Date: June 26, 2008
House Passes H.R. 6331, the
“Medicare Improvements for Patients and Providers Act of 2008”
On June 24, 2008, the House passed H.R. 6331, the “Medicare Improvements for Patients and Providers Act of 2008,” by a vote of 355–59. The bill would prevent a scheduled 10.6 percent pay cut to physicians from becoming effective on July 1, 2008, and would provide a 1.1 percent increase in Medicare payments to physicians, effective January 1, 2009. H.R. 6331 also contains provisions intended to improve Medicare services, pharmacy access, and assistance to low-income beneficiaries. The bill has been referred to the Senate for further consideration.
H.R. 6331 contains the following provisions of interest to SSA:
Eliminating Barriers to Medicare Savings Programs Enrollment
• Would require SSA to provide applicants for Medicare Part D Low-Income Subsidy (LIS) with information about Medicare Savings Programs (MSP) assistance, including information about how to contact the State health insurance assistance program (SHIP).
• Would require SSA (with the consent of those filing) to transmit LIS application data to the States. Once received, the LIS data would serve as a protective filing for MSP, with State agencies being required to complete appropriate MSP development and make eligibility determinations. The content, form, and manner in which information (on a uniform basis for all States) shall be transmitted would be determined by the Commissioner, in consultation with HHS and the States. Would be effective January 1, 2010.
• Would require SSA to provide MSP training to employees currently involved in LIS application-taking, so that those employees can promote beneficiary awareness of MSP, thereby increasing MSP participation.
• Would provide start-up funding of $24.1 million to SSA for activities related to MSP outreach and transmittal of data to States. Funds would be appropriated as of October 1, 2008, and remain available until expended. Ongoing funding for MSP-related activities would be provided, beginning with fiscal year 2011, through a separate ongoing appropriation of $3 million annually to HHS. HHS would provide this funding to SSA via a reimbursable agreement, and the funds would only be available to HHS for this specific purpose.
• Would provide additional funding of $24.8 million to SSA for LIS activities required due to changes in MSP and LIS programs. Funds would be appropriated as of October 1, 2008, and remain available until expended.
Exemption From Income and Resources for Determination of Eligibility for Low-Income Subsidy
• Would eliminate counting in-kind support and maintenance as income and life insurance as a resource for LIS purposes. Effective for applications filed on or after January 1, 2010.
Judicial Review of Decisions of the Commissioner of Social Security Under the Low-Income Subsidy Program
• Would codify SSA's existing policy that denied LIS applicants can appeal to the civil courts, once the administrative appeals process is exhausted. Would be effective as if enacted with the Medicare Prescription Drug, Improvement, and Modernization Act of 2003.
Translation of Standardized Medicare Savings Programs Application
• Would require HHS to translate their model MSP application into at least the 10 languages (other than English) most often used by Medicare applicants, and to make the translated forms available at Social Security offices. Effective January 1, 2010.
OTHER PROVISIONS OF INTEREST:
Extension of Qualifying Individual Program
• Would extend the Qualifying Individual (QI) program through December 2009. Additional funding of $200 million would be provided through December 2008, with an additional $500 million for 2009.
Application of Low-Income Subsidy Assets Test to Medicare Savings Programs
• Would apply the LIS standard resources test ($6,290 for an individual/$9,440 for a couple in 2008) to MSP, effective January 1, 2010.
Elimination of Medicare Part D Late Enrollment Penalties Paid By Subsidy- Eligible Individuals
• Would eliminate Part D late enrollment penalties for individuals who are eligible for LIS, effective January 1, 2009.
Eliminating Application of Estate Recovery
- Would clarify that, in the event of a recipient's death, the State is not allowed to attempt recovery (through the recipient's estate) of costs associated with providing MSP assistance. Would be effective January 1, 2010.