 et 16 seq.) is amended by inserting after section 1144 the 17 following new section: 18 ‘‘SEC. 1144A. MEDICARE ENROLLMENT NOTIFICATION AND 19 ELIGIBILITY NOTICES FOR SOCIAL SECURITY 20 BENEFICIARIES PRIOR TO MEDICARE ELIGI- 21 BILITY. 22 ‘‘(a) NOTICES.— 23 ‘‘(1) IN GENERAL.—The Commissioner of So- 24 cial Security shall distribute the notice to be pro- 25 VerDate Sep 11 2014 03:35 Jun 02, 2023 Jkt 039200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\S1687.IS S1687 kjohnson on DSK79L0C42PROD with BILLS 8 •S 1687 IS vided pursuant to section 1143(a)(4), as may be 1 modified under paragraph (2), to individuals entitled 2 to monthly insurance benefits under title II in ac- 3 cordance with subsection (b). 4 ‘‘(2) AUTHORITY TO MODIFY NOTICE.—The 5 Secretary, in coordination with the Commissioner of 6 Social Security, may modify the notice to be distrib- 7 uted under paragraph (1) as necessary to take into 8 account the individuals described in such paragraph. 9 ‘‘(3) POSTING OF NOTICE ON WEBSITES.—The 10 Commissioner of Social Security and the Secretary 11 shall post the notice required to be distributed under 12 paragraph (1) on the public internet website of the 13 Social Security Administration and on Medicare.gov 14 (or a successor website), respectively. 15 ‘‘(b) TIMING.—Beginning not later than 2 years after 16 the date of the enactment of this section, a notice required 17 under subsection (a)(1) shall be mailed to an individual 18 described in such subsection— 19 ‘‘(1) in the third month before the date on 20 which such individual’s initial enrollment period be- 21 gins as provided under section 1837; and 22 ‘‘(2) in the case of an individual with respect to 23 whom section 226(b) applies (except for an indi- 24 vidual who will attain age 65 during the 24 month 25 VerDate Sep 11 2014 03:35 Jun 02, 2023 Jkt 039200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\S1687.IS S1687 kjohnson on DSK79L0C42PROD with BILLS 9 •S 1687 IS period described in such section), in the month be- 1 fore such date on which such individual’s initial en- 2 rollment period so begins.’’. 3 Æ VerDate Sep 11 2014 03:35 Jun 02, 2023 Jkt 039200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6301 E:\BILLS\S1687.IS S1687 kjohnson on DSK79L0C42PROD with BILLS