US Code

Public Law 119-73 (01/23/2026)

42 U.S.C. § 1320b–14

Outreach efforts to increase awareness of the availability of medicare cost-sharing and subsidies for low-income individuals under subchapter XVIII

(a)

Outreach

(1)

In general

The Commissioner of Social Security (in this section referred to as the “Commissioner”) shall conduct outreach efforts to—
(A)
1
1 So in original. Probably should be followed by a comma.
section 1395w–141(f) of this titlesection 1395w–114 of this title identify individuals entitled to benefits under the medicare program under subchapter XVIII who may be eligible for medical assistance for payment of the cost of medicare cost-sharing under the medicaid program pursuant to sections 1396a(a)(10)(E) and 1396u–3 of this title  for the transitional assistance under , or for premium and cost-sharing subsidies under ; and
(B)
notify such individuals of the availability of such medical assistance, program, and subsidies under such sections.
(2)

Content of notice

section 1395w–141(f) of this titlesection 1395w–114 of this titleAny notice furnished under paragraph (1) shall state that eligibility for medicare cost-sharing assistance, the transitional assistance under , or premium and cost-sharing subsidies under under such sections is conditioned upon—
(A)
the individual providing to the State information about income and resources (in the case of an individual residing in a State that imposes an assets test for eligibility for medicare cost-sharing under the medicaid program); and
(B)
meeting the applicable eligibility criteria.
(b)

Coordination with States

(1)

In general

In conducting the outreach efforts under this section, the Commissioner shall—
(A)
section 1395w–141(f) of this titlesection 1395w–114 of this title furnish the agency of each State responsible for the administration of the medicaid program and any other appropriate State agency with information consisting of the name and address of individuals residing in the State that the Commissioner determines may be eligible for medical assistance for payment of the cost of medicare cost-sharing under the medicaid program pursuant to sections 1396a(a)(10)(E) and 1396u–3 of this title, for transitional assistance under , or for premium and cost-sharing subsidies for low-income individuals under ; and
(B)
update any such information not less frequently than once per year.
(2)

Information in periodic updates

The periodic updates described in paragraph (1)(B) shall include information on individuals who are or may be eligible for the medical assistance, program, and subsidies described in paragraph (1)(A) because such individuals have experienced reductions in benefits under subchapter II.

(c)

Assistance with Medicare Savings Program and low-income subsidy program applications

(1)

Distribution of applications and information to individuals who are potentially eligible for low-income subsidy program

section 1395w–114 of this titleFor each individual who submits an application for low-income subsidies under , requests an application for such subsidies, or is otherwise identified as an individual who is potentially eligible for such subsidies, the Commissioner shall do the following:
(A)
section 1395w–114 of this title Provide information describing the low-income subsidy program under and the Medicare Savings Program (as defined in paragraph (7)).
(B)
Provide an application for enrollment under such low-income subsidy program (if not already received by the Commissioner).
(C)
In accordance with paragraph (3), transmit data from such an application for purposes of initiating an application for benefits under the Medicare Savings Program.
(D)
Provide information on how the individual may obtain assistance in completing such application and an application under the Medicare Savings Program, including information on how the individual may contact the State health insurance assistance program (SHIP).
(E)
Make the application described in subparagraph (B) and the information described in subparagraphs (A) and (D) available at local offices of the Social Security Administration.
(2)

Training personnel in explaining benefit programs and assisting in completing LIS application

The Commissioner shall provide training to those employees of the Social Security Administration who are involved in receiving applications for benefits described in paragraph (1)(B) in order that they may promote beneficiary understanding of the low-income subsidy program and the Medicare Savings Program in order to increase participation in these programs. Such employees shall provide assistance in completing an application described in paragraph (1)(B) upon request.

(3)

Transmittal of data to States

Beginning on , with the consent of an individual completing an application for benefits described in paragraph (1)(B), the Commissioner shall electronically transmit to the appropriate State Medicaid agency data from such application, as determined by the Commissioner, which transmittal shall initiate an application of the individual for benefits under the Medicare Savings Program with the State Medicaid agency. In order to ensure that such data transmittal provides effective assistance for purposes of State adjudication of applications for benefits under the Medicare Savings Program, the Commissioner shall consult with the Secretary, after the Secretary has consulted with the States, regarding the content, form, frequency, and manner in which data (on a uniform basis for all States) shall be transmitted under this subparagraph.

(4)

Coordination with outreach

The Commissioner shall coordinate outreach activities under this subsection in connection with the low-income subsidy program and the Medicare Savings Program.

(5)

Reimbursement of Social Security Administration administrative costs

(A)

Initial Medicare Savings Program costs; additional low-income subsidy costs

(i)

Initial Medicare Savings Program costs

2

2 So in original. Probably should be “this”.
There are hereby appropriated to the Commissioner to carry out this subsection, out of any funds in the Treasury not otherwise appropriated, $24,100,000. The amount appropriated under ths  clause shall be available on , and shall remain available until expended.

(ii)

Additional amount for low-income subsidy activities

section 1395w–114 of this titleThere are hereby appropriated to the Commissioner, out of any funds in the Treasury not otherwise appropriated, $24,800,000 for fiscal year 2009 to carry out low-income subsidy activities under and the Medicare Savings Program (in accordance with this subsection), to remain available until expended. Such funds shall be in addition to the Social Security Administration’s Limitation on Administrative Expenditure appropriations for such fiscal year.

(B)

Subsequent funding under agreements

(i)

In general

Effective for fiscal years beginning on or after , the Commissioner and the Secretary shall enter into an agreement which shall provide funding (subject to the amount appropriated under clause (ii)) to cover the administrative costs of the Commissioner’s activities under this subsection. Such agreement shall—
(I)
provide funds to the Commissioner for the full cost of the Social Security Administration’s work related to the Medicare Savings Program required under this section;
(II)
provide such funding quarterly in advance of the applicable quarter based on estimating methodology agreed to by the Commissioner and the Secretary; and
(III)
require an annual accounting and reconciliation of the actual costs incurred and funds provided under this subsection.
(ii)

Appropriation

There are hereby appropriated to the Secretary solely for the purpose of providing payments to the Commissioner pursuant to an agreement specified in clause (i) that is in effect, out of any funds in the Treasury not otherwise appropriated, not more than $3,000,000 for fiscal year 2011 and each fiscal year thereafter.

(C)

Limitation

In no case shall funds from the Social Security Administration’s Limitation on Administrative Expenses be used to carry out activities related to the Medicare Savings Program. For fiscal years beginning on or after , no such activities shall be undertaken by the Social Security Administration unless the agreement specified in subparagraph (B) is in effect and full funding has been provided to the Commissioner as specified in such subparagraph.

(6)

GAO analysis and report

(A)

Analysis

The Comptroller General of the United States shall prepare an analysis of the impact of this subsection—
(i)
in increasing participation in the Medicare Savings Program, and
(ii)
on States and the Social Security Administration.
(B)

Report

Not later than , the Comptroller General shall submit to Congress, the Commissioner, and the Secretary a report on the analysis conducted under subparagraph (A).

(7)

Medicare Savings Program defined

For purposes of this subsection, the term “Medicare Savings Program” means the program of medical assistance for payment of the cost of medicare cost-sharing under the Medicaid program pursuant to sections 1396a(a)(10)(E) and 1396u–3 of this title.

Aug. 14, 1935, ch. 531Pub. L. 106–554, § 1(a)(6) [title IX, § 911(a)(1)]114 Stat. 2763Pub. L. 108–173, title I, § 103(g)117 Stat. 2160Pub. L. 110–275, title I, § 113(a)122 Stat. 2503(, title XI, § 1144, as added , , , 2763A–583; amended , , ; , , .)

Editorial Notes

Prior Provisions

act Aug. 14, 1935, ch. 531, title XI, § 1144Pub. L. 103–66, title XIII, § 13581(a)107 Stat. 609Pub. L. 105–34, title XV, § 1503(e)111 Stat. 1063Pub. L. 104–226, § 1(a)110 Stat. 3033A prior section 1320b–14, , as added , , ; , , , related to Medicare and Medicaid Coverage Data Bank, prior to repeal by , , .

Amendments

Pub. L. 110–2752008—Subsec. (c). added subsec. (c).

Pub. L. 108–173, § 103(g)(1)2003—, inserted “and subsidies for low-income individuals under subchapter XVIII” after “cost-sharing” in section catchline.

Pub. L. 108–173, § 103(g)(2)(A)(i)section 1395w–141(f) of this titlesection 1395w–114 of this titleSubsec. (a)(1)(A). , inserted “for the transitional assistance under , or for premium and cost-sharing subsidies under ” before semicolon.

Pub. L. 108–173, § 103(g)(2)(A)(ii)Subsec. (a)(1)(B). , inserted “, program, and subsidies” after “medical assistance”.

Pub. L. 108–173, § 103(g)(2)(B)(i)section 1395w–141(f) of this titlesection 1395w–114 of this titleSubsec. (a)(2). , inserted “, the transitional assistance under , or premium and cost-sharing subsidies under ” after “assistance” in introductory provisions.

Pub. L. 108–173, § 103(g)(2)(B)(ii)Subsec. (a)(2)(A). , substituted “eligibility for medicare cost-sharing under the medicaid program” for “such eligibility”.

Pub. L. 108–173, § 103(g)(3)(A)section 1395w–141(f) of this titlesection 1395w–114 of this titleSubsec. (b)(1)(A). , inserted “, for transitional assistance under , or for premium and cost-sharing subsidies for low-income individuals under ” after “1396u–3 of this title”.

Pub. L. 108–173, § 103(g)(3)(B)Subsec. (b)(2). , inserted “, program, and subsidies” after “medical assistance”.

Statutory Notes and Related Subsidiaries

Effective Date of 2008 Amendment

Pub. L. 110–275, title I, § 113(c)122 Stat. 2506

section 1396u–5 of this title“Except as otherwise provided, the amendments made by this section [amending this section and ] shall take effect on .”
, , , provided that:

Effective Date

Pub. L. 106–554, § 1(a)(6) [title IX, § 911(c)]114 Stat. 2763

section 1396d of this title“The amendments made by subsection (a) [enacting this section and amending ] shall take effect one year after the date of the enactment of this Act [].”
, , , 2763A–584, provided that:

GAO Report

Pub. L. 106–554, § 1(a)(6) [title IX, § 911(b)]114 Stat. 2763, , , 2763A–584, required the Comptroller General of the United States to conduct a study of the impact of this section on the enrollment of individuals for medicare cost-sharing under the medicaid program and to submit a report on the study no later than 18 months after the initial outreach.