Medicare Program; Part A Premium for Calendar Year 2008 for the Uninsured Aged and for Certain Disabled Individuals Who Have Exhausted Other Entitlement, 57037-57039 [07-4909]
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Federal Register / Vol. 72, No. 193 / Friday, October 5, 2007 / Notices
The estimated total increase in costs
to beneficiaries is about $870 million
(rounded to the nearest $10 million),
due to: (1) the increase in the deductible
and coinsurance amounts; and (2) the
change in the number of deductibles
and daily coinsurance amounts paid.
V. Waiver of Proposed Notice and
Comment Period
The Medicare statute, as discussed
previously, requires publication of the
Medicare Part A inpatient hospital
deductible and the hospital and
extended care services coinsurance
amounts for services for each CY. The
amounts are determined according to
the statute. As has been our custom, we
use general notices, rather than notice
and comment rulemaking procedures, to
make the announcements. In doing so,
we acknowledge that, under the
Administrative Procedure Act (APA),
interpretive rules, general statements of
policy, and rules of agency organization,
procedure, or practice are excepted from
the requirements of notice and comment
rulemaking.
We considered publishing a proposed
notice to provide a period for public
comment. However, we may waive that
procedure if we find good cause that
prior notice and comment are
impracticable, unnecessary, or contrary
to the public interest. We find that the
procedure for notice and comment is
unnecessary because the formulae used
to calculate the inpatient hospital
deductible and hospital and extended
care services coinsurance amounts are
statutorily directed, and we can exercise
no discretion in following the formulae.
Moreover, the statute establishes the
time period for which the deductible
and coinsurance amounts will apply
and delaying publication would be
contrary to the public interest.
Therefore, we find good cause to waive
publication of a proposed notice and
solicitation of public comments.
yshivers on PROD1PC62 with NOTICES
VI. Collection of Information
Requirements
This document does not impose
information collection and
recordkeeping requirements.
Consequently, it need not be reviewed
by the Office of Management and
Budget under the authority of the
Paperwork Reduction Act of 1995 (44
U.S.C. 35).
VII. Regulatory Impact Statement
We have examined the impacts of this
notice as required by Executive Order
12866 (September 1993, Regulatory
Planning and Review), the Regulatory
Flexibility Act (RFA) (September 19,
1980, Pub. L. 96–354), section 1102(b) of
VerDate Aug<31>2005
15:33 Oct 04, 2007
Jkt 214001
the Act, the Unfunded Mandates Reform
Act of 1995 (Pub. L. 104–4), and
Executive Order 13132.
Executive Order 12866 directs
agencies to assess all costs and benefits
of available regulatory alternatives and,
if regulation is necessary, to select
regulatory approaches that maximize
net benefits (including potential
economic, environmental, public health
and safety effects, distributive impacts,
and equity). A regulatory impact
analysis (RIA) must be prepared for
major rules with economically
significant effects ($100 million or more
in any 1 year). As stated in section IV
of this notice, we estimate that the total
increase in costs to beneficiaries
associated with this notice is about $870
million due to: (1) The increase in the
deductible and coinsurance amounts
and (2) the change in the number of
deductibles and daily coinsurance
amounts paid. Therefore, this notice is
a major rule as defined in Title 5,
United States Code, section 804(2), and
is an economically significant rule
under Executive Order 12866.
The RFA requires agencies to analyze
options for regulatory relief of small
entities. For purposes of the RFA, small
entities include small businesses,
nonprofit organizations, and
government agencies. Most hospitals
and most other providers and suppliers
are small entities, either by nonprofit
status or by having revenues of $6.5
million to $31.5 million in any 1 year.
Individuals and States are not included
in the definition of a small entity. We
have determined that this notice will
not have a significant economic impact
on a substantial number of small
entities. Therefore we are not preparing
an analysis for the RFA.
In addition, section 1102(b) of the Act
requires us to prepare a regulatory
impact analysis if a rule may have a
significant impact on the operations of
a substantial number of small rural
hospitals. This analysis must conform to
the provisions of section 604 of the
RFA. For purposes of section 1102(b) of
the Act, we define a small rural hospital
as a hospital that is located outside of
a Metropolitan Statistical Area and has
fewer than 100 beds. We have
determined that this notice will not
have a significant effect on the
operations of a substantial number of
small rural hospitals. Therefore, we are
not preparing an analysis for section
1102(b) of the Act.
Section 202 of the Unfunded
Mandates Reform Act of 1995 also
requires that agencies assess anticipated
costs and benefits before issuing any
rule that may result in expenditures in
any 1 year by State, local, or tribal
PO 00000
Frm 00057
Fmt 4703
Sfmt 4703
57037
governments, in the aggregate, or by the
private sector, of $120 million. This
notice has no consequential effect on
State, local, or tribal governments or on
the private sector. However, States are
required to pay the premiums for
dually-eligible beneficiaries.
Executive Order 13132 establishes
certain requirements that an agency
must meet when it promulgates a
proposed rule (and subsequent final
rule) that imposes substantial direct
requirement costs on State and local
governments, preempts State law, or
otherwise has Federalism implications.
In accordance with the provisions of
Executive Order 12866, this regulation
was reviewed by the Office of
Management and Budget.
Authority: Sections 1813(b)(2) of the Social
Security Act (42 U.S.C. 1395e–2(b)(2)).
(Catalog of Federal Domestic Assistance
Program No. 93.773, Medicare—Hospital
Insurance)
Dated: September 26, 2007.
Kerry Weems,
Acting Administrator, Centers for Medicare
& Medicaid Services.
Dated: September 26 2007.
Michael O. Leavitt,
Secretary.
[FR Doc. 07–4911 Filed 10–1–07; 11:18 am]
BILLING CODE 4120–01–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Centers for Medicare & Medicaid
Services
[CMS–8031–N]
RIN 0938–AO62
Medicare Program; Part A Premium for
Calendar Year 2008 for the Uninsured
Aged and for Certain Disabled
Individuals Who Have Exhausted Other
Entitlement
Centers for Medicare &
Medicaid Services (CMS), HHS.
ACTION: Notice.
AGENCY:
SUMMARY: This annual notice announces
Medicare’s Hospital Insurance (Part A)
premium for uninsured enrollees in
calendar year (CY) 2008. This premium
is to be paid by enrollees age 65 and
over who are not otherwise eligible for
benefits under Medicare Part A
(hereafter known as the ‘‘uninsured
aged’’) and by certain disabled
individuals who have exhausted other
entitlement. The monthly Part A
premium for the 12 months beginning
January 1, 2008 for these individuals
will be $423. The reduced premium for
E:\FR\FM\05OCN1.SGM
05OCN1
57038
Federal Register / Vol. 72, No. 193 / Friday, October 5, 2007 / Notices
certain other individuals as described in
this notice will be $233.
DATES: Effective Date: This notice is
effective on January 1, 2008.
FOR FURTHER INFORMATION CONTACT:
Clare McFarland, (410) 786–6390.
SUPPLEMENTARY INFORMATION:
yshivers on PROD1PC62 with NOTICES
I. Background
Section 1818 of the Social Security
Act (the Act) provides for voluntary
enrollment in the Medicare Hospital
Insurance program (Medicare Part A),
subject to payment of a monthly
premium, of certain persons aged 65
and older who are uninsured under the
Old-Age, Survivors and Disability
Insurance (OASDI) program or the
Railroad Retirement Act and do not
otherwise meet the requirements for
entitlement to Medicare Part A. (Persons
insured under the OASDI program or
the Railroad Retirement Act and certain
others do not have to pay premiums for
hospital insurance.)
Section 1818A of the Act provides for
voluntary enrollment in Medicare Part
A, subject to payment of a monthly
premium, of certain disabled
individuals who have exhausted other
entitlement. These are individuals who
are not currently entitled to Part A
coverage, but who were entitled to
coverage due to a disabling impairment
under section 226(b) of the Act, and
who would still be entitled to Part A
coverage if their earnings had not
exceeded the statutorily defined
substantial gainful activity amount
(section 223(d)(4) of the Act).
Section 1818A(d)(2) of the Act
specifies that the provisions relating to
premiums under section 1818(d)
through section 1818(f) of the Act for
the aged will also apply to certain
disabled individuals as described above.
Section 1818(d) of the Act requires us
to estimate, on an average per capita
basis, the amount to be paid from the
Federal Hospital Insurance Trust Fund
for services incurred in the following
calendar year (CY) (including the
associated administrative costs) on
behalf of individuals aged 65 and over
who will be entitled to benefits under
Medicare Part A. We must then
determine, during September of each
year, the monthly actuarial rate for the
following year (the per capita amount
estimated above divided by 12) and
publish the dollar amount for the
monthly premium in the succeeding CY.
If the premium is not a multiple of $1,
the premium is rounded to the nearest
multiple of $1 (or, if it is a multiple of
50 cents but not of $1, it is rounded to
the next highest $1).
VerDate Aug<31>2005
15:33 Oct 04, 2007
Jkt 214001
Section 13508 of the Omnibus Budget
Reconciliation Act of 1993 (Pub. L. 103–
66) amended section 1818(d) of the Act
to provide for a reduction in the
premium amount for certain voluntary
enrollees (section 1818 and section
1818A). The reduction applies to an
individual who is eligible to buy into
the Medicare Part A program and who,
as of the last day of the previous
month—
• Had at least 30 quarters of coverage
under title II of the Act;
• Was married, and had been married
for the previous 1-year period, to a
person who had at least 30 quarters of
coverage;
• Had been married to a person for at
least 1 year at the time of the person’s
death if, at the time of death, the person
had at least 30 quarters of coverage; or
• Is divorced from a person and had
been married to the person for at least
10 years at the time of the divorce if, at
the time of the divorce, the person had
at least 30 quarters of coverage.
Section 1818(d)(4)(A) of the Act
specifies that the premium that these
individuals will pay for CY 2008 will be
equal to the premium for uninsured
aged enrollees reduced by 45 percent.
II. Monthly Premium Amount for CY
2008
The monthly premium for the
uninsured aged and certain disabled
individuals who have exhausted other
entitlement for the 12 months beginning
January 1, 2008, is $423.
The monthly premium for those
individuals subject to the 45 percent
reduction in the monthly premium is
$233.
III. Monthly Premium Rate Calculation
As discussed in section I of this
notice, the monthly Medicare Part A
premium is equal to the estimated
monthly actuarial rate for CY 2008
rounded to the nearest multiple of $1
and equals one-twelfth of the average
per capita amount, which is determined
by projecting the number of Part A
enrollees aged 65 years and over as well
as the benefits and administrative costs
that will be incurred on their behalf.
The steps involved in projecting these
future costs to the Federal Hospital
Insurance Trust Fund are:
• Establishing the present cost of
services furnished to beneficiaries, by
type of service, to serve as a projection
base;
• Projecting increases in payment
amounts for each of the service types;
and
• Projecting increases in
administrative costs.
We base our projections for CY 2008
on: (a) Current historical data, and (b)
PO 00000
Frm 00058
Fmt 4703
Sfmt 4703
projection assumptions derived from
current law and the Mid-Session Review
of the President’s Fiscal Year 2008
Budget.
We estimate that in CY 2008, 36.777
million people aged 65 years and over
will be entitled to benefits (without
premium payment) and that they will
incur $186.757 billion of benefits and
related administrative costs. Thus, the
estimated monthly average per capita
amount is $423.17 and the monthly
premium is $423. The full monthly
premium reduced by 45 percent is $233.
IV. Costs to Beneficiaries
The CY 2008 premium of $423 is over
3 percent higher than the CY 2007
premium of $410.
We estimate that approximately
579,000 enrollees will voluntarily enroll
in Medicare Part A by paying the full
premium. We estimate an additional
10,000 enrollees will pay the reduced
premium. We estimate that the aggregate
cost to enrollees paying these premiums
will be about $91 million in CY 2008
over the amount that they paid in CY
2007.
V. Waiver of Proposed Notice and
Comment Period
We are not using notice and comment
rulemaking in this notification of Part A
premiums for CY 2008, as that
procedure is unnecessary because of the
lack of discretion in the statutory
formula that is used to calculate the
premium and the solely ministerial
function that this notice serves. The
Administrative Procedure Act (APA)
permits agencies to waive notice and
comment rulemaking when notice and
public comment thereon are
unnecessary. On this basis, we waive
publication of a proposed notice and a
solicitation of public comments.
VI. Regulatory Impact Statement
We have examined the impacts of this
notice as required by Executive Order
12866 (September 1993, Regulatory
Planning and Review), the Regulatory
Flexibility Act (RFA) (September 19,
1980, Pub. L. 96–354), section 1102(b) of
the Act, the Unfunded Mandates Reform
Act of 1995 (Pub. L. 104–4), and
Executive Order 13132.
Executive Order 12866 directs
agencies to assess all costs and benefits
of available regulatory alternatives and,
if regulation is necessary, to select
regulatory approaches that maximize
net benefits (including potential
economic, environmental, public health
and safety effects, distributive impacts,
and equity). A regulatory impact
analysis (RIA) must be prepared for
major rules with economically
E:\FR\FM\05OCN1.SGM
05OCN1
yshivers on PROD1PC62 with NOTICES
Federal Register / Vol. 72, No. 193 / Friday, October 5, 2007 / Notices
significant effects ($100 million or more
in any 1 year). As stated in section IV
of this notice, we estimate that the
overall effect of these changes in the
Part A premium will be a cost to
voluntary enrollees (section 1818 and
section 1818A of the Act) of about $91
million. Therefore, this notice is not a
major rule as defined in Title 5, United
States Code, section 804(2) and is not an
economically significant rule under
Executive Order 12866.
The RFA requires agencies to analyze
options for regulatory relief of small
entities. For purposes of the RFA, small
entities include small businesses,
nonprofit organizations, and
government agencies. Most hospitals
and most other providers and suppliers
are small entities, either by nonprofit
status or by having revenues of $6
million to $29 million in any 1 year.
Individuals and States are not included
in the definition of a small entity. We
have determined that this notice will
not have a significant economic impact
on a substantial number of small
entities. Therefore, we are not preparing
an analysis for the RFA.
In addition, section 1102(b) of the Act
requires us to prepare a regulatory
impact analysis if a rule may have a
significant impact on the operations of
a substantial number of small rural
hospitals. This analysis must conform to
the provisions of section 604 of the
RFA. For purposes of section 1102(b) of
the Act, we define a small rural hospital
as a hospital that is located outside of
a Metropolitan Statistical Area (MSA)
and has fewer than 100 beds. We have
determined that this notice will not
have a significant effect on the
operations of a substantial number of
small rural hospitals. Therefore, we are
not preparing an analysis for section
1102(b) of the Act.
Section 202 of the Unfunded
Mandates Reform Act of 1995 also
requires that agencies assess anticipated
costs and benefits before issuing any
rule that may result in expenditure in
any 1 year by State, local, or tribal
governments, in the aggregate, or by the
private sector, of $120 million. This
notice has no consequential effect on
State, local, or tribal governments or on
the private sector. However, States are
required to pay the premiums for
dually-eligible beneficiaries.
Executive Order 13132 establishes
certain requirements that an agency
must meet when it publishes a proposed
rule (and subsequent final rule) that
imposes substantial direct requirement
costs on State and local governments,
preempts State law, or otherwise has
Federalism implications. This notice
VerDate Aug<31>2005
15:33 Oct 04, 2007
Jkt 214001
will not have a substantial effect on
State or local governments.
In accordance with the provisions of
Executive Order 12866, this regulation
was reviewed by the Office of
Management and Budget.
Authority: Sections 1818(d)(2) and
1818A(d)(2) of the Social Security Act (42
U.S.C. 1395i–2(d)(2) and 1395i–2a(d)(2)).
(Catalog of Federal Domestic Assistance
Program No. 93.773, Medicare—Hospital
Insurance)
Dated: September 26, 2007.
Kerry Weems,
Acting Administrator, Centers for Medicare
& Medicaid Services.
Dated: September 26, 2007.
Michael O. Leavitt,
Secretary.
[FR Doc. 07–4909 Filed 10–1–07; 11:18 am]
BILLING CODE 4120–01–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Centers for Medicare & Medicaid
Services
[CMS–8033–N]
RIN 0938–AO68
Medicare Program; Medicare Part B
Monthly Actuarial Rates, Premium
Rate, and Annual Deductible
Beginning January 1, 2008
Centers for Medicare &
Medicaid Services (CMS), HHS.
ACTION: Notice.
AGENCY:
SUMMARY: This notice announces the
monthly actuarial rates for aged (age 65
and over) and disabled (under age 65)
beneficiaries enrolled in Part B of the
Medicare Supplementary Medical
Insurance (SMI) program beginning
January 1, 2008. In addition, this notice
announces the monthly premium for
aged and disabled beneficiaries as well
as the income-related monthly
adjustment amounts to be paid by
beneficiaries with modified adjusted
gross income above certain threshold
amounts. The monthly actuarial rates
for 2008 are $192.70 for aged enrollees
and $209.70 for disabled enrollees. The
standard monthly Part B premium rate
for 2008 is $96.40, which is equal to 50
percent of the monthly actuarial rate for
aged enrollees or approximately 25
percent of the expected average total
cost of Part B coverage for aged
enrollees. (The 2007 standard premium
rate was $93.50.) The Part B deductible
for 2008 is $135.00 for all Part B
beneficiaries. If a beneficiary has to pay
an income-related monthly adjustment,
they may have to pay a total monthly
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Frm 00059
Fmt 4703
Sfmt 4703
57039
premium of about 35, 50, 65, or 80
percent of the total cost of Part B
coverage, by the end of the 3-year
transition period. However, for 2008,
the beneficiary is only responsible for
67 percent of any applicable incomerelated monthly adjustment amount.
(For 2007, the beneficiary was
responsible for 33 percent of the
applicable amount.)
DATES: Effective Date: January 1, 2008.
FOR FURTHER INFORMATION CONTACT: M.
Kent Clemens, (410) 786–6391.
SUPPLEMENTARY INFORMATION:
I. Background
Part B is the voluntary portion of the
Medicare program that pays all or part
of the costs for physicians’ services,
outpatient hospital services, certain
home health services, services furnished
by rural health clinics, ambulatory
surgical centers, comprehensive
outpatient rehabilitation facilities, and
certain other medical and health
services not covered by Medicare Part
A, Hospital Insurance. Medicare Part B
is available to individuals who are
entitled to Medicare Part A, as well as
to U.S. residents who have attained age
65 and are citizens, and aliens who were
lawfully admitted for permanent
residence and have resided in the
United States for 5 consecutive years.
Part B requires enrollment and payment
of monthly premiums, as provided for
in 42 CFR part 407, subpart B, and part
408, respectively. The difference
between the premiums paid by all
enrollees and total incurred costs is met
from the general revenues of the Federal
Government.
The Secretary of the Department of
Health and Human Services (the
Secretary) is required by section 1839 of
the Social Security Act (the Act) to
announce the Part B monthly actuarial
rates for aged and disabled beneficiaries
as well as the monthly Part B premium.
The Part B annual deductible is
included because its determination is
directly linked to the aged actuarial rate.
The monthly actuarial rates for aged
and disabled enrollees are used to
determine the correct amount of general
revenue financing per beneficiary each
month. These amounts, according to
actuarial estimates, will equal,
respectively, one-half the expected
average monthly cost of Part B for each
aged enrollee (age 65 or over) and onehalf the expected average monthly cost
of Part B for each disabled enrollee
(under age 65).
The Part B deductible to be paid by
enrollees is also announced. Prior to the
Medicare Prescription Drug,
Improvement, and Modernization Act of
E:\FR\FM\05OCN1.SGM
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]]>Agencies
[Federal Register Volume 72, Number 193 (Friday, October 5, 2007)]
[Notices]
[Pages 57037-57039]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 07-4909]
-----------------------------------------------------------------------
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
[CMS-8031-N]
RIN 0938-AO62
Medicare Program; Part A Premium for Calendar Year 2008 for the
Uninsured Aged and for Certain Disabled Individuals Who Have Exhausted
Other Entitlement
AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS.
ACTION: Notice.
-----------------------------------------------------------------------
SUMMARY: This annual notice announces Medicare's Hospital Insurance
(Part A) premium for uninsured enrollees in calendar year (CY) 2008.
This premium is to be paid by enrollees age 65 and over who are not
otherwise eligible for benefits under Medicare Part A (hereafter known
as the ``uninsured aged'') and by certain disabled individuals who have
exhausted other entitlement. The monthly Part A premium for the 12
months beginning January 1, 2008 for these individuals will be $423.
The reduced premium for
[[Page 57038]]
certain other individuals as described in this notice will be $233.
DATES: Effective Date: This notice is effective on January 1, 2008.
FOR FURTHER INFORMATION CONTACT: Clare McFarland, (410) 786-6390.
SUPPLEMENTARY INFORMATION:
I. Background
Section 1818 of the Social Security Act (the Act) provides for
voluntary enrollment in the Medicare Hospital Insurance program
(Medicare Part A), subject to payment of a monthly premium, of certain
persons aged 65 and older who are uninsured under the Old-Age,
Survivors and Disability Insurance (OASDI) program or the Railroad
Retirement Act and do not otherwise meet the requirements for
entitlement to Medicare Part A. (Persons insured under the OASDI
program or the Railroad Retirement Act and certain others do not have
to pay premiums for hospital insurance.)
Section 1818A of the Act provides for voluntary enrollment in
Medicare Part A, subject to payment of a monthly premium, of certain
disabled individuals who have exhausted other entitlement. These are
individuals who are not currently entitled to Part A coverage, but who
were entitled to coverage due to a disabling impairment under section
226(b) of the Act, and who would still be entitled to Part A coverage
if their earnings had not exceeded the statutorily defined substantial
gainful activity amount (section 223(d)(4) of the Act).
Section 1818A(d)(2) of the Act specifies that the provisions
relating to premiums under section 1818(d) through section 1818(f) of
the Act for the aged will also apply to certain disabled individuals as
described above.
Section 1818(d) of the Act requires us to estimate, on an average
per capita basis, the amount to be paid from the Federal Hospital
Insurance Trust Fund for services incurred in the following calendar
year (CY) (including the associated administrative costs) on behalf of
individuals aged 65 and over who will be entitled to benefits under
Medicare Part A. We must then determine, during September of each year,
the monthly actuarial rate for the following year (the per capita
amount estimated above divided by 12) and publish the dollar amount for
the monthly premium in the succeeding CY. If the premium is not a
multiple of $1, the premium is rounded to the nearest multiple of $1
(or, if it is a multiple of 50 cents but not of $1, it is rounded to
the next highest $1).
Section 13508 of the Omnibus Budget Reconciliation Act of 1993
(Pub. L. 103-66) amended section 1818(d) of the Act to provide for a
reduction in the premium amount for certain voluntary enrollees
(section 1818 and section 1818A). The reduction applies to an
individual who is eligible to buy into the Medicare Part A program and
who, as of the last day of the previous month--
Had at least 30 quarters of coverage under title II of the
Act;
Was married, and had been married for the previous 1-year
period, to a person who had at least 30 quarters of coverage;
Had been married to a person for at least 1 year at the
time of the person's death if, at the time of death, the person had at
least 30 quarters of coverage; or
Is divorced from a person and had been married to the
person for at least 10 years at the time of the divorce if, at the time
of the divorce, the person had at least 30 quarters of coverage.
Section 1818(d)(4)(A) of the Act specifies that the premium that
these individuals will pay for CY 2008 will be equal to the premium for
uninsured aged enrollees reduced by 45 percent.
II. Monthly Premium Amount for CY 2008
The monthly premium for the uninsured aged and certain disabled
individuals who have exhausted other entitlement for the 12 months
beginning January 1, 2008, is $423.
The monthly premium for those individuals subject to the 45 percent
reduction in the monthly premium is $233.
III. Monthly Premium Rate Calculation
As discussed in section I of this notice, the monthly Medicare Part
A premium is equal to the estimated monthly actuarial rate for CY 2008
rounded to the nearest multiple of $1 and equals one-twelfth of the
average per capita amount, which is determined by projecting the number
of Part A enrollees aged 65 years and over as well as the benefits and
administrative costs that will be incurred on their behalf.
The steps involved in projecting these future costs to the Federal
Hospital Insurance Trust Fund are:
Establishing the present cost of services furnished to
beneficiaries, by type of service, to serve as a projection base;
Projecting increases in payment amounts for each of the
service types; and
Projecting increases in administrative costs.
We base our projections for CY 2008 on: (a) Current historical
data, and (b) projection assumptions derived from current law and the
Mid-Session Review of the President's Fiscal Year 2008 Budget.
We estimate that in CY 2008, 36.777 million people aged 65 years
and over will be entitled to benefits (without premium payment) and
that they will incur $186.757 billion of benefits and related
administrative costs. Thus, the estimated monthly average per capita
amount is $423.17 and the monthly premium is $423. The full monthly
premium reduced by 45 percent is $233.
IV. Costs to Beneficiaries
The CY 2008 premium of $423 is over 3 percent higher than the CY
2007 premium of $410.
We estimate that approximately 579,000 enrollees will voluntarily
enroll in Medicare Part A by paying the full premium. We estimate an
additional 10,000 enrollees will pay the reduced premium. We estimate
that the aggregate cost to enrollees paying these premiums will be
about $91 million in CY 2008 over the amount that they paid in CY 2007.
V. Waiver of Proposed Notice and Comment Period
We are not using notice and comment rulemaking in this notification
of Part A premiums for CY 2008, as that procedure is unnecessary
because of the lack of discretion in the statutory formula that is used
to calculate the premium and the solely ministerial function that this
notice serves. The Administrative Procedure Act (APA) permits agencies
to waive notice and comment rulemaking when notice and public comment
thereon are unnecessary. On this basis, we waive publication of a
proposed notice and a solicitation of public comments.
VI. Regulatory Impact Statement
We have examined the impacts of this notice as required by
Executive Order 12866 (September 1993, Regulatory Planning and Review),
the Regulatory Flexibility Act (RFA) (September 19, 1980, Pub. L. 96-
354), section 1102(b) of the Act, the Unfunded Mandates Reform Act of
1995 (Pub. L. 104-4), and Executive Order 13132.
Executive Order 12866 directs agencies to assess all costs and
benefits of available regulatory alternatives and, if regulation is
necessary, to select regulatory approaches that maximize net benefits
(including potential economic, environmental, public health and safety
effects, distributive impacts, and equity). A regulatory impact
analysis (RIA) must be prepared for major rules with economically
[[Page 57039]]
significant effects ($100 million or more in any 1 year). As stated in
section IV of this notice, we estimate that the overall effect of these
changes in the Part A premium will be a cost to voluntary enrollees
(section 1818 and section 1818A of the Act) of about $91 million.
Therefore, this notice is not a major rule as defined in Title 5,
United States Code, section 804(2) and is not an economically
significant rule under Executive Order 12866.
The RFA requires agencies to analyze options for regulatory relief
of small entities. For purposes of the RFA, small entities include
small businesses, nonprofit organizations, and government agencies.
Most hospitals and most other providers and suppliers are small
entities, either by nonprofit status or by having revenues of $6
million to $29 million in any 1 year. Individuals and States are not
included in the definition of a small entity. We have determined that
this notice will not have a significant economic impact on a
substantial number of small entities. Therefore, we are not preparing
an analysis for the RFA.
In addition, section 1102(b) of the Act requires us to prepare a
regulatory impact analysis if a rule may have a significant impact on
the operations of a substantial number of small rural hospitals. This
analysis must conform to the provisions of section 604 of the RFA. For
purposes of section 1102(b) of the Act, we define a small rural
hospital as a hospital that is located outside of a Metropolitan
Statistical Area (MSA) and has fewer than 100 beds. We have determined
that this notice will not have a significant effect on the operations
of a substantial number of small rural hospitals. Therefore, we are not
preparing an analysis for section 1102(b) of the Act.
Section 202 of the Unfunded Mandates Reform Act of 1995 also
requires that agencies assess anticipated costs and benefits before
issuing any rule that may result in expenditure in any 1 year by State,
local, or tribal governments, in the aggregate, or by the private
sector, of $120 million. This notice has no consequential effect on
State, local, or tribal governments or on the private sector. However,
States are required to pay the premiums for dually-eligible
beneficiaries.
Executive Order 13132 establishes certain requirements that an
agency must meet when it publishes a proposed rule (and subsequent
final rule) that imposes substantial direct requirement costs on State
and local governments, preempts State law, or otherwise has Federalism
implications. This notice will not have a substantial effect on State
or local governments.
In accordance with the provisions of Executive Order 12866, this
regulation was reviewed by the Office of Management and Budget.
Authority: Sections 1818(d)(2) and 1818A(d)(2) of the Social
Security Act (42 U.S.C. 1395i-2(d)(2) and 1395i-2a(d)(2)).
(Catalog of Federal Domestic Assistance Program No. 93.773,
Medicare--Hospital Insurance)
Dated: September 26, 2007.
Kerry Weems,
Acting Administrator, Centers for Medicare & Medicaid Services.
Dated: September 26, 2007.
Michael O. Leavitt,
Secretary.
[FR Doc. 07-4909 Filed 10-1-07; 11:18 am]
BILLING CODE 4120-01-P
