Medicare Program; Part A Premium for Calendar Year 2009 for the Uninsured Aged and for Certain Disabled Individuals Who Have Exhausted Other Entitlement, 55096-55098 [E8-22312]
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55096
Federal Register / Vol. 73, No. 186 / Wednesday, September 24, 2008 / Notices
announces the 2009 monthly Part B
premium rates to be paid by
beneficiaries who file an individual tax
return (including those who are single,
head of household, qualifying
widow(er) with a dependent child, or
married filing separately who lived
apart from their spouse for the entire
taxable year), or a joint tax return.
Beneficiaries who file an individual tax return with income:
Beneficiaries who file a joint tax return with income:
Less than or equal to $85,000 .....................................
Greater than $85,000 and less than or equal to
$107,000.
Greater than $107,000 and less than or equal to
$160,000.
Greater than $160,000 and less than or equal to
$213,000.
Greater than $213,000 .................................................
Income-related
monthly adjustment
amount
Total monthly
premium
amount
$0.00
38.50
$96.40
134.90
96.30
192.70
154.10
250.50
211.90
308.30
Less than or equal to $170,000 ...................................
Greater than $170,000 and less than or equal to
$214,000.
Greater than $214,000 and less than or equal to
$320,000.
Greater than $320,000 and less than or equal to
$426,000.
Greater than $426,000 .................................................
In addition, the monthly premium
rates to be paid by beneficiaries who are
married and lived with their spouse at
any time during the taxable year, but file
a separate tax return from their spouse,
are also announced and listed below.
Beneficiaries who are married and lived with their spouse at any time during the year, but file a separate tax
return from their spouse:
Income-related
monthly adjustment
amount
Total monthly
premium
amount
$0.00
154.10
211.90
$96.40
250.50
308.30
Less than or equal to $85,000 ................................................................................................................................
Greater than $85,000 and less than or equal to $128,000 .....................................................................................
Greater than $128,000 ............................................................................................................................................
jlentini on PROD1PC65 with NOTICES
The Part B deductible for calendar
year 2009 is $135.00. The standard Part
B premium rate of $96.40 is the same as
the premium rate for 2008, so there will
be no additional costs to the
approximately 42.3 million Part B
enrollees for 2009. The monthly impact
on the beneficiaries who are required to
pay a higher premium for 2009 because
their incomes exceed specified
thresholds is $38.50, $96.30, $154.10, or
$211.90, which is in addition to the
standard monthly premium. These
amounts are higher than the 2008
amounts of $25.80, $64.50, $103.30, and
$142.00, respectively, which results in
$770 million in additional costs to the
approximately 1.7 million Part B
enrollees who are affected. Therefore,
this notice is a major rule as defined in
5 U.S.C. 804(2) and is an economically
significant rule under Executive Order
12866.
In accordance with the provisions of
Executive Order 12866, this notice was
reviewed by the Office of Management
and Budget.
IV. Waiver of Proposed Notice
The Medicare statute requires the
publication of the monthly actuarial
rates and the Part B premium amounts
in September. We ordinarily use general
notices, rather than notice and comment
rulemaking procedures, to make such
announcements. In doing so, we note
that, under the Administrative
Procedure Act, interpretive rules,
general statements of policy, and rules
VerDate Aug<31>2005
17:26 Sep 23, 2008
Jkt 214001
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, for 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 formulas used
to calculate the Part B premiums are
statutorily directed, and we can exercise
no discretion in applying those
formulas. Moreover, the statute
establishes the time period for which
the premium rates will apply, and
delaying publication of the Part B
premium rate such that it would not be
published before that time would be
contrary to the public interest.
Therefore, we find good cause to waive
publication of a proposed notice and
solicitation of public comments.
(Catalog of Federal Domestic Assistance
Program No. 93.773, Medicare—Hospital
Insurance; and Program No. 93.774,
Medicare—Supplementary Medical
Insurance Program)
PO 00000
Frm 00076
Fmt 4703
Sfmt 4703
Dated: September 12, 2008.
Kerry Weems,
Acting Administrator, Centers for Medicare
& Medicaid Services.
Michael O. Leavitt,
Secretary.
[FR Doc. E8–22314 Filed 9–19–08; 9:00 am]
BILLING CODE 4120–01–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Centers for Medicare & Medicaid
Services
[CMS–8035–N]
RIN 0938–AP04
Medicare Program; Part A Premium for
Calendar Year 2009 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) 2009. 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
E:\FR\FM\24SEN1.SGM
24SEN1
Federal Register / Vol. 73, No. 186 / Wednesday, September 24, 2008 / Notices
entitlement. The monthly Part A
premium for the 12 months beginning
January 1, 2009 for these individuals
will be $443. The reduced premium for
certain other individuals as described in
this notice will be $244.
DATES: Effective Date: This notice is
effective on January 1, 2009.
FOR FURTHER INFORMATION CONTACT:
Clare McFarland, (410) 786–6390.
SUPPLEMENTARY INFORMATION:
jlentini on PROD1PC65 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
Medicare Part A.)
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
were entitled to coverage due to a
disabling impairment under section
226(b) of the Act, but are no longer
entitled to disability benefits and free
Medicare Part A coverage because they
have gone back to work and their
earnings exceed 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
VerDate Aug<31>2005
19:36 Sep 23, 2008
Jkt 214001
55097
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 of the Act). 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 2009 will be
equal to the premium for uninsured
aged enrollees reduced by 45 percent.
• Projecting increases in
administrative costs.
We base our projections for CY 2009
on: (1) Current historical data; and (2)
projection assumptions derived from
current law and the Mid-Session Review
of the President’s Fiscal Year 2009
Budget.
We estimate that in CY 2009,
37,402,000 people aged 65 years and
over will be entitled to benefits (without
premium payment) and that they will
incur about $198.827 billion in benefits
and related administrative costs. Thus,
the estimated monthly average per
capita amount is $443.00 and the
monthly premium is $443. The full
monthly premium reduced by 45
percent is $244.
II. Monthly Premium Amount for CY
2009
The monthly premium for the
uninsured aged and certain disabled
individuals who have exhausted other
entitlement for the 12 months beginning
January 1, 2009, is $443.
The monthly premium for those
individuals subject to the 45 percent
reduction in the monthly premium is
$244.
V. Waiver of Proposed Notice and
Comment Period
We are not using notice and comment
rulemaking in this notification of
Medicare Part A premiums for CY 2009,
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.
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 2009
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
PO 00000
Frm 00077
Fmt 4703
Sfmt 4703
IV. Costs to Beneficiaries
The CY 2009 premium of $443 is
approximately 5 percent higher than the
CY 2008 premium of $423.
We estimate that approximately
588,000 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 $142 million in CY 2009
over the amount that they paid in CY
2008.
VI. Regulatory Impact Statement
We have examined the impact of this
rule as required by Executive Order
12866 on regulatory planning and
review (September 30 1993), as further
amended, the Regulatory Flexibility Act
(RFA) (September 19, 1980, Pub. L. 96–
354), section 1102(b) of the Social
Security Act, section 202 of the
Unfunded Mandates Reform Act of 1995
(March 22, 1995; Pub. L. 104–4),
Executive Order 13132 on Federalism
(August 4, 1999) and the Congressional
Review Act (5 U.S.C. 804(2)).
Executive Order 12866 (as amended
by Executive Orders 13258 and 13422)
E:\FR\FM\24SEN1.SGM
24SEN1
jlentini on PROD1PC65 with NOTICES
55098
Federal Register / Vol. 73, No. 186 / Wednesday, September 24, 2008 / Notices
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 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 $142 million. 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
businesses, if a rule has a significant
impact on a substantial number 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. Therefore, the
Secretary has determined that this
notice will not have a significant impact
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 (UMRA)
also requires that agencies assess
anticipated costs and benefits before
issuing any rule whose mandates
require spending in any 1 year of $100
million in 1995 dollars, updated
annually for inflation. In 2008, that
threshold is approximately $130
million. This notice has no
VerDate Aug<31>2005
19:36 Sep 23, 2008
Jkt 214001
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.
This notice will not have a substantial
effect on State or local governments.
In accordance with the provisions of
Executive Order 12866, this notice was
reviewed by the Office of Management
and Budget.
(Catalog of Federal Domestic Assistance
Program No. 93.773, Medicare—Hospital
Insurance)
Dated: August 28, 2008.
Kerry Weems,
Acting Administrator, Centers for Medicare
& Medicaid Services.
Dated: September 5, 2008.
Michael O. Leavitt,
Secretary.
[FR Doc. E8–22312 Filed 9–19–08; 9:00 am]
BILLING CODE 4120–01–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Administration for Children and
Families
Notice of Public Comment on Section
635 [42 U.S.C. 9801]—The 2007 Head
Start School Readiness Act, SubSection 649(k)(1)(A–D)—‘‘Indian Head
Start Study’’
Office of Head Start (OHS),
Administration for Children and
Families (ACF), HHS.
ACTION: Notice of Public Comment on
Section 635 [42 U.S.C. 9801]—The 2007
Head Start School Readiness Act, SubSection 649(k)(1)(A–D)—‘‘Indian Head
Start Study’’.
AGENCY:
SUMMARY: The following Notice of
Public Comment is in response to
section 649(k) Sub-Section (3) of the
2007 Head Start School Readiness Act
that requires the Secretary no later than
9 months after the effective date of this
Sub-Section, publish in the Federal
Register a plan of how the Secretary
will carry out section 649 Sub-Section
(k) Sub-Paragraph (1) and shall provide
a period for public comment.
DATES: To ensure consideration, written
comments must be submitted on or
before 60 days after this notice is
published.
PO 00000
Frm 00078
Fmt 4703
Sfmt 4703
To Comment on This Document, or
for Further Information Contact: Anne
Bergan, Office of Planning, Research
and Evaluation, Administration for
Children and Families, 370 L’Enfant
Promenade, SW., Washington, DC
20447, 202–546–4273,
abergan@acf.hhs.gov.
Pursuant
to the Improving Head Start for School
Readiness Act of 2007, Public Law 110–
134, Section 635 [42 U.S.C. 9801]—SubSection 649(k)(1)(A–D), notice is hereby
given of a plan to conduct a set of
studies designed to focus on the
American Indian and Alaska Native (AI/
AN) Head Start-eligible population.
There are two requirements addressed
in this notice: (1) A plan for a set of
studies that will focus on the American
Indian and Alaska Native Head Starteligible population related to the
following areas: Curriculum
development, availability and need for
services, appropriate research
methodologies and measures, and best
practices for teaching and educating
American Indian and Alaska Native
Head Start Children, and (2) a plan to
accurately determine the number of
children nationwide who are eligible to
participate in Indian Head Start
programs each year and to document
how many of these children are
receiving Head Start services each year.
SUPPLEMENTARY INFORMATION:
Consultation and Collaboration
For the purposes of responding to the
requirements in the legislation related to
consultation and collaboration, ACF
conferred with the National Indian Head
Start Directors Association (NIHSDA),
the AI/AN Head Start Collaboration
Director, AI/AN Head Start Program
Directors, staff from the U.S.
Department of Education, the Bureau of
Indian Affairs, the Indian Health
Service, the U.S. Census Bureau, the
Annie E. Casey Foundation, the
American Indian and Alaska Native
Head Start Research Center at the
University of Colorado—Denver, Dr. C.
Matthew Snipp of Stanford University,
Dr. Angela Willeto of Northern Arizona
University and participants at the Tribal
consultation sessions held in Denver,
Colorado; Kansas City, Kansas; Seattle,
Washington; and Phoenix, Arizona.
Section I. A Plan for Carrying Out
Section 649 Subsection (k) Paragraph
(1) Subparagraph (A)
To address the first requirement, to
undertake a study or set of studies, the
Administration for Children and
Families (ACF) intends to build upon
previous and current efforts to develop
a viable research and evaluation agenda
E:\FR\FM\24SEN1.SGM
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]]>Agencies
[Federal Register Volume 73, Number 186 (Wednesday, September 24, 2008)]
[Notices]
[Pages 55096-55098]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: E8-22312]
-----------------------------------------------------------------------
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
[CMS-8035-N]
RIN 0938-AP04
Medicare Program; Part A Premium for Calendar Year 2009 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) 2009.
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
[[Page 55097]]
entitlement. The monthly Part A premium for the 12 months beginning
January 1, 2009 for these individuals will be $443. The reduced premium
for certain other individuals as described in this notice will be $244.
DATES: Effective Date: This notice is effective on January 1, 2009.
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 Medicare Part A.)
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 were entitled to coverage due to a disabling impairment
under section 226(b) of the Act, but are no longer entitled to
disability benefits and free Medicare Part A coverage because they have
gone back to work and their earnings exceed 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 of the Act). 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 2009 will be equal to the premium for
uninsured aged enrollees reduced by 45 percent.
II. Monthly Premium Amount for CY 2009
The monthly premium for the uninsured aged and certain disabled
individuals who have exhausted other entitlement for the 12 months
beginning January 1, 2009, is $443.
The monthly premium for those individuals subject to the 45 percent
reduction in the monthly premium is $244.
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 2009
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 2009 on: (1) Current historical
data; and (2) projection assumptions derived from current law and the
Mid-Session Review of the President's Fiscal Year 2009 Budget.
We estimate that in CY 2009, 37,402,000 people aged 65 years and
over will be entitled to benefits (without premium payment) and that
they will incur about $198.827 billion in benefits and related
administrative costs. Thus, the estimated monthly average per capita
amount is $443.00 and the monthly premium is $443. The full monthly
premium reduced by 45 percent is $244.
IV. Costs to Beneficiaries
The CY 2009 premium of $443 is approximately 5 percent higher than
the CY 2008 premium of $423.
We estimate that approximately 588,000 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 $142 million in CY 2009 over the amount that they paid in CY
2008.
V. Waiver of Proposed Notice and Comment Period
We are not using notice and comment rulemaking in this notification
of Medicare Part A premiums for CY 2009, 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 impact of this rule as required by Executive
Order 12866 on regulatory planning and review (September 30 1993), as
further amended, the Regulatory Flexibility Act (RFA) (September 19,
1980, Pub. L. 96-354), section 1102(b) of the Social Security Act,
section 202 of the Unfunded Mandates Reform Act of 1995 (March 22,
1995; Pub. L. 104-4), Executive Order 13132 on Federalism (August 4,
1999) and the Congressional Review Act (5 U.S.C. 804(2)).
Executive Order 12866 (as amended by Executive Orders 13258 and
13422)
[[Page 55098]]
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 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 $142 million. 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 businesses, if a rule has a significant impact on a
substantial number 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. Therefore, the Secretary
has determined that this notice will not have a significant impact 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 (UMRA) also
requires that agencies assess anticipated costs and benefits before
issuing any rule whose mandates require spending in any 1 year of $100
million in 1995 dollars, updated annually for inflation. In 2008, that
threshold is approximately $130 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. This notice will not have a substantial effect on State
or local governments.
In accordance with the provisions of Executive Order 12866, this
notice was reviewed by the Office of Management and Budget.
(Catalog of Federal Domestic Assistance Program No. 93.773,
Medicare--Hospital Insurance)
Dated: August 28, 2008.
Kerry Weems,
Acting Administrator, Centers for Medicare & Medicaid Services.
Dated: September 5, 2008.
Michael O. Leavitt,
Secretary.
[FR Doc. E8-22312 Filed 9-19-08; 9:00 am]
BILLING CODE 4120-01-P
