Medicare Program; Part A Premiums for CY 2014 for the Uninsured Aged and for Certain Disabled Individuals Who Have Exhausted Other Entitlement, 64951-64953 [2013-25591]
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64951
Federal Register / Vol. 78, No. 210 / Wednesday, October 30, 2013 / Notices
Incomerelated
monthly
adjustment
amount
Beneficiaries who are married and lived with their spouse at any time during the year, but file a separate
tax return from their spouse:
emcdonald on DSK67QTVN1PROD with NOTICES
Less than or equal to $85,000 ........................................................................................................................
Greater than $85,000 and less than or equal to $129,000 .............................................................................
Greater than $129,000 ....................................................................................................................................
The RFA requires agencies to analyze
options for regulatory relief of small
businesses, if a rule has a significant
impact on a substantial number of small
entities. For purposes of the RFA, small
entities include small businesses,
nonprofit organizations, and small
governmental jurisdictions. Most
hospitals and most other providers and
suppliers are small entities, either by
nonprofit status or by having revenues
of less than $7.0 million to $34.5
million in any 1 year. Individuals and
States are not included in the definition
of a small entity. This notice announces
the monthly actuarial rates for aged (age
65 and over) and disabled (under 65)
beneficiaries enrolled in Part B of the
Medicare SMI program beginning
January 1, 2014. Also, 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. As a result, we are not
preparing an analysis for the RFA
because the Secretary has determined
that this notice will not have a
significant economic impact on a
substantial number of small entities.
In addition, section 1102(b) of the Act
requires us to prepare a regulatory
impact analysis if a rule may have a
significant impact on the operations of
a substantial number of small rural
hospitals. This analysis must conform to
the provisions of section 604 of the
RFA. For purposes of section 1102(b) of
the Act, we define a small rural hospital
as a hospital that is located outside of
a Metropolitan Statistical Area and has
fewer than 100 beds. As we discussed
previously, we are not preparing an
analysis for section 1102(b) of the Act
because the Secretary has determined
that this notice will not have a
significant effect on a substantial
number of small rural hospitals
Section 202 of the Unfunded
Mandates Reform Act of 1995 (UMRA)
also requires that agencies assess
anticipated costs and benefits before
issuing any rule whose mandates
require spending in any 1 year of $100
million in 1995 dollars, updated
annually for inflation. In 2013, that
VerDate Mar<15>2010
16:58 Oct 29, 2013
Jkt 232001
threshold is approximately $141
million. This notice does not impose
mandates that will have a consequential
effect of $142 million or more on State,
local, or tribal governments or on the
private sector.
Executive Order 13132 establishes
certain requirements that an agency
must meet when it publishes a proposed
rule (and subsequent final rule) that
imposes substantial direct compliance
costs on State and local governments,
preempts State law, or otherwise has
Federalism implications. We have
determined that this notice does not
significantly affect the rights, roles, and
responsibilities of States.
For 2014, the standard Part B
premium rate, the Part B income-related
premium rates, and the Part B
deductible are the same as the
respective amounts for 2013. Therefore,
this notice is not a major rule as defined
in 5 U.S.C. 804(2) and is not an
economically significant rule under
Executive Order 12866.
In accordance with the provisions of
Executive Order 12866, this notice was
reviewed by the Office of Management
and Budget.
IV. Waiver of Proposed Notice
The Medicare statute requires the
publication of the monthly actuarial
rates and the Part B premium amounts
in September. We ordinarily use general
notices, rather than notice and comment
rulemaking procedures, to make such
announcements. In doing so, we note
that, under the Administrative
Procedure Act, interpretive rules,
general statements of policy, and rules
of agency organization, procedure, or
practice are excepted from the
requirements of notice and comment
rulemaking.
We considered publishing a proposed
notice to provide a period for public
comment. However, we may waive that
procedure if we find, for good cause,
that prior notice and comment are
impracticable, unnecessary, or contrary
to the public interest. The statute
establishes the time period for which
the premium rates will apply, and
delaying publication of the Part B
premium rate such that it would not be
published before that time would be
contrary to the public interest.
PO 00000
Frm 00045
Fmt 4703
Sfmt 4703
Total
monthly
premium
amount
$0.00
167.80
230.80
$104.90
272.70
335.70
Moreover, we find that notice and
comment are unnecessary because the
formulas used to calculate the Part B
premiums are statutorily directed.
Therefore, we find good cause to waive
publication of a proposed notice and
solicitation of public comments.
(Catalog of Federal Domestic Assistance
Program No. 93.774, Medicare—
Supplementary Medical Insurance Program)
Dated: September 20, 2013.
Marilyn Tavenner,
Administrator, Centers for Medicare &
Medicaid Services.
Approved: October 18, 2013
Kathleen Sebelius,
Secretary, Department of Health and Human
Services.
[FR Doc. 2013–25668 Filed 10–28–13; 11:15 am]
BILLING CODE 4120–01–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Centers for Medicare & Medicaid
Services
[CMS–8054–N]
RIN 0938–AR57
Medicare Program; Part A Premiums
for CY 2014 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) 2014. 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, 2014, for
these individuals will be $426. The
premium for certain other individuals as
described in this notice will be $234.
DATES: Effective Date: This notice is
effective on January 1, 2014.
SUMMARY:
E:\FR\FM\30OCN1.SGM
30OCN1
64952
Federal Register / Vol. 78, No. 210 / Wednesday, October 30, 2013 / Notices
FOR FURTHER INFORMATION CONTACT:
Clare McFarland, (410) 786–6390.
SUPPLEMENTARY INFORMATION:
emcdonald on DSK67QTVN1PROD with NOTICES
I. Background
Section 1818 of the Social Security
Act (the Act) provides for voluntary
enrollment in the Medicare Hospital
Insurance Program (Medicare Part A),
subject to payment of a monthly
premium, of certain persons aged 65
and older who are uninsured under the
Old-Age, Survivors, and Disability
Insurance (OASDI) program or the
Railroad Retirement Act and do not
otherwise meet the requirements for
entitlement to Medicare Part A. 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 upcoming
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 the monthly actuarial rate for
the following year (the per capita
amount estimated above divided by 12)
and publish the dollar amount for the
monthly premium in the succeeding CY.
If the premium is not a multiple of $1,
the premium is rounded to the nearest
multiple of $1 (or, if it is a multiple of
50 cents but not of $1, it is rounded to
the next highest $1).
VerDate Mar<15>2010
16:58 Oct 29, 2013
Jkt 232001
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 2014 will be
equal to the premium for uninsured
aged enrollees reduced by 45 percent.
II. Monthly Premium Amount for CY
2014
The monthly premium for the
uninsured aged and certain disabled
individuals who have exhausted other
entitlement for the 12 months beginning
January 1, 2014, is $426.
The monthly premium for the
individuals eligible under Section
1818(d)(4)(B) of the Act, and therefore
subject to the 45 percent reduction in
the monthly premium, is $234.
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 2014
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.
PO 00000
Frm 00046
Fmt 4703
Sfmt 4703
We base our projections for CY 2014
on: (1) Current historical data, and (2)
projection assumptions derived from
current law and the Mid-Session Review
of the President’s Fiscal Year 2014
Budget.
We estimate that in CY 2014,
43,923,567 people aged 65 years and
over will be entitled to benefits (without
premium payment) and that they will
incur about $224.753 billion in benefits
and related administrative costs. Thus,
the estimated monthly average per
capita amount is $426.41 and the
monthly premium is $426.
Subsequently, the full monthly
premium reduced by 45 percent is $234.
IV. Costs to Beneficiaries
The CY 2014 premium of $426 is
approximately 3.40 percent lower than
the CY 2013 premium of $441. We
estimate that approximately 626,000
enrollees will voluntarily enroll in
Medicare Part A by paying the full
premium. Furthermore, the CY 2014
reduced premium of $234 is
approximately 3.70 percent lower than
the CY 2013 premium of $243. We
estimate an additional 55,000 enrollees
will pay the reduced premium.
Therefore, we estimate that the total
aggregate savings to enrollees paying
these premiums in CY 2014, compared
to the amount that they paid in CY
2013, will be about $119 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 2014
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
E:\FR\FM\30OCN1.SGM
30OCN1
Federal Register / Vol. 78, No. 210 / Wednesday, October 30, 2013 / Notices
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 Analysis
A. Statement of Need
Section 1818(d) of the Act requires
the Secretary of the Department of
Health and Human Services (the
Secretary) during September of each
year to determine and publish the
amount to be paid, on an average per
capita basis, from the Federal Hospital
Insurance Trust Fund for services
incurred in the impending 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.
emcdonald on DSK67QTVN1PROD with NOTICES
B. Overall Impact
We have examined the impacts of this
rule 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., Part I, Ch. 8).
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
notices 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 the changes in the Part A
premium will be a savings to voluntary
VerDate Mar<15>2010
16:58 Oct 29, 2013
Jkt 232001
enrollees (section 1818 and section
1818A of the Act) of about $119 million.
As a result, this notice is economically
significant under section 3(f)(1) of
Executive Order 12866 and thus, a
major action under the Congressional
Review Act. In accordance with the
provisions of Executive Order 12866,
this notice was reviewed by the Office
of Management and Budget.
The RFA requires agencies to analyze
options for regulatory relief of small
entities, if a rule has a significant impact
on a substantial number of small
entities. For purposes of the RFA, small
entities include small businesses,
nonprofit organizations, and small
governmental jurisdictions. Most
hospitals and most other providers and
suppliers are small entities, either by
nonprofit status or by having revenues
of less than $7.0 million to $35.5
million in any 1 year (for details, see the
Small Business Administration’s Web
site at https://www.sba.gov/sites/default/
files/files/Size_Standards_Table.pdf).
Individuals and states are not
included in the definition of a small
entity. As discussed above, this annual
notice announces Medicare’s Hospital
Insurance (Part A) premium for
uninsured enrollees in calendar year
(CY) 2014. As a result, we are not
preparing an analysis for the RFA
because the Secretary has determined
that this notice will not have a
significant economic impact on a
substantial number of small entities.
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. As discussed above, we are not
preparing an analysis for section 1102(b)
of the Act, because the Secretary has
determined that this notice will not
have a significant impact on the
operations of a substantial number of
small rural hospitals.
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 2013, that threshold is approximately
$141 million. This notice does not
impose mandates that will have a
consequential effect of $141 million or
PO 00000
Frm 00047
Fmt 4703
Sfmt 4703
64953
more on state, local, or tribal
governments or on the private sector.
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.
Since this notice does not impose any
costs on state or local governments, the
requirements of Executive Order 13132
are not applicable.
(Catalog of Federal Domestic Assistance
Program No. 93.773, Medicare—Hospital
Insurance)
Dated: September 20, 2013.
Marilyn Tavenner,
Administrator, Centers for Medicare &
Medicaid Services.
Dated: October 18, 2013.
Kathleen Sebelius,
Secretary.
[FR Doc. 2013–25591 Filed 10–28–13; 11:15 am]
BILLING CODE 4120–01–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Centers for Medicare & Medicaid
Services
[CMS–8053–N]
RIN 0938–AR59
Medicare Program; Inpatient Hospital
Deductible and Hospital and Extended
Care Services Coinsurance Amounts
for CY 2014
Centers for Medicare &
Medicaid Services (CMS), HHS.
ACTION: Notice.
AGENCY:
This notice announces the
inpatient hospital deductible and the
hospital and extended care services
coinsurance amounts for services
furnished in calendar year (CY) 2014
under Medicare’s Hospital Insurance
Program (Medicare Part A). The
Medicare statute specifies the formulae
used to determine these amounts. For
CY 2014, the inpatient hospital
deductible will be $1,216. The daily
coinsurance amounts for CY 2014 will
be: $304 for the 61st through 90th day
of hospitalization in a benefit period;
$608 for lifetime reserve days; and $152
for the 21st through 100th day of
extended care services in a skilled
nursing facility in a benefit period.
DATES: Effective Date: This notice is
effective on January 1, 2014.
FOR FURTHER INFORMATION CONTACT:
Clare McFarland, (410) 786–6390 for
SUMMARY:
E:\FR\FM\30OCN1.SGM
30OCN1
]]>Agencies
[Federal Register Volume 78, Number 210 (Wednesday, October 30, 2013)]
[Notices]
[Pages 64951-64953]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2013-25591]
-----------------------------------------------------------------------
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
[CMS-8054-N]
RIN 0938-AR57
Medicare Program; Part A Premiums for CY 2014 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) 2014.
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, 2014, for these individuals will be $426.
The premium for certain other individuals as described in this notice
will be $234.
DATES: Effective Date: This notice is effective on January 1, 2014.
[[Page 64952]]
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 upcoming 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 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 2014 will be equal to the premium for
uninsured aged enrollees reduced by 45 percent.
II. Monthly Premium Amount for CY 2014
The monthly premium for the uninsured aged and certain disabled
individuals who have exhausted other entitlement for the 12 months
beginning January 1, 2014, is $426.
The monthly premium for the individuals eligible under Section
1818(d)(4)(B) of the Act, and therefore subject to the 45 percent
reduction in the monthly premium, is $234.
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 2014
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 2014 on: (1) Current historical
data, and (2) projection assumptions derived from current law and the
Mid-Session Review of the President's Fiscal Year 2014 Budget.
We estimate that in CY 2014, 43,923,567 people aged 65 years and
over will be entitled to benefits (without premium payment) and that
they will incur about $224.753 billion in benefits and related
administrative costs. Thus, the estimated monthly average per capita
amount is $426.41 and the monthly premium is $426. Subsequently, the
full monthly premium reduced by 45 percent is $234.
IV. Costs to Beneficiaries
The CY 2014 premium of $426 is approximately 3.40 percent lower
than the CY 2013 premium of $441. We estimate that approximately
626,000 enrollees will voluntarily enroll in Medicare Part A by paying
the full premium. Furthermore, the CY 2014 reduced premium of $234 is
approximately 3.70 percent lower than the CY 2013 premium of $243. We
estimate an additional 55,000 enrollees will pay the reduced premium.
Therefore, we estimate that the total aggregate savings to enrollees
paying these premiums in CY 2014, compared to the amount that they paid
in CY 2013, will be about $119 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 2014 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
[[Page 64953]]
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 Analysis
A. Statement of Need
Section 1818(d) of the Act requires the Secretary of the Department
of Health and Human Services (the Secretary) during September of each
year to determine and publish the amount to be paid, on an average per
capita basis, from the Federal Hospital Insurance Trust Fund for
services incurred in the impending 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.
B. Overall Impact
We have examined the impacts of this rule 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., Part I, Ch. 8).
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 notices
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 the changes in the Part A premium will be a savings
to voluntary enrollees (section 1818 and section 1818A of the Act) of
about $119 million. As a result, this notice is economically
significant under section 3(f)(1) of Executive Order 12866 and thus, a
major action under the Congressional Review Act. In accordance with the
provisions of Executive Order 12866, this notice was reviewed by the
Office of Management and Budget.
The RFA requires agencies to analyze options for regulatory relief
of small entities, if a rule has a significant impact on a substantial
number of small entities. For purposes of the RFA, small entities
include small businesses, nonprofit organizations, and small
governmental jurisdictions. Most hospitals and most other providers and
suppliers are small entities, either by nonprofit status or by having
revenues of less than $7.0 million to $35.5 million in any 1 year (for
details, see the Small Business Administration's Web site at https://www.sba.gov/sites/default/files/files/Size_Standards_Table.pdf).
Individuals and states are not included in the definition of a
small entity. As discussed above, this annual notice announces
Medicare's Hospital Insurance (Part A) premium for uninsured enrollees
in calendar year (CY) 2014. As a result, we are not preparing an
analysis for the RFA because the Secretary has determined that this
notice will not have a significant economic impact on a substantial
number of small entities.
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. As discussed above, we are not preparing an
analysis for section 1102(b) of the Act, because the Secretary has
determined that this notice will not have a significant impact on the
operations of a substantial number of small rural hospitals.
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 2013, that
threshold is approximately $141 million. This notice does not impose
mandates that will have a consequential effect of $141 million or more
on state, local, or tribal governments or on the private sector.
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. Since this notice does not impose any costs on state or
local governments, the requirements of Executive Order 13132 are not
applicable.
(Catalog of Federal Domestic Assistance Program No. 93.773,
Medicare--Hospital Insurance)
Dated: September 20, 2013.
Marilyn Tavenner,
Administrator, Centers for Medicare & Medicaid Services.
Dated: October 18, 2013.
Kathleen Sebelius,
Secretary.
[FR Doc. 2013-25591 Filed 10-28-13; 11:15 am]
BILLING CODE 4120-01-P
