Amendments to Regulations Regarding Major Life-Changing Events Affecting Income-Related Monthly Adjustment Amounts to Medicare Part B Premiums, 41084-41087 [2010-17198]
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41084
Federal Register / Vol. 75, No. 135 / Thursday, July 15, 2010 / Rules and Regulations
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Kevin J. Wolf,
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[FR Doc. 2010–17338 Filed 7–14–10; 8:45 am]
BILLING CODE 3510–33–P
SOCIAL SECURITY ADMINISTRATION
20 CFR Part 418
[Docket No. SSA–2009–0078]
RIN 0960–AH06
Amendments to Regulations
Regarding Major Life-Changing Events
Affecting Income-Related Monthly
Adjustment Amounts to Medicare Part
B Premiums
Social Security Administration.
Interim rule with request for
comments.
AGENCY:
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ACTION:
SUMMARY: We are modifying our
regulations to clarify and revise what we
consider major life-changing events for
the Medicare Part B income-related
monthly adjustment amount (IRMAA)
and what evidence we require to
support a claim of a major life-changing
event. Recent changes in the economy
and other unforeseen events have had a
significant effect on many Medicare Part
B beneficiaries. The changes we are
making in this interim final rule will
allow us to respond appropriately to
circumstances brought about by the
current economic climate and other
unforeseen events, as described below.
DATES:
Effective Date: This interim rule will
be effective July 15, 2010.
Comment Date: To ensure that your
comments are considered, we must
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receive them no later than September
13, 2010.
You may submit comments
by any one of three methods—Internet,
fax, or mail. Do not submit the same
comments multiple times or by more
than one method. Regardless of which
method you choose, please state that
your comments refer to Docket No.
SSA–2009–0078 so that we may
associate your comments with the
correct regulation.
Caution: You should be careful to
include in your comments only
information that you wish to make
publicly available. We strongly urge you
not to include in your comments any
personal information such as Social
Security numbers or medical
information.
1. Internet: We strongly recommend
that you submit your comments via the
Internet. Please visit the Federal
eRulemaking portal at https://
www.regulations.gov. Use the Search
function to find docket number SSA–
2009–0078. The system will issue a
tracking number to confirm your
submission. You will not be able to
view your comment immediately
because we must post each comment
manually. It may take up to a week for
your comment to be viewable.
2. Fax: Fax comments to (410) 966–
2830.
3. Mail: Mail your comments to the
Office of Regulations, Social Security
Administration, 107 Altmeyer Building,
6401 Security Boulevard, Baltimore,
Maryland 21235–6401.
Comments are available for public
viewing on the Federal eRulemaking
portal at https://www.regulations.gov or
in person, during regular business
hours, by arranging with the contact
person identified below.
ADDRESSES:
FOR FURTHER INFORMATION CONTACT:
Craig Streett, Office of Income Security
Programs, Social Security
Administration, 2–R–24 Operations
Building, 6401 Security Boulevard,
Baltimore, MD 21235–6401, (410) 965–
9793. For information on eligibility or
filing for benefits, call our national tollfree number, 1–800–772–1213 or TTY
1–800–325–0778, or visit our Internet
site, Social Security Online, at https://
www.socialsecurity.gov.
SUPPLEMENTARY INFORMATION:
Electronic Version
The electronic file of this document is
available on the date of publication in
the Federal Register at https://
www.gpoaccess.gov/fr/.
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Background
Medicare Part B is a voluntary
medical insurance program that
provides coverage for services such as
physician’s care, diagnostic services,
and medical supplies. A beneficiary
enrolled in Medicare Part B pays
monthly premiums, deductibles, and coinsurance associated with covered
services. The Centers for Medicare &
Medicaid Services (CMS) promulgates
rules and regulations about the
Medicare program, including the
standard monthly premium. We
determine and deduct the amount of
certain Medicare Part B premiums from
beneficiaries’ Social Security benefits
and make rules and regulations
necessary to carry out these functions.
The Federal Government subsidizes
the cost of Medicare Part B medical
coverage. However, beneficiaries with
modified adjusted gross incomes
(MAGI) above a specified threshold
must pay a higher percentage of their
cost than those with MAGIs below the
threshold.1 We refer to this subsidy
reduction as an IRMAA. CMS
determines and publishes the annual
MAGI thresholds and ranges.
The Internal Revenue Service (IRS)
provides us with MAGI information. We
use MAGI and Federal income tax filing
status for the tax year 2 years before the
effective year to determine whether a
beneficiary must pay an IRMAA, and if
so, how much.2 If information is not yet
available for the tax year 2 years before
the effective year, we will use
information from the tax year 3 years
before the effective year until the later
information becomes available.
A beneficiary who experiences a
major life-changing event may request
that we use a more recent tax year to
make a new IRMAA determination. If a
beneficiary provides evidence that the
qualifying major life-changing event
reduces his or her MAGI below the
threshold amount, we will determine
the IRMAA based on data from a more
recent tax year.3 We define a significant
reduction in MAGI as any change that
results in a reduction or elimination of
IRMAA.4 The Social Security Act
provides that major life-changing events
include marriage, divorce, death of
1 MAGI is defined in 42 U.S.C. 1395r(i)(4). The
threshold amount is defined in 42 U.S.C.
1395r(i)(2).
2 MAGI ranges are established in 42 U.S.C.
1395r(i)(3), (5). The MAGI dollar amounts listed in
1395r(i)(3) may increase annually based on changes
in the Consumer Price Index under 42 U.S.C.
1395r(i)(5).
3 20 CFR 418.1201.
4 20 CFR 418.1215.
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spouse, or other events specified in our
regulations.5
Our current regulations identify the
following additional events as major
life-changing events: (1) The annulment
of a marriage, (2) a work stoppage,
(3) reduced hours of work, (4)
reductions in income due to certain
losses of income-producing property, (5)
a scheduled cessation of a pension, and
(6) a reduction in or loss of income from
an insured pension plan due to
termination or reorganization of the
plan.6 Our current regulations also
provide that we do not consider events
other than those described in 20 CFR
418.1205 to be major life-changing
events. In addition, under our current
regulations we do not consider events
that affect expenses but not income, or
that result in the loss of dividend
income, to be major life-changing
events.7
Recent changes in the economy and
other unforeseen events have
significantly affected many Medicare
Part B beneficiaries. These unforeseen
events have caused reductions in the
MAGI of beneficiaries for the tax years
following the tax year reported to us by
the IRS, which results in IRMAAs that
may be higher than a beneficiary’s
ability to pay. Several major employers
in the United States have closed or
reorganized in recent years. As a result,
some companies have provided
settlement payments to current and
retired employees in lieu of periodic
pension payments, extended health
insurance coverage, or both. These
settlement payments have caused an
unexpected one-time increase in a
beneficiary’s income for a tax-reporting
year, which in turn may result in the
imposition of an IRMAA or a higher
IRMAA.
In order to address these recent
changes in the economy, we are adding
a new paragraph (g) to 20 CFR 418.1205
to include the receipt of a settlement
payment from an employer or former
employer in the list of major lifechanging events. To qualify as a major
life-changing event, a settlement
payment received by a beneficiary or the
spouse of a beneficiary must be the
result of an employer’s or former
employer’s closure, bankruptcy, or
reorganization. This change will allow a
beneficiary to request that we base the
IRMAA on the MAGI from a more recent
tax year.
Section 418.1205(e) of our current
regulations provides that a reduction in
the income of a beneficiary or the
5 42
U.S.C. 1395r(i)(4)(C)(ii)(II).
CFR 418.1205.
7 20 CFR 418.1210.
spouse of a beneficiary due to a loss of
income-producing property is a major
life-changing event. In order to qualify
as a major life-changing event, the loss
of income-producing property must not
be at the direction of the beneficiary,
such as through the sale or transfer of
the property. Section 418.1205(e)
provides some examples of qualifying
property losses. Most examples in the
current regulation result from natural
disasters, but we also include the loss of
income from real property due to the
criminal act of arson as an example of
a life-changing event. Some
beneficiaries also have experienced a
loss of income-producing property as
the result of another type of criminal
act: Fraud or theft. To address this
situation, we are revising 20 CFR
418.1205(e) to include the loss of
investment property as a result of fraud
or theft due to a criminal act by a third
party.
We are also making several other
changes to this section of our
regulations. First, we are specifically
providing that the beneficiary’s spouse
cannot direct the loss of incomeproducing property. While our current
regulations state that the loss cannot be
at the direction of the beneficiary, it was
our intent to include both the
beneficiary and spouse. Second, we are
revising section 418.1205(e) to clarify
that the loss of income-producing
property due to the ordinary risk of
investment is not a major life-changing
event. In some cases, beneficiaries and
adjudicators have misinterpreted our
current regulations in this regard. We
are making a similar change to 20 CFR
418.1210(b) to clarify that we do not
consider events that result in the loss of
dividend income as the result of the
ordinary risk of investment to be major
life-changing events.
Our current regulations provide that
‘‘a reduction in or loss of income from
an insured pension plan due to
termination or reorganization of the
pension plan or a scheduled cessation of
pension’’ qualifies as a major lifechanging event.8 Recently, a number of
uninsured pension plans have been
terminated or reorganized. The
termination or reorganization of an
uninsured pension plan does not qualify
as a major life-changing event under our
current regulations. To ensure that
Medicare Part B beneficiaries who
experience a loss of income under these
circumstances can request new initial
determinations using a more recent tax
year, we are replacing ‘‘insured pension
plan’’ with ‘‘employer’s pension plan’’ in
20 CFR 418.1205(f). This language
6 20
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change will qualify both insured and
uninsured pension plans.
We are further revising sections
418.1205(e) and (f) and 418.1255(e) and
(f) to remove the wording that requires
a reduction in or loss of income from
these life-changing events. This
language has confused beneficiaries and
adjudicators and is redundant in light of
the first sentence of current section
418.1201(b), which we are not revising.
That sentence says that in order to use
information from a more recent tax year
because of a major life-changing event,
the event must ‘‘result in a significant
reduction in your modified adjusted
gross income for the year which you
request we use and the next year, if
applicable.’’ The change we are making
will make the wording of the revised
subsections consistent with that of the
subsections explaining other lifechanging events found in 20 CFR
418.1205 and 20 CFR 418.1255.
Required Evidence
We are also revising 20 CFR 418.1255
to clarify the type of evidence we
require when a beneficiary asks us to
use a more recent tax year to calculate
an IRMAA based on certain changes in
circumstance. If a beneficiary or his or
her spouse experiences a loss of incomeproducing property due to criminal
fraud or theft by a third party, we will
require proof of the conviction and
evidence of loss. If a beneficiary or his
or her spouse experiences a scheduled
cessation, termination, or reorganization
of an employer’s pension plan, we will
require evidence documenting the
change in or loss of the pension. If a
beneficiary or his or her spouse receives
a settlement from an employer or a
former employer because of the
employer’s closure, bankruptcy, or
reorganization, we will require evidence
documenting the settlement and the
reason(s) for the settlement. These
changes will make it easier for a
beneficiary to meet the burden of proof
for establishing a major life-changing
event.
Technical Revisions
We are revising paragraph (d) of 20
CFR 418.1230 and paragraphs (c)(2) and
(3) of 20 CFR 418.1265 to reflect the
addition of new paragraph 418.1205(g),
which concerns the addition of receipt
of certain settlements as life-changing
events, as discussed above.
When will we start to use this rule?
We will start to use this rule on the
date shown under DATES earlier in this
preamble.
We are also inviting public comment
on the changes made by this rule. We
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will consider any relevant comments we
receive. We will publish a final rule to
respond to those comments and to make
any appropriate changes.
Regulatory Procedures
We follow the Administrative
Procedure Act (APA) rulemaking
procedures specified in 5 U.S.C. 553
when we develop regulations.
Generally, the APA requires that an
agency provide prior notice and
opportunity for public comment before
issuing a final regulation. The APA
provides exceptions to its notice and
public comment procedures when an
agency finds good cause for dispensing
with such procedures as impracticable,
unnecessary, or contrary to the public
interest.9
We find that good cause exists for
proceeding without prior public notice
and comment because any delay in
revising our regulations could
negatively affect the financial welfare of
our beneficiaries. This interim rule
addresses, among other things, the
unintended consequences of higher
Medicare Part B premium burdens for
beneficiaries who have lost their
pensions or suffered other deleterious
effects due to the economic recession.
Accordingly, we find that prior public
comment would be contrary to the
public interest. However, we are
inviting public comment on the interim
rule, and we will consider any
responsive comments we receive within
60 days of the publication of the interim
rule.
We also find good cause for
proceeding without prior public notice
and comment regarding the technical
revisions we are making in 20 CFR
418.1205(e) and (f) and 20 CFR
418.1255(e) and (f). These revisions
simply make the language defining each
life-changing event consistent and will
have no substantive effect on the
IRMAA program. Therefore, we find
that public comment is unnecessary
regarding those changes.
In addition, for the reasons cited
above, we also find good cause for
dispensing with the 30-day delay in the
effective date of this interim rule.10
Because unintended and extraordinary
hardships to affected Medicare Part B
beneficiaries and their families could
occur if we delay the effective date of
this interim rule, we find that it is
contrary to the public interest to delay
the effective date of our rule changes.
Additionally, because the technical
revisions to 20 CFR 418.1205(e) and (f)
and 20 CFR 418.1255(e) and (f) have no
95
U.S.C. 553(b)(B).
10 See 5 U.S.C. 553(d)(3).
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substantive effect on how we determine
what is a major life-changing event, we
find that it is unnecessary to delay the
effective date of those changes.
Accordingly, we are making this interim
rule effective upon publication.
Executive Order 12866
We have consulted with the Office of
Management and Budget (OMB) and
determined that this interim rule does
meet the criteria for a significant
regulatory action under Executive Order
12866. It was subject to OMB formal
review.
Regulatory Flexibility Act
We certify that this interim rule will
not have a significant economic impact
on a substantial number of small entities
because it affects individuals only.
Therefore, a regulatory flexibility
analysis is not required under the
Regulatory Flexibility Act, as amended.
Paperwork Reduction Act
The Office of Management and Budget
(OMB) previously approved the new
public reporting requirements posed by
these rules under a separate Information
Collection Request (OMB No. 0960–
0735). We are therefore not seeking
OMB approval for these requirements
here under the Paperwork Reduction
Act.
(Catalog of Federal Domestic Assistance
Program Nos. 93.774 Medicare
Supplementary Medical Insurance; 96.002
Social Security—Retirement Insurance.)
List of Subjects in 20 CFR Part 418
Administrative practice and
procedure, Aged, Blind, Disability
benefits, Public assistance programs,
Reporting and recordkeeping
requirements, Supplemental Security
Income (SSI), Medicare subsidies.
Dated: April 20, 2010.
Michael J. Astrue,
Commissioner of Social Security.
For the reasons set out in the
preamble, we amend 20 CFR chapter III,
part 418, subpart B as set forth below:
■
PART 418—MEDICARE SUBSIDIES
Subpart B—[Amended]
1. The authority citation for subpart B
of part 418 continues to read as follows:
■
Authority: Secs. 702(a)(5) and 1839(i) of
the Social Security Act (42 U.S.C. 902(a)(5)
and 1395r(i)).
2. Amend § 418.1205 to revise
paragraphs (e) and (f) and add paragraph
(g) to read as follows:
■
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§ 418.1205
event?
What is a major life-changing
*
*
*
*
*
(e) You or your spouse experiences a
loss of income-producing property,
provided the loss is not at the direction
of you or your spouse (e.g., due to the
sale or transfer of the property) and is
not a result of the ordinary risk of
investment. Examples of the type of
property loss include, but are not
limited to: Loss of real property within
a Presidentially or Gubernatoriallydeclared disaster area, destruction of
livestock or crops by natural disaster or
disease, loss from real property due to
arson, or loss of investment property as
a result of fraud or theft due to a
criminal act by a third party;
(f) You or your spouse experiences a
scheduled cessation, termination, or
reorganization of an employer’s pension
plan;
(g) You or your spouse receives a
settlement from an employer or former
employer because of the employer’s
closure, bankruptcy, or reorganization.
3. Amend § 418.1210 to revise
paragraph (b) to read as follows:
■
§ 418.1210 What is not a major lifechanging event?
*
*
*
*
*
(b) Events that result in the loss of
dividend income because of the
ordinary risk of investment.
4. Amend § 418.1230 to revise
paragraph (d) to read as follows:
■
§ 418.1230 What is the effective date of an
income-related monthly adjustment amount
initial determination that is based on a more
recent tax year?
*
*
*
*
*
(d) Our initial determination will be
effective January 1 of the year following
the year you make your request, when
your modified adjusted gross income
will not be significantly reduced as a
result of one or more of the events
described in § 418.1205(a) through (g)
until the year following the year you
make your request.
5. Amend § 418.1255 to revise
paragraphs (e) and (f) and add paragraph
(g) to read as follows:
■
§ 418.1255 What kind of evidence of a
major life-changing event will you need to
support your request for us to use a more
recent tax year?
*
*
*
*
*
(e) If you or your spouse experiences
a loss of income-producing property, we
will require evidence documenting the
loss. Examples of acceptable evidence
include, but are not limited to,
insurance claims or an insurance
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adjuster’s statement. If the claim of loss
is due to criminal fraud or theft by a
third party, we will also require proof of
conviction for the fraud or theft, such as
a court document.
(f) If you or your spouse experiences
a scheduled cessation, termination, or
reorganization of an employer’s pension
plan, we will require evidence
documenting the change in or loss of the
pension. An example of acceptable
evidence includes, but is not limited to,
a statement from your pension fund
administrator explaining the reduction
or termination of your benefits.
(g) If you or your spouse receives a
settlement from an employer or former
employer because of the employer’s
closure, bankruptcy, or reorganization,
we will require evidence documenting
the settlement and the reason(s) for the
settlement. An example of acceptable
evidence includes, but is not limited to,
a letter from the former employer stating
the settlement terms and how they affect
you or your spouse.
6. Amend § 418.1265 to revise
paragraphs (c)(2) and (c)(3) to read as
follows:
■
§ 418.1265 What kind of evidence of a
significant modified adjusted gross income
reduction will you need to support your
request?
*
*
*
*
*
(c) * * *
(2) If you experience one or more of
the events described in § 418.1205(d),
(e), (f), or (g), you must provide
evidence of how the event(s)
significantly reduced your modified
adjusted gross income, such as a
statement explaining any modified
adjusted gross income changes for the
tax year we used and a copy of your
filed Federal income tax return (if you
have filed one).
(3) If your spouse experiences one or
more of the events described in
§ 418.1205(d), (e), (f), or (g), you must
provide evidence of the resulting
significant reduction in your modified
adjusted gross income. The evidence
requirements are described in paragraph
(c)(2) of this section.
*
*
*
*
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DEPARTMENT OF HOUSING AND
URBAN DEVELOPMENT
24 CFR Parts 5, 84, and 85
[Docket No. FR–5350–I–01]
RIN 2501–AD50
Conforming Changes to Applicant
Submission Requirements;
Implementing Federal Financial Report
and Central Contractor Registration
Requirements
Office of the Secretary, HUD.
Interim rule.
AGENCY:
ACTION:
SUMMARY: This interim rule revises HUD
regulations to reference the new
governmentwide Federal Financial
Report (FFR), approved by the Office of
Management and Budget (OMB). The
purpose of the FFR is to consolidate
requirements from the OMB issued
Standard Forms SF–269, SF–269A SF–
272, and the SF–272A, into a single
governmentwide form. The
consolidation provides recipients of
HUD grants and cooperative agreements
a standard format for reporting the
financial status of their grants and
cooperative agreements and will assist
in efforts to move to electronic grants
management by reducing the variation
and number of forms required for
reporting. In including the new FFR in
its regulations, HUD revises its
regulations to remove references to SF–
270 and SF–271, since they are no
longer in use.
This interim rule also codifies the
requirement that applicants for HUD
assistance possess an active Central
Contractor Registration (CCR).
Registration with CCR assists HUD in
collecting, validating, and storing
information in support of its grant
programs and assists in ensuring the
accuracy of data placed on the
USASpending.gov website.
DATES: Effective Date: August 16, 2010.
Comment Due Date: September 13,
2010.
ADDRESSES: Interested persons are
invited to submit comments regarding
this rule to the Regulations Division,
Office of General Counsel, Department
of Housing and Urban Development,
451 7th Street, SW., Room 10276,
Washington, DC 20410–0500.
Communications must refer to the above
docket number and title. There are two
methods for submitting public
comments. All submissions must refer
to the above docket number and title.
1. Submission of Comments by Mail.
Comments may be submitted by mail to
the Regulations Division, Office of
General Counsel, Department of
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41087
Housing and Urban Development, 451
7th Street, SW., Room 10276,
Washington, DC 20410–0500. HUD
advises that comments submitted by
mail are subject to irradiation security
procedures which may result in a delay
of up to 10 days before receipt by the
HUD. As a result, HUD recommends
that comments be submitted
electronically, if feasible.
2. Electronic Submission of
Comments. Interested persons may
submit comments electronically through
the Federal eRulemaking Portal at
https://www.regulations.gov. HUD
strongly encourages commenters to
submit comments electronically.
Electronic submission of comments
allows the commenter maximum time to
prepare and submit a comment, ensures
timely receipt by HUD, and enables
HUD to make them immediately
available to the public. Comments
submitted electronically through the
https://www.regulations.gov website can
be viewed by other commenters and
interested members of the public.
Commenters should follow the
instructions provided on that site to
submit comments electronically.
Note: To receive consideration as public
comments, comments must be submitted
through one of the two methods specified
above. Again, all submissions must refer to
the docket number and title of the rule.
No Facsimile Comments. Facsimile
(FAX) comments are not acceptable.
Public Inspection of Public
Comments. All properly submitted
comments and communications
submitted to HUD will be available for
public inspection and copying between
8 a.m. and 5 p.m. weekdays at the above
address. Due to security measures at the
HUD Headquarters building, an advance
appointment to review the public
comments must be scheduled by calling
the Regulations Division at 202–402–
3055 (this is not a toll-free number).
Individuals with speech or hearing
impairments may access this number
via TTY by calling the Federal
Information Relay Service, toll-free, at
800–877–8339. Copies of all comments
submitted are available for inspection
and downloading at https://
www.regulations.gov.
FOR FURTHER INFORMATION CONTACT:
Barbara Dorf, Director, Office of
Departmental Grants Management and
Oversight, Office of Administration,
Department of Housing and Urban
Development, 451 7th Street, SW.,
Room 3156, Washington, DC 20410–
0500, telephone number 202–708–0667.
Persons with hearing or speech
impairments may access this number
through TTY by calling the toll-free
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Agencies
[Federal Register Volume 75, Number 135 (Thursday, July 15, 2010)]
[Rules and Regulations]
[Pages 41084-41087]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2010-17198]
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SOCIAL SECURITY ADMINISTRATION
20 CFR Part 418
[Docket No. SSA-2009-0078]
RIN 0960-AH06
Amendments to Regulations Regarding Major Life-Changing Events
Affecting Income-Related Monthly Adjustment Amounts to Medicare Part B
Premiums
AGENCY: Social Security Administration.
ACTION: Interim rule with request for comments.
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SUMMARY: We are modifying our regulations to clarify and revise what we
consider major life-changing events for the Medicare Part B income-
related monthly adjustment amount (IRMAA) and what evidence we require
to support a claim of a major life-changing event. Recent changes in
the economy and other unforeseen events have had a significant effect
on many Medicare Part B beneficiaries. The changes we are making in
this interim final rule will allow us to respond appropriately to
circumstances brought about by the current economic climate and other
unforeseen events, as described below.
DATES:
Effective Date: This interim rule will be effective July 15, 2010.
Comment Date: To ensure that your comments are considered, we must
receive them no later than September 13, 2010.
ADDRESSES: You may submit comments by any one of three methods--
Internet, fax, or mail. Do not submit the same comments multiple times
or by more than one method. Regardless of which method you choose,
please state that your comments refer to Docket No. SSA-2009-0078 so
that we may associate your comments with the correct regulation.
Caution: You should be careful to include in your comments only
information that you wish to make publicly available. We strongly urge
you not to include in your comments any personal information such as
Social Security numbers or medical information.
1. Internet: We strongly recommend that you submit your comments
via the Internet. Please visit the Federal eRulemaking portal at https://www.regulations.gov. Use the Search function to find docket number
SSA-2009-0078. The system will issue a tracking number to confirm your
submission. You will not be able to view your comment immediately
because we must post each comment manually. It may take up to a week
for your comment to be viewable.
2. Fax: Fax comments to (410) 966-2830.
3. Mail: Mail your comments to the Office of Regulations, Social
Security Administration, 107 Altmeyer Building, 6401 Security
Boulevard, Baltimore, Maryland 21235-6401.
Comments are available for public viewing on the Federal
eRulemaking portal at https://www.regulations.gov or in person, during
regular business hours, by arranging with the contact person identified
below.
FOR FURTHER INFORMATION CONTACT: Craig Streett, Office of Income
Security Programs, Social Security Administration, 2-R-24 Operations
Building, 6401 Security Boulevard, Baltimore, MD 21235-6401, (410) 965-
9793. For information on eligibility or filing for benefits, call our
national toll-free number, 1-800-772-1213 or TTY 1-800-325-0778, or
visit our Internet site, Social Security Online, at https://www.socialsecurity.gov.
SUPPLEMENTARY INFORMATION:
Electronic Version
The electronic file of this document is available on the date of
publication in the Federal Register at https://www.gpoaccess.gov/fr/.
Background
Medicare Part B is a voluntary medical insurance program that
provides coverage for services such as physician's care, diagnostic
services, and medical supplies. A beneficiary enrolled in Medicare Part
B pays monthly premiums, deductibles, and co-insurance associated with
covered services. The Centers for Medicare & Medicaid Services (CMS)
promulgates rules and regulations about the Medicare program, including
the standard monthly premium. We determine and deduct the amount of
certain Medicare Part B premiums from beneficiaries' Social Security
benefits and make rules and regulations necessary to carry out these
functions.
The Federal Government subsidizes the cost of Medicare Part B
medical coverage. However, beneficiaries with modified adjusted gross
incomes (MAGI) above a specified threshold must pay a higher percentage
of their cost than those with MAGIs below the threshold.\1\ We refer to
this subsidy reduction as an IRMAA. CMS determines and publishes the
annual MAGI thresholds and ranges.
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\1\ MAGI is defined in 42 U.S.C. 1395r(i)(4). The threshold
amount is defined in 42 U.S.C. 1395r(i)(2).
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The Internal Revenue Service (IRS) provides us with MAGI
information. We use MAGI and Federal income tax filing status for the
tax year 2 years before the effective year to determine whether a
beneficiary must pay an IRMAA, and if so, how much.\2\ If information
is not yet available for the tax year 2 years before the effective
year, we will use information from the tax year 3 years before the
effective year until the later information becomes available.
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\2\ MAGI ranges are established in 42 U.S.C. 1395r(i)(3), (5).
The MAGI dollar amounts listed in 1395r(i)(3) may increase annually
based on changes in the Consumer Price Index under 42 U.S.C.
1395r(i)(5).
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A beneficiary who experiences a major life-changing event may
request that we use a more recent tax year to make a new IRMAA
determination. If a beneficiary provides evidence that the qualifying
major life-changing event reduces his or her MAGI below the threshold
amount, we will determine the IRMAA based on data from a more recent
tax year.\3\ We define a significant reduction in MAGI as any change
that results in a reduction or elimination of IRMAA.\4\ The Social
Security Act provides that major life-changing events include marriage,
divorce, death of
[[Page 41085]]
spouse, or other events specified in our regulations.\5\
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\3\ 20 CFR 418.1201.
\4\ 20 CFR 418.1215.
\5\ 42 U.S.C. 1395r(i)(4)(C)(ii)(II).
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Our current regulations identify the following additional events as
major life-changing events: (1) The annulment of a marriage, (2) a work
stoppage, (3) reduced hours of work, (4) reductions in income due to
certain losses of income-producing property, (5) a scheduled cessation
of a pension, and (6) a reduction in or loss of income from an insured
pension plan due to termination or reorganization of the plan.\6\ Our
current regulations also provide that we do not consider events other
than those described in 20 CFR 418.1205 to be major life-changing
events. In addition, under our current regulations we do not consider
events that affect expenses but not income, or that result in the loss
of dividend income, to be major life-changing events.\7\
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\6\ 20 CFR 418.1205.
\7\ 20 CFR 418.1210.
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Recent changes in the economy and other unforeseen events have
significantly affected many Medicare Part B beneficiaries. These
unforeseen events have caused reductions in the MAGI of beneficiaries
for the tax years following the tax year reported to us by the IRS,
which results in IRMAAs that may be higher than a beneficiary's ability
to pay. Several major employers in the United States have closed or
reorganized in recent years. As a result, some companies have provided
settlement payments to current and retired employees in lieu of
periodic pension payments, extended health insurance coverage, or both.
These settlement payments have caused an unexpected one-time increase
in a beneficiary's income for a tax-reporting year, which in turn may
result in the imposition of an IRMAA or a higher IRMAA.
In order to address these recent changes in the economy, we are
adding a new paragraph (g) to 20 CFR 418.1205 to include the receipt of
a settlement payment from an employer or former employer in the list of
major life-changing events. To qualify as a major life-changing event,
a settlement payment received by a beneficiary or the spouse of a
beneficiary must be the result of an employer's or former employer's
closure, bankruptcy, or reorganization. This change will allow a
beneficiary to request that we base the IRMAA on the MAGI from a more
recent tax year.
Section 418.1205(e) of our current regulations provides that a
reduction in the income of a beneficiary or the spouse of a beneficiary
due to a loss of income-producing property is a major life-changing
event. In order to qualify as a major life-changing event, the loss of
income-producing property must not be at the direction of the
beneficiary, such as through the sale or transfer of the property.
Section 418.1205(e) provides some examples of qualifying property
losses. Most examples in the current regulation result from natural
disasters, but we also include the loss of income from real property
due to the criminal act of arson as an example of a life-changing
event. Some beneficiaries also have experienced a loss of income-
producing property as the result of another type of criminal act: Fraud
or theft. To address this situation, we are revising 20 CFR 418.1205(e)
to include the loss of investment property as a result of fraud or
theft due to a criminal act by a third party.
We are also making several other changes to this section of our
regulations. First, we are specifically providing that the
beneficiary's spouse cannot direct the loss of income-producing
property. While our current regulations state that the loss cannot be
at the direction of the beneficiary, it was our intent to include both
the beneficiary and spouse. Second, we are revising section 418.1205(e)
to clarify that the loss of income-producing property due to the
ordinary risk of investment is not a major life-changing event. In some
cases, beneficiaries and adjudicators have misinterpreted our current
regulations in this regard. We are making a similar change to 20 CFR
418.1210(b) to clarify that we do not consider events that result in
the loss of dividend income as the result of the ordinary risk of
investment to be major life-changing events.
Our current regulations provide that ``a reduction in or loss of
income from an insured pension plan due to termination or
reorganization of the pension plan or a scheduled cessation of
pension'' qualifies as a major life-changing event.\8\ Recently, a
number of uninsured pension plans have been terminated or reorganized.
The termination or reorganization of an uninsured pension plan does not
qualify as a major life-changing event under our current regulations.
To ensure that Medicare Part B beneficiaries who experience a loss of
income under these circumstances can request new initial determinations
using a more recent tax year, we are replacing ``insured pension plan''
with ``employer's pension plan'' in 20 CFR 418.1205(f). This language
change will qualify both insured and uninsured pension plans.
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\8\ 20 CFR 418.1205(f).
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We are further revising sections 418.1205(e) and (f) and
418.1255(e) and (f) to remove the wording that requires a reduction in
or loss of income from these life-changing events. This language has
confused beneficiaries and adjudicators and is redundant in light of
the first sentence of current section 418.1201(b), which we are not
revising. That sentence says that in order to use information from a
more recent tax year because of a major life-changing event, the event
must ``result in a significant reduction in your modified adjusted
gross income for the year which you request we use and the next year,
if applicable.'' The change we are making will make the wording of the
revised subsections consistent with that of the subsections explaining
other life-changing events found in 20 CFR 418.1205 and 20 CFR
418.1255.
Required Evidence
We are also revising 20 CFR 418.1255 to clarify the type of
evidence we require when a beneficiary asks us to use a more recent tax
year to calculate an IRMAA based on certain changes in circumstance. If
a beneficiary or his or her spouse experiences a loss of income-
producing property due to criminal fraud or theft by a third party, we
will require proof of the conviction and evidence of loss. If a
beneficiary or his or her spouse experiences a scheduled cessation,
termination, or reorganization of an employer's pension plan, we will
require evidence documenting the change in or loss of the pension. If a
beneficiary or his or her spouse receives a settlement from an employer
or a former employer because of the employer's closure, bankruptcy, or
reorganization, we will require evidence documenting the settlement and
the reason(s) for the settlement. These changes will make it easier for
a beneficiary to meet the burden of proof for establishing a major
life-changing event.
Technical Revisions
We are revising paragraph (d) of 20 CFR 418.1230 and paragraphs
(c)(2) and (3) of 20 CFR 418.1265 to reflect the addition of new
paragraph 418.1205(g), which concerns the addition of receipt of
certain settlements as life-changing events, as discussed above.
When will we start to use this rule?
We will start to use this rule on the date shown under DATES
earlier in this preamble.
We are also inviting public comment on the changes made by this
rule. We
[[Page 41086]]
will consider any relevant comments we receive. We will publish a final
rule to respond to those comments and to make any appropriate changes.
Regulatory Procedures
We follow the Administrative Procedure Act (APA) rulemaking
procedures specified in 5 U.S.C. 553 when we develop regulations.
Generally, the APA requires that an agency provide prior notice and
opportunity for public comment before issuing a final regulation. The
APA provides exceptions to its notice and public comment procedures
when an agency finds good cause for dispensing with such procedures as
impracticable, unnecessary, or contrary to the public interest.\9\
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\9\ 5 U.S.C. 553(b)(B).
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We find that good cause exists for proceeding without prior public
notice and comment because any delay in revising our regulations could
negatively affect the financial welfare of our beneficiaries. This
interim rule addresses, among other things, the unintended consequences
of higher Medicare Part B premium burdens for beneficiaries who have
lost their pensions or suffered other deleterious effects due to the
economic recession. Accordingly, we find that prior public comment
would be contrary to the public interest. However, we are inviting
public comment on the interim rule, and we will consider any responsive
comments we receive within 60 days of the publication of the interim
rule.
We also find good cause for proceeding without prior public notice
and comment regarding the technical revisions we are making in 20 CFR
418.1205(e) and (f) and 20 CFR 418.1255(e) and (f). These revisions
simply make the language defining each life-changing event consistent
and will have no substantive effect on the IRMAA program. Therefore, we
find that public comment is unnecessary regarding those changes.
In addition, for the reasons cited above, we also find good cause
for dispensing with the 30-day delay in the effective date of this
interim rule.\10\ Because unintended and extraordinary hardships to
affected Medicare Part B beneficiaries and their families could occur
if we delay the effective date of this interim rule, we find that it is
contrary to the public interest to delay the effective date of our rule
changes. Additionally, because the technical revisions to 20 CFR
418.1205(e) and (f) and 20 CFR 418.1255(e) and (f) have no substantive
effect on how we determine what is a major life-changing event, we find
that it is unnecessary to delay the effective date of those changes.
Accordingly, we are making this interim rule effective upon
publication.
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\10\ See 5 U.S.C. 553(d)(3).
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Executive Order 12866
We have consulted with the Office of Management and Budget (OMB)
and determined that this interim rule does meet the criteria for a
significant regulatory action under Executive Order 12866. It was
subject to OMB formal review.
Regulatory Flexibility Act
We certify that this interim rule will not have a significant
economic impact on a substantial number of small entities because it
affects individuals only. Therefore, a regulatory flexibility analysis
is not required under the Regulatory Flexibility Act, as amended.
Paperwork Reduction Act
The Office of Management and Budget (OMB) previously approved the
new public reporting requirements posed by these rules under a separate
Information Collection Request (OMB No. 0960-0735). We are therefore
not seeking OMB approval for these requirements here under the
Paperwork Reduction Act.
(Catalog of Federal Domestic Assistance Program Nos. 93.774 Medicare
Supplementary Medical Insurance; 96.002 Social Security--Retirement
Insurance.)
List of Subjects in 20 CFR Part 418
Administrative practice and procedure, Aged, Blind, Disability
benefits, Public assistance programs, Reporting and recordkeeping
requirements, Supplemental Security Income (SSI), Medicare subsidies.
Dated: April 20, 2010.
Michael J. Astrue,
Commissioner of Social Security.
0
For the reasons set out in the preamble, we amend 20 CFR chapter III,
part 418, subpart B as set forth below:
PART 418--MEDICARE SUBSIDIES
Subpart B--[Amended]
0
1. The authority citation for subpart B of part 418 continues to read
as follows:
Authority: Secs. 702(a)(5) and 1839(i) of the Social Security
Act (42 U.S.C. 902(a)(5) and 1395r(i)).
0
2. Amend Sec. 418.1205 to revise paragraphs (e) and (f) and add
paragraph (g) to read as follows:
Sec. 418.1205 What is a major life-changing event?
* * * * *
(e) You or your spouse experiences a loss of income-producing
property, provided the loss is not at the direction of you or your
spouse (e.g., due to the sale or transfer of the property) and is not a
result of the ordinary risk of investment. Examples of the type of
property loss include, but are not limited to: Loss of real property
within a Presidentially or Gubernatorially-declared disaster area,
destruction of livestock or crops by natural disaster or disease, loss
from real property due to arson, or loss of investment property as a
result of fraud or theft due to a criminal act by a third party;
(f) You or your spouse experiences a scheduled cessation,
termination, or reorganization of an employer's pension plan;
(g) You or your spouse receives a settlement from an employer or
former employer because of the employer's closure, bankruptcy, or
reorganization.
0
3. Amend Sec. 418.1210 to revise paragraph (b) to read as follows:
Sec. 418.1210 What is not a major life-changing event?
* * * * *
(b) Events that result in the loss of dividend income because of
the ordinary risk of investment.
0
4. Amend Sec. 418.1230 to revise paragraph (d) to read as follows:
Sec. 418.1230 What is the effective date of an income-related monthly
adjustment amount initial determination that is based on a more recent
tax year?
* * * * *
(d) Our initial determination will be effective January 1 of the
year following the year you make your request, when your modified
adjusted gross income will not be significantly reduced as a result of
one or more of the events described in Sec. 418.1205(a) through (g)
until the year following the year you make your request.
0
5. Amend Sec. 418.1255 to revise paragraphs (e) and (f) and add
paragraph (g) to read as follows:
Sec. 418.1255 What kind of evidence of a major life-changing event
will you need to support your request for us to use a more recent tax
year?
* * * * *
(e) If you or your spouse experiences a loss of income-producing
property, we will require evidence documenting the loss. Examples of
acceptable evidence include, but are not limited to, insurance claims
or an insurance
[[Page 41087]]
adjuster's statement. If the claim of loss is due to criminal fraud or
theft by a third party, we will also require proof of conviction for
the fraud or theft, such as a court document.
(f) If you or your spouse experiences a scheduled cessation,
termination, or reorganization of an employer's pension plan, we will
require evidence documenting the change in or loss of the pension. An
example of acceptable evidence includes, but is not limited to, a
statement from your pension fund administrator explaining the reduction
or termination of your benefits.
(g) If you or your spouse receives a settlement from an employer or
former employer because of the employer's closure, bankruptcy, or
reorganization, we will require evidence documenting the settlement and
the reason(s) for the settlement. An example of acceptable evidence
includes, but is not limited to, a letter from the former employer
stating the settlement terms and how they affect you or your spouse.
0
6. Amend Sec. 418.1265 to revise paragraphs (c)(2) and (c)(3) to read
as follows:
Sec. 418.1265 What kind of evidence of a significant modified
adjusted gross income reduction will you need to support your request?
* * * * *
(c) * * *
(2) If you experience one or more of the events described in Sec.
418.1205(d), (e), (f), or (g), you must provide evidence of how the
event(s) significantly reduced your modified adjusted gross income,
such as a statement explaining any modified adjusted gross income
changes for the tax year we used and a copy of your filed Federal
income tax return (if you have filed one).
(3) If your spouse experiences one or more of the events described
in Sec. 418.1205(d), (e), (f), or (g), you must provide evidence of
the resulting significant reduction in your modified adjusted gross
income. The evidence requirements are described in paragraph (c)(2) of
this section.
* * * * *
[FR Doc. 2010-17198 Filed 7-14-10; 8:45 am]
BILLING CODE 4191-02-P