Regulations Regarding Income-Related Monthly Adjustment Amounts to Medicare Beneficiaries' Prescription Drug Coverage Premiums, 43496-43498 [2012-17935]
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Federal Register / Vol. 77, No. 143 / Wednesday, July 25, 2012 / Rules and Regulations
§ 416.987 Disability redeterminations for
individuals who attain age 18.
SOCIAL SECURITY ADMINISTRATION
*
20 CFR Part 418
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*
*
*
(b) * * * When we redetermine your
eligibility, we will use the rules for
adults (individuals age 18 or older) who
file new applications explained in
§ 416.920(c) through (h). * * *
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*
*
*
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19. Amend § 416.994 by revising
paragraph (b)(5)(vii) and adding a new
paragraph (b)(5)(viii) to read as follows:
■
§ 416.994 How we will determine whether
your disability continues or ends, disabled
adults.
*
*
*
*
*
(b) * * *
(5) * * *
(vii) Step 7. If you are not able to do
work you have done in the past, we will
consider whether you can do other work
given the residual functional capacity
assessment made under paragraph
(b)(5)(vi) of this section and your age,
education, and past work experience
(see paragraph (b)(5)(viii) of this section
for an exception to this rule). If you can,
we will find that your disability has
ended. If you cannot, we will find that
your disability continues.
(viii) Step 8. We may proceed to the
final step, described in paragraph
(b)(5)(vii) of this section, if the evidence
in your file about your past relevant
work is not sufficient for us to make a
finding under paragraph (b)(5)(vi) of this
section about whether you can perform
your past relevant work. If we find that
you can adjust to other work based
solely on your age, education, and
residual functional capacity, we will
find that you are no longer disabled, and
we will not make a finding about
whether you can do your past relevant
work under paragraph (b)(5)(vi) of this
section. If we find that you may be
unable to adjust to other work or if
§ 416.962 may apply, we will assess
your claim under paragraph (b)(5)(vi) of
this section and make a finding about
whether you can perform your past
relevant work.
*
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[FR Doc. 2012–17934 Filed 7–24–12; 8:45 am]
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BILLING CODE 4191–02–P
[Docket No. SSA–2010–0029]
RIN 0960–AH22
Regulations Regarding Income-Related
Monthly Adjustment Amounts to
Medicare Beneficiaries’ Prescription
Drug Coverage Premiums
ACTION:
This final rule adopts,
without change, the interim final rule
with request for comments we
published in the Federal Register on
December 7, 2010, at 75 FR 75884. The
interim final rule contained the rules
that we apply to determine the incomerelated monthly adjustment amount for
Medicare prescription drug coverage
(also known as Medicare Part D)
premiums. This new subpart
implemented changes made to the
Social Security Act (Act) by the
Affordable Care Act. The interim final
rule allowed us to implement the
provisions of the Affordable Care Act
related to the income-related monthly
adjustment amount for Medicare
prescription drug coverage premiums
when they went into effect on January
1, 2011.
DATES: The interim final rule with
request for comments published on
December 7, 2010 (75 FR 75884) is
confirmed as final effective July 25,
2012.
SUMMARY:
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:
Background
As we discussed in the interim final
rule, in March 2010 Congress passed the
Affordable Care Act, which established
an income-related adjustment to
Medicare prescription drug coverage
premiums.1 The interim final rule
added a new subpart C, Income-Related
Monthly Adjustments to Medicare
Prescription Drug Coverage Premiums,
to part 418 of our rules. Subpart C
1 Public
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16:20 Jul 24, 2012
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Social Security Administration.
Final rule.
AGENCY:
PO 00000
Law 111–148 § 3308(a).
Frm 00010
Fmt 4700
Sfmt 4700
contains the rules that we use to
determine when you will be required to
pay an income-related monthly
adjustment amount in addition to your
Medicare prescription drug coverage
monthly premium.
The interim final rule also amended
our rules on the Medicare Part B
(supplementary medical insurance)
income-related monthly adjustment
amounts to add section 418.1322. This
section explains that if we make an
income-related monthly adjustment
amount determination for you for the
effective year for purposes of the
Medicare prescription drug coverage
program, we will apply the same
income-related monthly adjustment
amount determination to your Medicare
Part B premium for the same effective
year.
Public Comments
On December 7, 2010, we published
an interim final rule with request for
comments in the Federal Register at 75
FR 75884 and provided a 60-day
comment period. We received one
comment from a member of the public,
comments from one organization, and
joint comments from four other
organizations. We carefully considered
the concerns expressed in these
comments, but did not make any
changes to the interim final rule. We
have summarized the commenters’
views and have responded to the
significant comments that are within the
scope of the interim final rule.
Comment: One commenter stated that
the reasoning behind charging higher
Medicare premiums is flawed because
citizens who have contributed more to
the system should have access to the
same products and benefits at the same
rate as other citizens. The commenter
considered the income-related monthly
adjustment to be a tax that could only
be established by amending the tax code
and suggested that a better alternative
would be to reduce Medicare premiums
and apportion the costs for primary
coverage among the multiple health
insurance policies that he believes most
beneficiaries have.
Response: We have not adopted this
comment because the reduction of
Federal premium subsidies was
legislated by Congress, and our
regulations must conform to the
provisions of the law.
Comment: One organization suggested
that we provide notices to beneficiaries
affected by the income-related monthly
adjustment as early as possible, for
example, by October 31 for premium
adjustments beginning the following
January. The commenter stated that
early notice would give enrollees time
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Federal Register / Vol. 77, No. 143 / Wednesday, July 25, 2012 / Rules and Regulations
to adjust their finances, raise any
disagreements with income
determinations, and reduce the number
of retroactive adjustments that are
required.
Response: We did not adopt this
comment. The Internal Revenue Service
provides us with modified adjusted
gross income data no later than October
15 of each year, as required by law.2 We
must then process the data, verify our
data processing, print, and mail the
notices. For this reason, we cannot
provide notice to beneficiaries regarding
the income-related monthly adjustment
amount as early as October 31. We do
strive to mail the notices promptly and
believe that delivery before December
provides sufficient time for beneficiaries
to make suitable preparations.
These notices contain information
about beneficiaries’ appeal rights and
notify the beneficiaries that they have
60 days to file an appeal when they
disagree with the determination. Our
notices also inform the beneficiaries of
their right to request a new initial
determination.
Comment: Another comment
encouraged us to develop materials to
explain what beneficiaries who pay an
income-related monthly adjustment can
do if they experience a major lifechanging event and a significant
reduction in income, but have not yet
filed a tax return reflecting that change.
Response: We already provide
information to beneficiaries concerning
the issues the commenter raised. When
we send a letter telling a beneficiary that
he or she must pay an income-related
monthly adjustment, we include
comprehensive information about what
the beneficiary can do if he or she
experiences a major life-changing event
with a significant reduction in income.
We also make available at our offices
and on our web site, publications with
information explaining this issue.3 The
Centers for Medicare & Medicaid
Services (CMS) also provides
information on this subject on its
Medicare Web site, www.medicare.gov.
Comment: A comment submitted
jointly by four organizations proposed a
change in regulations to clarify that a
beneficiary’s appeal of the imposition of
an income-related monthly adjustment
on Medicare Part B would automatically
apply to an income-related monthly
adjustment imposed on Medicare
prescription drug coverage, and vice
versa. In addition, the organizations
suggested that if a beneficiary appeals
2 42
U.S.C. 1395w–113(a)(7)(E)(ii).
e.g., Medicare Premiums: Rules for HigherIncome Beneficiaries. Available at: https://
www.socialsecurity.gov/pubs/10536.pdf.
3 See,
VerDate Mar<15>2010
16:20 Jul 24, 2012
Jkt 226001
either a Medicare Part B or Medicare
prescription drug coverage incomerelated monthly adjustment initial
determination, we should suspend
determinations for both parts until the
appeals process is complete and there is
a final determination. The commenters
proposed that joining the appeals and
determinations resulting from those
appeals would be beneficial in saving
time and paperwork.
Response: We agree that 20 CFR
418.1322 and 418.2322 ensure that we
apply any income-related monthly
adjustment decision made in one
program to the other. Under these
provisions, if we make a new decision
or change a decision on appeal for one
program, we will also apply the
decision to the other program.
Thus, if a beneficiary has both
Medicare Part B and Medicare
prescription drug coverage, any changes
to an income-related monthly
adjustment determination made on
appeal will affect both programs and
separate appeals are not necessary. In
the current income-related monthly
adjustment appeal process, we do not
suspend the collection of the incomerelated monthly adjustment while the
beneficiary appeals the determination.
We make every effort possible to
adjudicate the appeal quickly and
implement the decision immediately
thereafter. If an appeal decision results
in an overpayment of premiums, we
process refunds without additional
action by the beneficiary.
Comment: Another commenter
proposed a change in regulations to
allow a request for a new initial
determination when a beneficiary
believes that CMS has provided
incorrect Medicare prescription drug
coverage information. The commenter
stated that beneficiaries not enrolled in
a Medicare prescription drug coverage
plan are entitled to a workable Social
Security Administration (SSA) process
to establish that an income-related
monthly adjustment does not apply. In
addition, the commenter suggested that
regulatory language include a
requirement that Medicare prescription
drug plan sponsors, CMS, and SSA
exchange updated enrollment
information frequently to decrease the
probability that beneficiaries are
charged an income-related monthly
adjustment inappropriately.
Response: We are not involved in the
Medicare prescription drug coverage
enrollment process and we cannot
determine the absence of coverage
without CMS input. Additionally,
adding a process to allow a beneficiary
to establish the absence of Medicare
prescription drug coverage could
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43497
negatively affect beneficiaries who
merely change plans or re-enroll shortly
thereafter. The income-related monthly
adjustment could be removed and result
in the beneficiary owing a lump sum
payment when the new plan
information is received. CMS provides
us with information about participation
in Medicare-approved prescription drug
coverage, and we refund any incorrectly
billed income-related monthly
adjustment for prescription drug
coverage money as soon as possible.
Comment: The four organizations also
suggested that we include the language
of the subpart B regulations in the
subpart C regulations rather than
incorporating the text by crossreferences.
Response: We have not adopted the
comment. We believe that stating the
language one time promotes
administrative simplicity. We use crossreferences in our regulations in other
instances, and we are confident that
they do not confuse the reader or make
it more difficult to use our regulations.
Guidelines issued by the Office of the
Federal Register authorize agencies to
use cross-references in their rules in
appropriate situations, and we believe
that the situations in which we have
used cross-references in these rules are
necessary and appropriate. Moreover,
adding the subpart B text to our subpart
C rules would make the subpart C
regulations more complicated and more
difficult to use.
Regulatory Procedures
Executive Order 12866 as supplemented
by Executive Order 13563
We consulted with the Office of
Management and Budget (OMB) and
determined that this final rule meets the
criteria for a significant regulatory
action under Executive Order 12866 as
supplemented by Executive Order
13563. Thus, OMB reviewed the final
rule.
Regulatory Flexibility Act
We certify that this 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
These rules do not create any new or
affect any existing collections and,
therefore, do not require Office of
Management and Budget approval
under the Paperwork Reduction Act.
(Catalog of Federal Domestic Assistance
Program Nos. 93.770 Medicare Prescription
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Federal Register / Vol. 77, No. 143 / Wednesday, July 25, 2012 / Rules and Regulations
Drug Coverage; 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.
Michael J. Astrue,
Commissioner of Social Security.
Accordingly, the interim final rule
amending 20 CFR chapter III, part 418,
subpart B and adding subpart C that was
published at 75 FR 75884 on December
7, 2010, is adopted as a final rule
without change.
[FR Doc. 2012–17935 Filed 7–24–12; 8:45 am]
BILLING CODE 4191–02–P
EQUAL EMPLOYMENT OPPORTUNITY
COMMISSION
29 CFR Part 1614
RIN Number 3046–AA73
Federal Sector Equal Employment
Opportunity
Equal Employment
Opportunity Commission.
ACTION: Final rule.
AGENCY:
The Equal Employment
Opportunity Commission (‘‘EEOC’’ or
‘‘Commission’’) is issuing this final rule
to revise its regulations for processing
equal employment opportunity
complaints by federal sector employees
and job applicants. The revisions
implement those recommendations of
the Commission’s Federal Sector
Workgroup which require regulatory
changes. The revisions include:
reaffirming the existing statutory
requirement that agencies comply with
EEOC regulations, Management
Directives, and Bulletins; providing for
EEOC notices to non-compliant
agencies; permitting pilot projects for
EEO complaint processing; requiring
agencies to issue a notice of rights to
complainants when the investigation
will not be timely completed; requiring
agencies to submit complaint files and
appeals documents to EEOC in digital
formats; and making administrative
judge decisions on the merits of class
complaints final with both parties
having the right to appeal to EEOC. The
Commission is engaged in further
review of the Federal sector EEO
complaint process in order to improve
its quality and efficiency. The current
rulemaking constitutes the
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SUMMARY:
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16:20 Jul 24, 2012
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Commission’s initial step in that review.
The Commission will consider
additional reforms, including, but not
limited to, regulatory changes.
DATES: Effective September 24, 2012.
FOR FURTHER INFORMATION CONTACT:
Thomas J. Schlageter, Assistant Legal
Counsel, Kathleen Oram, Senior
Attorney, or Gary Hozempa, Senior
Attorney, Office of Legal Counsel, 202–
663–4640 (voice), 202–663–7026 (TTY).
(These are not toll free numbers.) This
notice is also available in the following
formats: Large print, braille, audio tape,
and electronic file on computer disk.
Requests for this notice in an alternative
format should be made to EEOC’s
Publications Center at 1–800–669–3362
(voice) or 1–800–800–3302 (TTY).
SUPPLEMENTARY INFORMATION:
Introduction
EEOC enforces the statutes that
prohibit workplace discrimination in
the federal government. These statutes
include: section 717 of Title VII of the
Civil Rights Act of 1964, which
prohibits discrimination against
applicants and employees based on
race, color, religion, sex, and national
origin; section 501 of the Rehabilitation
Act of 1973, which prohibits
employment discrimination on the basis
of disability; section 15 of the Age
Discrimination in Employment Act of
1967, which prohibits employment
discrimination on the basis of age; the
Equal Pay Act of 1963, which prohibits
sex-based wage discrimination; and the
Genetic Information Nondiscrimination
Act of 2008, which prohibits
employment discrimination on the basis
of genetic information. EEOC is
responsible under these statutes for
processing equal employment
opportunity (EEO) complaints by
Federal employees and applicants.
The EEO complaint process is
initiated when a federal employee or job
applicant contacts an EEO counselor to
allege discrimination. If the allegation is
not resolved in counseling, the
individual may file a formal EEO
complaint with the employing agency
and that agency investigates the
complaint. At the conclusion of the
investigation, the complainant may
request a hearing before an EEOC
administrative judge or a final decision
by the agency. After the hearing or final
decision, the complainant may appeal to
EEOC. Complainants also have the right
to sue the alleged discriminating agency
in federal district court if they are not
satisfied with the administrative
resolution of their complaints.
In 2004, former EEOC Chair Cari M.
Dominguez asked Commissioner Stuart
PO 00000
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Fmt 4700
Sfmt 4700
J. Ishimaru to lead a workgroup to
develop consensus recommendations
from the Commissioners for
improvements to the EEO complaint
process. The Federal Sector Workgroup
considered testimony and submissions
from the November 12, 2002
Commission meeting on federal sector
reform, draft staff proposals for federal
sector reform, and numerous
submissions from internal and external
stakeholders with suggestions for
improvements to the federal sector
process. The Workgroup determined
that it did not have internal consensus
for large scale revision of the federal
sector EEO complaint process at the
time, but that there was agreement on
several discrete changes to the existing
regulations that would clarify or build
on the improvements made by the last
major revisions to 29 CFR Part 1614 in
1999. The EEOC plans to accompany
this final rule with the issuance of
additional guidance in Management
Directive 110 and other program
changes at EEOC. This final rule is part
of an ongoing review by the
Commission of the federal sector EEO
complaint process in which the
Commission is examining
recommendations regarding the
investigative function, including
perceived conflicts of interest in the
way investigations are conducted and
alternatives to the current investigation
process, and the hearings and appellate
review process.
A notice of proposed rulemaking
(NPRM) was circulated to all agencies
for comment pursuant to Executive
Order 12067 and subsequently
published in the Federal Register on
December 21, 2009. 74 FR 67839 (2009).
The notice proposed changes to the
Commission’s federal sector EEO
complaint processing regulations at 29
CFR Part 1614 to implement the
recommendations of the Federal Sector
Workgroup. It sought public comment
on those proposals.
The Commission received thirty-five
public comments on the NPRM:
fourteen comments from federal
agencies; five comments from civil
rights groups; five comments from
unions and other groups; five comments
from attorneys; and six comments from
individuals. The Commission has
carefully considered all of the
comments and has made several
changes to the NPRM in response to the
comments. The comments on the NPRM
and the changes made are discussed
more fully below.
Agency Process
The Workgroup considered many
recommendations for improvement to
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Agencies
[Federal Register Volume 77, Number 143 (Wednesday, July 25, 2012)]
[Rules and Regulations]
[Pages 43496-43498]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2012-17935]
-----------------------------------------------------------------------
SOCIAL SECURITY ADMINISTRATION
20 CFR Part 418
[Docket No. SSA-2010-0029]
RIN 0960-AH22
Regulations Regarding Income-Related Monthly Adjustment Amounts
to Medicare Beneficiaries' Prescription Drug Coverage Premiums
AGENCY: Social Security Administration.
ACTION: Final rule.
-----------------------------------------------------------------------
SUMMARY: This final rule adopts, without change, the interim final rule
with request for comments we published in the Federal Register on
December 7, 2010, at 75 FR 75884. The interim final rule contained the
rules that we apply to determine the income-related monthly adjustment
amount for Medicare prescription drug coverage (also known as Medicare
Part D) premiums. This new subpart implemented changes made to the
Social Security Act (Act) by the Affordable Care Act. The interim final
rule allowed us to implement the provisions of the Affordable Care Act
related to the income-related monthly adjustment amount for Medicare
prescription drug coverage premiums when they went into effect on
January 1, 2011.
DATES: The interim final rule with request for comments published on
December 7, 2010 (75 FR 75884) is confirmed as final effective July 25,
2012.
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:
Background
As we discussed in the interim final rule, in March 2010 Congress
passed the Affordable Care Act, which established an income-related
adjustment to Medicare prescription drug coverage premiums.\1\ The
interim final rule added a new subpart C, Income-Related Monthly
Adjustments to Medicare Prescription Drug Coverage Premiums, to part
418 of our rules. Subpart C contains the rules that we use to determine
when you will be required to pay an income-related monthly adjustment
amount in addition to your Medicare prescription drug coverage monthly
premium.
---------------------------------------------------------------------------
\1\ Public Law 111-148 Sec. 3308(a).
---------------------------------------------------------------------------
The interim final rule also amended our rules on the Medicare Part
B (supplementary medical insurance) income-related monthly adjustment
amounts to add section 418.1322. This section explains that if we make
an income-related monthly adjustment amount determination for you for
the effective year for purposes of the Medicare prescription drug
coverage program, we will apply the same income-related monthly
adjustment amount determination to your Medicare Part B premium for the
same effective year.
Public Comments
On December 7, 2010, we published an interim final rule with
request for comments in the Federal Register at 75 FR 75884 and
provided a 60-day comment period. We received one comment from a member
of the public, comments from one organization, and joint comments from
four other organizations. We carefully considered the concerns
expressed in these comments, but did not make any changes to the
interim final rule. We have summarized the commenters' views and have
responded to the significant comments that are within the scope of the
interim final rule.
Comment: One commenter stated that the reasoning behind charging
higher Medicare premiums is flawed because citizens who have
contributed more to the system should have access to the same products
and benefits at the same rate as other citizens. The commenter
considered the income-related monthly adjustment to be a tax that could
only be established by amending the tax code and suggested that a
better alternative would be to reduce Medicare premiums and apportion
the costs for primary coverage among the multiple health insurance
policies that he believes most beneficiaries have.
Response: We have not adopted this comment because the reduction of
Federal premium subsidies was legislated by Congress, and our
regulations must conform to the provisions of the law.
Comment: One organization suggested that we provide notices to
beneficiaries affected by the income-related monthly adjustment as
early as possible, for example, by October 31 for premium adjustments
beginning the following January. The commenter stated that early notice
would give enrollees time
[[Page 43497]]
to adjust their finances, raise any disagreements with income
determinations, and reduce the number of retroactive adjustments that
are required.
Response: We did not adopt this comment. The Internal Revenue
Service provides us with modified adjusted gross income data no later
than October 15 of each year, as required by law.\2\ We must then
process the data, verify our data processing, print, and mail the
notices. For this reason, we cannot provide notice to beneficiaries
regarding the income-related monthly adjustment amount as early as
October 31. We do strive to mail the notices promptly and believe that
delivery before December provides sufficient time for beneficiaries to
make suitable preparations.
---------------------------------------------------------------------------
\2\ 42 U.S.C. 1395w-113(a)(7)(E)(ii).
---------------------------------------------------------------------------
These notices contain information about beneficiaries' appeal
rights and notify the beneficiaries that they have 60 days to file an
appeal when they disagree with the determination. Our notices also
inform the beneficiaries of their right to request a new initial
determination.
Comment: Another comment encouraged us to develop materials to
explain what beneficiaries who pay an income-related monthly adjustment
can do if they experience a major life-changing event and a significant
reduction in income, but have not yet filed a tax return reflecting
that change.
Response: We already provide information to beneficiaries
concerning the issues the commenter raised. When we send a letter
telling a beneficiary that he or she must pay an income-related monthly
adjustment, we include comprehensive information about what the
beneficiary can do if he or she experiences a major life-changing event
with a significant reduction in income. We also make available at our
offices and on our web site, publications with information explaining
this issue.\3\ The Centers for Medicare & Medicaid Services (CMS) also
provides information on this subject on its Medicare Web site,
www.medicare.gov.
---------------------------------------------------------------------------
\3\ See, e.g., Medicare Premiums: Rules for Higher-Income
Beneficiaries. Available at: https://www.socialsecurity.gov/pubs/10536.pdf.
---------------------------------------------------------------------------
Comment: A comment submitted jointly by four organizations proposed
a change in regulations to clarify that a beneficiary's appeal of the
imposition of an income-related monthly adjustment on Medicare Part B
would automatically apply to an income-related monthly adjustment
imposed on Medicare prescription drug coverage, and vice versa. In
addition, the organizations suggested that if a beneficiary appeals
either a Medicare Part B or Medicare prescription drug coverage income-
related monthly adjustment initial determination, we should suspend
determinations for both parts until the appeals process is complete and
there is a final determination. The commenters proposed that joining
the appeals and determinations resulting from those appeals would be
beneficial in saving time and paperwork.
Response: We agree that 20 CFR 418.1322 and 418.2322 ensure that we
apply any income-related monthly adjustment decision made in one
program to the other. Under these provisions, if we make a new decision
or change a decision on appeal for one program, we will also apply the
decision to the other program.
Thus, if a beneficiary has both Medicare Part B and Medicare
prescription drug coverage, any changes to an income-related monthly
adjustment determination made on appeal will affect both programs and
separate appeals are not necessary. In the current income-related
monthly adjustment appeal process, we do not suspend the collection of
the income-related monthly adjustment while the beneficiary appeals the
determination. We make every effort possible to adjudicate the appeal
quickly and implement the decision immediately thereafter. If an appeal
decision results in an overpayment of premiums, we process refunds
without additional action by the beneficiary.
Comment: Another commenter proposed a change in regulations to
allow a request for a new initial determination when a beneficiary
believes that CMS has provided incorrect Medicare prescription drug
coverage information. The commenter stated that beneficiaries not
enrolled in a Medicare prescription drug coverage plan are entitled to
a workable Social Security Administration (SSA) process to establish
that an income-related monthly adjustment does not apply. In addition,
the commenter suggested that regulatory language include a requirement
that Medicare prescription drug plan sponsors, CMS, and SSA exchange
updated enrollment information frequently to decrease the probability
that beneficiaries are charged an income-related monthly adjustment
inappropriately.
Response: We are not involved in the Medicare prescription drug
coverage enrollment process and we cannot determine the absence of
coverage without CMS input. Additionally, adding a process to allow a
beneficiary to establish the absence of Medicare prescription drug
coverage could negatively affect beneficiaries who merely change plans
or re-enroll shortly thereafter. The income-related monthly adjustment
could be removed and result in the beneficiary owing a lump sum payment
when the new plan information is received. CMS provides us with
information about participation in Medicare-approved prescription drug
coverage, and we refund any incorrectly billed income-related monthly
adjustment for prescription drug coverage money as soon as possible.
Comment: The four organizations also suggested that we include the
language of the subpart B regulations in the subpart C regulations
rather than incorporating the text by cross-references.
Response: We have not adopted the comment. We believe that stating
the language one time promotes administrative simplicity. We use cross-
references in our regulations in other instances, and we are confident
that they do not confuse the reader or make it more difficult to use
our regulations. Guidelines issued by the Office of the Federal
Register authorize agencies to use cross-references in their rules in
appropriate situations, and we believe that the situations in which we
have used cross-references in these rules are necessary and
appropriate. Moreover, adding the subpart B text to our subpart C rules
would make the subpart C regulations more complicated and more
difficult to use.
Regulatory Procedures
Executive Order 12866 as supplemented by Executive Order 13563
We consulted with the Office of Management and Budget (OMB) and
determined that this final rule meets the criteria for a significant
regulatory action under Executive Order 12866 as supplemented by
Executive Order 13563. Thus, OMB reviewed the final rule.
Regulatory Flexibility Act
We certify that this 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
These rules do not create any new or affect any existing
collections and, therefore, do not require Office of Management and
Budget approval under the Paperwork Reduction Act.
(Catalog of Federal Domestic Assistance Program Nos. 93.770 Medicare
Prescription
[[Page 43498]]
Drug Coverage; 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.
Michael J. Astrue,
Commissioner of Social Security.
Accordingly, the interim final rule amending 20 CFR chapter III,
part 418, subpart B and adding subpart C that was published at 75 FR
75884 on December 7, 2010, is adopted as a final rule without change.
[FR Doc. 2012-17935 Filed 7-24-12; 8:45 am]
BILLING CODE 4191-02-P