Sec. 5. Improving Medicare beneficiary enrollment procedures and effective dates of coverage
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/bill/115/s/3316/is/section-5A research copy — for the controlling text, always check the official state or federal source. Not legal advice.
Section 1837(e) of the Social Security Act ( 42 U.S.C. 1395p(e) ) is amended to read as follows: There shall be a general enrollment period during the period beginning on January 1 and ending on March 31 of each year before 2020. Subject to subparagraph (B), there shall be a general enrollment period beginning on October 15 and ending on December 31 of 2019 and each subsequent year. Beginning January 1, 2020, the Secretary shall establish special enrollment periods in the case of individual who meets such exceptional conditions as the Secretary may provide. . Section 1838(a) of the Social Security Act ( 42 U.S.C. 1395q(a) ) is amended— by amending paragraph
(2)to read as follows: in the case of an individual who enrolls pursuant to subsection
(d)of section 1837 before the month in which he first satisfies paragraph
(1)or
(2)of section 1836, the first day of such month; or in the case of an individual not described in subparagraph
(A)who first satisfies such paragraph in a month beginning before January 1, 2020 and who enrolls— pursuant to such subsection
(d)in such month in which he first satisfies such paragraph, the first day of the month following the month in which he so enrolls; or pursuant to such subsection
(d)in the month following such month in which he first satisfies such paragraph, the first day of the second month following the month in which he so enrolls; or pursuant to such subsection
(d)more than one month following such month in which he satisfies such paragraph, the first day of the third month following the month in which he so enrolls; or in the case of an individual not described in subparagraph
(A)who enrolls pursuant to subsection
(e)of section 1837 in a month beginning— before April 1, 2019, the July 1 following the month in which he so enrolls; or on or after October 1, 2019, the first day of the month following the month in which he so enrolls; or in the case of an individual not described in subparagraph
(A)who first satisfies such paragraph in a month beginning on or after January 1, 2020, and who enrolls pursuant to such subsection
(d)in such month in which he first satisfies such paragraph or in any subsequent month in the initial enrollment period, the first day of the month following the month in which he so enrolls; or ; and in paragraph (3), by striking subparagraphs (B), (C), (D), and
(E)of paragraph
(2)of this subsection and inserting subparagraphs
(B)and
(C)of paragraph (2), as applicable . Section 1839(b) of the Social Security Act ( 42 U.S.C. 1395r(b) ) is amended, in the second sentence, by striking close of the enrollment period each place it appears and inserting close of the month . Section 1839(b) of the Social Security Act ( 42 U.S.C. 1395r(b) ) is amended by adding at the end the following new sentence: Any percent increase in an individual's monthly premium under the first sentence shall only apply to premiums paid during a period equal to twice the number of months in the full 12-month periods described in the first sentence. . Section 1818(c)(6) of the Social Security Act ( 42 U.S.C. 1395i–2(c)(6) ) is amended by striking and shall only apply to premiums paid during a period equal to twice the number of months in the full 12-month periods described in that section . The amendments made by this section shall take effect on the date of the enactment of this Act and shall apply to premiums for months beginning on or after January 1, 2020. In applying the amendment made by paragraph (1), months (occurring before, during, or after the month that includes the date of the enactment of this Act) in which an individual's monthly premium is increased under subsection
(b)of section 1839 of the Social Security Act ( 42 U.S.C. 1395r ) shall be taken into account in determining whether the limitation under the last sentence of such subsection (b), as added by paragraph (1), is applicable. Section 1837(f)(3) of the Social Security Act ( 42 U.S.C. 1395p(f)(3) ) is amended by striking , exclusive of Puerto Rico . The amendment made by paragraph
(1)shall apply to individuals whose initial enrollment period under section 1837(d) of the Social Security Act begins on or after the first day of the effective month, specified by the Secretary of Health and Human Services under section 1839(j)(1)(C) of such Act, as added by subsection (c)(2). Section 1839 of the Social Security Act ( 42 U.S.C. 1395r ) is amended— in the first sentence of subsection (b), by inserting subject to section 1839(j)(2), after subsection (i)(4) or
(l)of section 1837, ; and by adding at the end the following new subsection: In the case of a transition individual (as defined in paragraph (3)) who is not enrolled under this part as of the day before the first day of the effective month (as defined in subparagraph (C)), the Secretary shall provide for a special enrollment period under section 1837 of 7 months beginning with such effective month during which the individual may be enrolled under this part. In the case of such an individual who enrolls during such special enrollment period, the coverage period under section 1838 shall begin on the first day of the second month after the month in which the individual enrolls. In this section, the term effective month means a month, not earlier than October 2019 and not later than January 2020, specified by the Secretary. In the case of a transition individual who is enrolled under this part as of the day before the first day of the effective month or who enrolls under this part on or after the date of the enactment of this subsection but before the end of the special enrollment period under paragraph (1)(A), the amount of the late enrollment penalty imposed under section 1839(b) shall be recalculated by reducing the penalty to 15 percent of the penalty otherwise established. Subparagraph
(A)shall be applied in the case of a transition individual who— is enrolled under this part as of the month before the effective month, for premiums for months beginning with such effective month; or enrolls under this part on or after the date of the enactment of this Act and before the end of the special enrollment period under paragraph (1)(A), for premiums for months during the coverage period under this part which occur during or after the effective month. Subparagraph
(A)shall not apply to a transition individual if the individual terminates enrollment under this part after the end of the special enrollment period under paragraph (1). In this section, the term transition individual means an individual who resides in Puerto Rico and who would have been deemed enrolled under this part pursuant to section 1837(f) before the first day of the effective month but for the fact that the individual was a resident of Puerto Rico, regardless of whether the individual is enrolled under this part as of such first day. .
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- 42 USC 1395i–2(c)(6)
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Sec. 5
Improving Medicare beneficiary enrollment procedures and effective dates of coverage
Cite42 USC 1395i–2(c)(6)
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