S 1669 ISCommentsClose CommentsPermalink

To provide all Medicare beneficiaries with the right to guaranteed issue of a Medicare supplemental policy.CommentsClose CommentsPermalink

September 15, 2009CommentsClose CommentsPermalink

Mr. KERRY introduced the following bill; which was read twice and referred to the Committee on FinanceCommentsClose CommentsPermalink

To provide all Medicare beneficiaries with the right to guaranteed issue of a Medicare supplemental policy.CommentsClose CommentsPermalink

Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled,CommentsClose CommentsPermalink

SECTION 1. SHORT TITLE.

This Act may be cited as the ‘Equal Access to Medicare Options Act of 2009’.CommentsClose CommentsPermalink

SEC. 2. GUARANTEED ISSUE OF MEDIGAP POLICIES TO ALL MEDICARE BENEFICIARIES.

(a) In General- Section 1882(s) of the Social Security Act (42 U.S.C. 1395ss(s)) is amended--CommentsClose CommentsPermalink





(1) in paragraph (2)(A), by striking ‘65 years of age or older and is enrolled for benefits under part B’ and inserting ‘entitled to, or enrolled for, benefits under part A and enrolled for benefits under part B’;CommentsClose CommentsPermalink





(2) in paragraph (2)(D), by striking ‘who is 65 years of age or older as of the date of issuance and’; andCommentsClose CommentsPermalink





(3) in paragraph (3)(B)(vi), by striking ‘at age 65’.CommentsClose CommentsPermalink





(b) Phase-In Authority-CommentsClose CommentsPermalink





(1) IN GENERAL- Subject to paragraph (2), the Secretary of Health and Human Services may phase in the implementation of the amendments made under subsection (a) in such manner as the Secretary determines appropriate to minimize any adverse impact on individuals enrolled under a Medicare supplemental policy prior to the effective date of this Act.CommentsClose CommentsPermalink





(2) LIMIT- The phase-in period under paragraph (1) shall not exceed 5 years.CommentsClose CommentsPermalink





(c) Separate Premium Class-CommentsClose CommentsPermalink





(1) IN GENERAL- Subject to paragraph (2), any individuals enrolled under a Medicare supplemental policy pursuant to the amendments made under subsection (a) shall be classified by the issuer as part of a separate premium class.CommentsClose CommentsPermalink





(2) LIMIT- The provision in paragraph (1) shall apply to individuals that enroll under a Medicare supplemental policy prior to January 1, 2015.CommentsClose CommentsPermalink





(d) Additional Enrollment Period for Certain Individuals-CommentsClose CommentsPermalink





(1) ONE-TIME ENROLLMENT PERIOD-CommentsClose CommentsPermalink





(A) IN GENERAL- In the case of an individual described in paragraph (2), the Secretary shall establish a one-time enrollment period during which such an individual may enroll in any Medicare supplemental policy of the individual’s choosing.CommentsClose CommentsPermalink





(B) PERIOD- The enrollment period established under subparagraph (A) shall begin on the date on which the phase-in period under subsection (b) is completed and end 6 months after such date.CommentsClose CommentsPermalink





(2) INDIVIDUAL DESCRIBED- An individual described in this paragraph is an individual who--CommentsClose CommentsPermalink





(A) is entitled to hospital insurance benefits under part A under section 226(b) or section 226A of the Social Security Act (42 U.S.C. 426(b); 426-1);CommentsClose CommentsPermalink





(B) is enrolled for benefits under part B of such Act (42 U.S.C. 1395j et seq.); andCommentsClose CommentsPermalink





(C) would not, but for the provisions of and amendments made by this section, be eligible for the guaranteed issue of a Medicare supplemental policy under section 1882(s)(2) of such Act (42 U.S.C. 1395ss(s)(2)).CommentsClose CommentsPermalink





(3) OUTREACH PLAN- The Secretary shall develop an outreach plan to notify individuals described in paragraph (2) of the one-time enrollment period established under paragraph (1).CommentsClose CommentsPermalink

SEC. 3. GUARANTEED ISSUE OF MEDIGAP POLICIES FOR MEDICARE ADVANTAGE AND MEDICAID ENROLLEES.

(a) In General- Section 1882(s)(3) of the Social Security Act (42 U.S.C. 1395ss(s)(3)), as amended by section 2, is amended--CommentsClose CommentsPermalink





(1) in subparagraph (B), by adding at the end the following new clauses:CommentsClose CommentsPermalink





‘(vii) The individual was enrolled in a Medicare Advantage plan under part C for not less than 12 months and subsequently disenrolled from such plan and elects to receive benefits under this title through the original Medicare fee-for-service program under parts A and B.CommentsClose CommentsPermalink





‘(viii) The individual--CommentsClose CommentsPermalink





‘(I) is entitled to, or enrolled for, benefits under part A and enrolled for benefits under part B;CommentsClose CommentsPermalink





‘(II) was eligible for medical assistance under a State plan or waiver under title XIX and was enrolled in such plan or waiver; andCommentsClose CommentsPermalink





‘(III) subsequently lost eligibility for such medical assistance.’; andCommentsClose CommentsPermalink





(2) by striking subparagraph (C)(iii) and inserting the following:CommentsClose CommentsPermalink





‘(iii) Subject to subsection (v)(1), for purposes of an individual described in clause (vi), (vii), or (viii) of subparagraph (B), a Medicare supplemental policy described in this subparagraph shall include any Medicare supplemental policy.’.CommentsClose CommentsPermalink





(3) in subparagraph (E)--CommentsClose CommentsPermalink





(A) in clause (iv), by striking ‘and’ at the end;CommentsClose CommentsPermalink





(B) in clause (v), by striking the period at the end and inserting a semicolon; andCommentsClose CommentsPermalink





(C) by adding at the end the following new clauses:CommentsClose CommentsPermalink





‘(vi) in the case of an individual described in subparagraph (B)(vii), the annual, coordinated election period (as defined in section 1851(e)(3)(B)) or a continuous open enrollment period (as defined in section 1851(e)(2)) during which the individual disenrolls from a Medicare Advantage plan under part C; andCommentsClose CommentsPermalink





‘(vii) in the case of an individual described in subparagraph (B)(viii), the period beginning on the date that the individual receives a notice of cessation of such individual’s eligibility for medical assistance under the State plan or waiver under title XIX and ending on the date that is 123 days after the individual receives such notice.’.CommentsClose CommentsPermalink





(b) Effective Date- The amendments made by subsection (a) shall apply to Medicare supplemental policies effective on or after January 1, 2010.CommentsClose CommentsPermalink

SEC. 4. ENROLLMENT OF INDIVIDUALS WITH END STAGE RENAL DISEASE IN MEDICARE ADVANTAGE.

(a) In General- Section 1851(a) of the Social Security Act (42 U.S.C. 1395w-21(a)) is amended by striking paragraph (3) and inserting the following:CommentsClose CommentsPermalink





‘(3) Medicare+Choice Eligible Individual- In this title, the term ‘Medicare+Choice eligible individual’ means an individual who is entitled to benefits under part A and enrolled under part B.’.CommentsClose CommentsPermalink





(b) Conforming Amendments-CommentsClose CommentsPermalink





(1) Section 1852(b) of the Social Security Act (42 U.S.C. 1395w-22(b)) is amended by striking paragraph (1) and inserting the following:CommentsClose CommentsPermalink





‘(1) Beneficiaries- A Medicare+Choice organization may not deny, limit, or condition the coverage or provision of benefits under this part, for individuals permitted to be enrolled with the organization under this part, based on any health status-related factor described in section 2702(a)(1) of the Public Health Service Act. The Secretary shall not approve a plan of an organization if the Secretary determines that the design of the plan and its benefits are likely to substantially discourage enrollment by certain MA eligible individuals with the organization.’.CommentsClose CommentsPermalink





(2) Section 1859(b)(6)(B) of such Act (42 U.S.C. 1395w-28(b)(6)(B)) is amended in the second sentence by striking ‘may waive application of section 1851(a)(3)(B) in the case of an individual described in clause (i), (ii), or (iii) of this subparagraph and’.CommentsClose CommentsPermalink





(c) Effective Date- The amendments made by this section shall apply to plan years beginning on or after January 1, 2010.CommentsClose CommentsPermalink