Medicare Program; Part A Premiums for CY 2012 for the Uninsured Aged and for Certain Disabled Individuals Who Have Exhausted Other Entitlement, 67570-67572 [2011-28188]
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67570
Federal Register / Vol. 76, No. 211 / Tuesday, November 1, 2011 / Notices
notice will not have a significant
economic impact on a substantial
number of small entities. Therefore, we
are not preparing an analysis under the
RFA.
In addition, section 1102(b) of the
Social Security 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 for Medicare payment
regulations and has fewer than 100
beds. 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 under 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 whose mandates require spending
in any 1 year of $100 million in 1995
dollars, updated annually for inflation.
In 2011, that threshold is approximately
$136 million. This notice will have no
consequential effect on State, local, or
tribal governments or on the private
sector. However, States may be required
to pay the deductibles and coinsurance
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.
emcdonald on DSK5VPTVN1PROD with NOTICES2
(Catalog of Federal Domestic Assistance
Program No. 93.773, Medicare—Hospital
Insurance)
Dated: September 22, 2011
Donald M. Berwick,
Administrator, Centers for Medicare &
Medicaid Services.
Dated: October 25, 2011.
Kathleen Sebelius,
Secretary.
[FR Doc. 2011–28187 Filed 10–27–11; 11:15 am]
BILLING CODE 4120–01–P
VerDate Mar<15>2010
17:18 Oct 31, 2011
Jkt 226001
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Centers for Medicare & Medicaid
Services
[CMS–8044–N]
RIN 0938–AQ15
Medicare Program; Part A Premiums
for CY 2012 for the Uninsured Aged
and for Certain Disabled Individuals
Who Have Exhausted Other
Entitlement
Centers for Medicare &
Medicaid Services (CMS), HHS.
ACTION: Notice.
AGENCY:
This annual notice announces
Medicare’s Hospital Insurance (Part A)
premium for uninsured enrollees in
calendar year (CY) 2012. This premium
is 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, 2012, for
these individuals will be $451. The
reduced premium for certain other
individuals as described in this notice
will be $248.
DATES: Effective Date: This notice is
effective on January 1, 2012.
FOR FURTHER INFORMATION CONTACT:
Clare McFarland, (410) 786–6390.
SUPPLEMENTARY INFORMATION:
SUMMARY:
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. These
‘‘uninsured aged’’ individuals are
uninsured under the OASDI program or
the Railroad Retirement Act, because
they do not have 40 quarters of coverage
under Title II of the Act (or are/were not
married to someone who did). (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 for certain disabled
individuals who have exhausted other
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entitlement. These are individuals who
were entitled to coverage due to a
disabling impairment under section
226(b) of the Act, but who 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 2012 will be
equal to the premium for uninsured
aged enrollees reduced by 45 percent.
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Federal Register / Vol. 76, No. 211 / Tuesday, November 1, 2011 / Notices
II. Monthly Premium Amount for CY
2012
V. Waiver of Proposed Notice and
Comment Period
The monthly premium for the
uninsured aged and certain disabled
individuals who have exhausted other
entitlement for the 12 months beginning
January 1, 2012, is $451.
The monthly premium for those
individuals subject to the 45 percent
reduction in the monthly premium is
$248.
We use general notices, rather than
notice and comment rulemaking
procedures, to make announcements
such as this premium notice. 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. The agency may also waive
notice and comment if there is ‘‘good
cause,’’ as defined by the statute. We
considered publishing a proposed
notice to provide a period for public
comment. However, under the APA, 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 are not using notice and comment
rulemaking in this notification of
Medicare Part A premiums for CY 2011
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 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 2012
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 2012
on—(1) Current historical data; and (2)
projection assumptions derived from
current law and the Mid-Session Review
of the President’s Fiscal Year 2012
Budget.
We estimate that in CY 2012,
40,787,939 people aged 65 years and
over will be entitled to benefits (without
premium payment) and that they will
incur about $220.656 billion in benefits
and related administrative costs. Thus,
the estimated monthly average per
capita amount is $450.82 and the
monthly premium is $451. The full
monthly premium reduced by 45
percent is $248.
emcdonald on DSK5VPTVN1PROD with NOTICES2
IV. Costs to Beneficiaries
The CY 2012 premium of $451 is
approximately 0.22 percent higher than
the CY 2011 premium of $450.
We estimate that approximately
590,000 enrollees will voluntarily enroll
in Medicare Part A by paying the full
premium. We estimate an additional
45,000 enrollees will pay the reduced
premium. We estimate that the aggregate
cost to enrollees paying these premiums
in CY 2012, compared to the amount
that they paid in CY 2011, will be about
$7 million.
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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 impact of this
notice as required by Executive Order
12866 on Regulatory Planning and
Review (September 30, 1993), Executive
Order 13563 on Improving Regulation
and Regulatory Review (January 18,
2011), 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 Orders 12866 and 13563
direct agencies to assess all costs and
PO 00000
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67571
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 $7 million. Therefore, this notice
is a not a major action as defined in
Title 5, United States Code, section
804(2) and is not an economically
significant action 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 small
governmental jurisdictions. Most
hospitals and most other providers and
suppliers are small entities, either by
nonprofit status or by having revenues
of $7.0 million to $34.5 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 under the
RFA.
In addition, section 1102(b) of the
Social Security 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 for Medicare payment
regulations and has fewer than 100
beds. 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 under 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 whose mandates require spending
in any 1 year of $100 million in 1995
dollars, updated annually for inflation.
In 2011, that threshold is approximately
$136 million. This notice will have no
E:\FR\FM\01NON2.SGM
01NON2
67572
Federal Register / Vol. 76, No. 211 / Tuesday, November 1, 2011 / Notices
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: September 22, 2011.
Donald M. Berwick,
Administrator, Centers for Medicare &
Medicaid Services.
Dated: October 25, 2011.
Kathleen Sebelius,
Secretary.
[FR Doc. 2011–28188 Filed 10–27–11; 11:15 am]
BILLING CODE 4120–01–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Centers for Medicare & Medicaid
Services
[CMS–8045–N]
RIN 0938–AQ16
Medicare Program; Medicare Part B
Monthly Actuarial Rates, Premium
Rate, and Annual Deductible
Beginning January 1, 2012
Centers for Medicare &
Medicaid Services (CMS), HHS.
ACTION: Notice.
AGENCY:
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, 2012. 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 2012 are $199.80 for aged enrollees
and $192.50 for disabled enrollees. The
standard monthly Part B premium rate
for 2012 is $99.90, which is equal to 50
emcdonald on DSK5VPTVN1PROD with NOTICES2
SUMMARY:
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17:18 Oct 31, 2011
Jkt 226001
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 2011 standard premium
rate was $115.40) The Part B deductible
for 2012 is $140.00 for all Part B
beneficiaries. If a beneficiary has to pay
an income-related monthly adjustment,
they may have to pay a total monthly
premium of about 35, 50, 65, or 80
percent of the total cost of Part B
coverage.
Effective Date: January 1, 2012.
M.
Kent Clemens, (410) 786–6391.
SUPPLEMENTARY INFORMATION:
DATES:
FOR FURTHER INFORMATION CONTACT:
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 described 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
by transfers from the general fund of the
Treasury.
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 of the expected
average monthly cost of Part B for each
aged enrollee (age 65 or over) and onehalf of the expected average monthly
cost of Part B for each disabled enrollee
(under age 65).
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The Part B deductible to be paid by
enrollees is also announced. Prior to the
Medicare Prescription Drug,
Improvement, and Modernization Act of
2003 (MMA) (Pub. L. 108–173), the Part
B deductible was set in statute. After
setting the 2005 deductible amount at
$110.00, section 629 of the MMA
(amending section 1833(b) of the Act)
requires that the Part B deductible be
indexed beginning in 2006. The
inflation factor to be used each year is
the annual percentage increase in the
Part B actuarial rate for enrollees age 65
and over. Specifically, the 2012 Part B
deductible is calculated by multiplying
the 2011 deductible by the ratio of the
2012 aged actuarial rate over the 2011
aged actuarial rate. The amount
determined under this formula is then
rounded to the nearest $1.
The monthly Part B premium rate to
be paid by aged and disabled enrollees
is also announced. (Although the costs
to the program per disabled enrollee are
different than for the aged, the statute
provides that they pay the same
premium amount.) Beginning with the
passage of section 203 of the Social
Security Amendments of 1972 (Pub. L.
92–603), the premium rate, which was
determined on a fiscal year basis, was
limited to the lesser of the actuarial rate
for aged enrollees, or the current
monthly premium rate increased by the
same percentage as the most recent
general increase in monthly Title II
social security benefits.
However, the passage of section 124
of the Tax Equity and Fiscal
Responsibility Act of 1982 (TEFRA)
(Pub. L. 97–248) suspended this
premium determination process.
Section 124 of TEFRA changed the
premium basis to 50 percent of the
monthly actuarial rate for aged enrollees
(that is, 25 percent of program costs for
aged enrollees). Section 606 of the
Social Security Amendments of 1983
(Pub. L. 98–21), section 2302 of the
Deficit Reduction Act of 1984 (DEFRA
84) (Pub. L. 98–369), section 9313 of the
Consolidated Omnibus Budget
Reconciliation Act of 1985 (COBRA 85)
(Pub. L. 99–272), section 4080 of the
Omnibus Budget Reconciliation Act of
1987 (OBRA 87) (Pub. L. 100–203), and
section 6301 of the Omnibus Budget
Reconciliation Act of 1989 (OBRA 89)
(Pub. L. 101–239) extended the
provision that the premium be based on
50 percent of the monthly actuarial rate
for aged enrollees (that is, 25 percent of
program costs for aged enrollees). This
extension expired at the end of 1990.
The premium rate for 1991 through
1995 was legislated by section
1839(e)(1)(B) of the Act, as added by
section 4301 of the Omnibus Budget
E:\FR\FM\01NON2.SGM
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]]>Agencies
[Federal Register Volume 76, Number 211 (Tuesday, November 1, 2011)]
[Notices]
[Pages 67570-67572]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2011-28188]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
[CMS-8044-N]
RIN 0938-AQ15
Medicare Program; Part A Premiums for CY 2012 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) 2012.
This premium is 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, 2012, for these individuals will be $451.
The reduced premium for certain other individuals as described in this
notice will be $248.
DATES: Effective Date: This notice is effective on January 1, 2012.
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. These ``uninsured aged'' individuals
are uninsured under the OASDI program or the Railroad Retirement Act,
because they do not have 40 quarters of coverage under Title II of the
Act (or are/were not married to someone who did). (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 for 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 who 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 2012 will be equal to the premium for
uninsured aged enrollees reduced by 45 percent.
[[Page 67571]]
II. Monthly Premium Amount for CY 2012
The monthly premium for the uninsured aged and certain disabled
individuals who have exhausted other entitlement for the 12 months
beginning January 1, 2012, is $451.
The monthly premium for those individuals subject to the 45 percent
reduction in the monthly premium is $248.
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 2012
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 2012 on--(1) Current historical
data; and (2) projection assumptions derived from current law and the
Mid-Session Review of the President's Fiscal Year 2012 Budget.
We estimate that in CY 2012, 40,787,939 people aged 65 years and
over will be entitled to benefits (without premium payment) and that
they will incur about $220.656 billion in benefits and related
administrative costs. Thus, the estimated monthly average per capita
amount is $450.82 and the monthly premium is $451. The full monthly
premium reduced by 45 percent is $248.
IV. Costs to Beneficiaries
The CY 2012 premium of $451 is approximately 0.22 percent higher
than the CY 2011 premium of $450.
We estimate that approximately 590,000 enrollees will voluntarily
enroll in Medicare Part A by paying the full premium. We estimate an
additional 45,000 enrollees will pay the reduced premium. We estimate
that the aggregate cost to enrollees paying these premiums in CY 2012,
compared to the amount that they paid in CY 2011, will be about $7
million.
V. Waiver of Proposed Notice and Comment Period
We use general notices, rather than notice and comment rulemaking
procedures, to make announcements such as this premium notice. 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. The agency may also waive notice and
comment if there is ``good cause,'' as defined by the statute. We
considered publishing a proposed notice to provide a period for public
comment. However, under the APA, 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 are not using notice and comment rulemaking in this notification
of Medicare Part A premiums for CY 2011 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 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. 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 impact of this notice as required by Executive
Order 12866 on Regulatory Planning and Review (September 30, 1993),
Executive Order 13563 on Improving Regulation and Regulatory Review
(January 18, 2011), 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 Orders 12866 and 13563 direct 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 $7 million. Therefore, this notice is a not a major action as
defined in Title 5, United States Code, section 804(2) and is not an
economically significant action 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 small governmental
jurisdictions. Most hospitals and most other providers and suppliers
are small entities, either by nonprofit status or by having revenues of
$7.0 million to $34.5 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 under the RFA.
In addition, section 1102(b) of the Social Security 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 for Medicare payment regulations and
has fewer than 100 beds. 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 under 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 whose mandates require spending in any 1 year of $100
million in 1995 dollars, updated annually for inflation. In 2011, that
threshold is approximately $136 million. This notice will have no
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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: September 22, 2011.
Donald M. Berwick,
Administrator, Centers for Medicare & Medicaid Services.
Dated: October 25, 2011.
Kathleen Sebelius,
Secretary.
[FR Doc. 2011-28188 Filed 10-27-11; 11:15 am]
BILLING CODE 4120-01-P
