Announcement of Ruling: Implementing United States v. Windsor for Purposes of Entitlement and Enrollment in Medicare Hospital Insurance and Supplementary Medical Insurance, 7975-7977 [2015-03069]
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Federal Register / Vol. 80, No. 30 / Friday, February 13, 2015 / Rules and Regulations
described under Title II of the Unfunded
Mandates Reform Act (UMRA) (2 U.S.C.
1501 et seq.).
This action does not involve any
technical standards that would require
Agency consideration of voluntary
consensus standards pursuant to section
12(d) of the National Technology
Transfer and Advancement Act
(NTTAA) (15 U.S.C. 272 note).
VII. Congressional Review Act
Pursuant to the Congressional Review
Act (5 U.S.C. 801 et seq.), EPA will
submit a report containing this rule and
other required information to the U.S.
Senate, the U.S. House of
Representatives, and the Comptroller
General of the United States prior to
publication of the rule in the Federal
Register. This action is not a ‘‘major
rule’’ as defined by 5 U.S.C. 804(2).
List of Subjects in 40 CFR Part 180
Environmental protection,
Administrative practice and procedure,
Agricultural commodities, Pesticides
and pests, Reporting and recordkeeping
requirements.
Dated: February 6, 2015.
Daniel J. Rosenblatt,
Director, Registration Division, Office of
Pesticide Programs.
Therefore, 40 CFR chapter I is
amended as follows:
PART 180—AMENDED
1. The authority citation for part 180
continues to read as follows:
■
Authority: 21 U.S.C. 321(q), 346a and 371.
2. In § 180.518, alphabetically add the
commodity ‘‘Pomegranate’’ to the table
in paragraph (a)(1) to read as follows:
Rmajette on DSK2VPTVN1PROD with RULES
■
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Centers for Medicare & Medicaid
Services
BILLING CODE 6560–50–P
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Dated: February 9, 2015.
Marilyn Tavenner,
Administrator, Centers for Medicare &
Medicaid Services.
APPENDIX
42 CFR Parts 406, 407, and 408
CMS Rulings
[CMS–4176–NR]
Department of Health and Human
Services
Announcement of Ruling:
Implementing United States v. Windsor
for Purposes of Entitlement and
Enrollment in Medicare Hospital
Insurance and Supplementary Medical
Insurance
Centers for Medicare &
Medicaid Services (CMS), HHS.
ACTION: Notice of CMS ruling.
AGENCY:
This document announces a
CMS Ruling that states the CMS policies
for implementing United States v.
Windsor (‘‘Windsor’’), in which the
Supreme Court held that section 3 of the
Defense of Marriage Act (DOMA),
enacted in 1996, is unconstitutional.
Section 3 of DOMA defined ‘‘marriage’’
and ‘‘spouse’’ as excluding same-sex
marriages and same-sex spouses, and
effectively precluded the Federal
government from recognizing same-sex
marriages and spouses.
DATES: The CMS ruling announced in
this document is applicable beginning
February 9, 2015, with respect to
appeals pending on, initiated, or
reopened in accordance with applicable
rules after February 9, 2015, for
entitlement and enrollment
determinations made on or after June
26, 2013. This ruling does not apply to
appeals of entitlement and enrollment
determinations made before June 26,
2013.
SUMMARY:
FOR FURTHER INFORMATION CONTACT:
Patty Helphenstine (410) 786–0622.
In
‘‘Windsor,’’ (570 U.S. 12, 133 S. Ct. 2675
§ 180.518 Pyrimethanil; tolerance for
(2013), the Supreme Court held that
residues.
section 3 of the Defense of Marriage Act
(a) * * *
(DOMA), enacted in 1996 (codified at 1
U.S.C. 7), is unconstitutional.
(1) * * *
The CMS Administrator signed Ruling
CMS–4176–R on February 9, 2015. This
Parts per
Commodity
CMS Ruling, as well as other CMS
million
Rulings are available at https://
www.cms.gov/Regulations-and*
*
*
*
*
Guidance/Guidance/Rulings/
Pomegranate ..............................
5.0 index.html. For the readers’
convenience, the text of the CMS Ruling
*
*
*
*
*
4176–R is set forth in the Appendix to
this notice of CMS ruling.
*
*
*
*
*
[FR Doc. 2015–02949 Filed 2–12–15; 8:45 am]
7975
SUPPLEMENTARY INFORMATION:
(Catalog of Federal Domestic Assistance
Program No. 93.773, Medicare—Hospital
Insurance; and Program No. 93.774,
Medicare—Supplementary Medical
Insurance Program)
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Centers for Medicare & Medicaid
Services
Ruling No.: CMS–4176–R
Date: February 9, 2015
Centers for Medicare & Medicaid
Services (CMS) Rulings are decisions of
the Administrator of CMS that serve as
precedential final opinions, orders and
statements of policy and interpretation.
They provide clarification and
interpretation of complex provisions of
the law or regulations relating to
Medicare, Medicaid, Utilization and
Quality Control Peer Review, private
health insurance, and related matters.
They are published under the authority
of the Administrator.
CMS Rulings are binding on all CMS
components, Part A and Part B Medicare
Administrative Contractors (MACs),
Qualified Independent Contractors
(QICs), the Provider Reimbursement
Review Board, the Medicare Geographic
Classification Review Board, and on the
Medicare Appeals Council and
Administrative Law Judges (ALJs) who
hear Medicare appeals. Rulings promote
consistency in interpretation of policy
and adjudication of disputes.
This Ruling states the CMS policies
for implementing United States v.
Windsor, 570 U.S. 12, 133 S. Ct. 2675
(2013) (‘‘Windsor’’), in which the
Supreme Court held that section 3 of the
Defense of Marriage Act (DOMA),
enacted in 1996 (codified at 1 U.S.C. 7),
is unconstitutional. Section 3 of DOMA
defined ‘‘marriage’’ and ‘‘spouse’’ as
excluding same-sex marriages and samesex spouses, and effectively precluded
the Federal government from
recognizing same-sex marriages and
spouses.
MEDICARE PROGRAM
Entitlement and Enrollment in
Medicare Hospital Insurance (Part A)
and Medicare Supplementary Medical
Insurance (Part B)
CITATIONS: Sections 216(h), 226,
226A, 1818(c)–(d), 1837(i) and 1839 of
the Social Security Act (42 U.S.C.
Sections 416, 426, 426–1, 1395i–2,
1395p and 1395r); 42 CFR 406.5, 406.10,
406.13, 406.24, 406.32(c)–(d), 406.33,
406.34, 407.20, 407.22(a)(5), 407.25(c),
407.27(b), 408.22 and 408.24.
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7976
Federal Register / Vol. 80, No. 30 / Friday, February 13, 2015 / Rules and Regulations
BACKGROUND
Section 3 of the Defense of Marriage
Act (DOMA), enacted in 1996 (codified
at 1 U.S.C. 7), defined ‘‘marriage’’ and
‘‘spouse’’ as follows: ‘‘The word
‘marriage’ means only a legal union
between one man and one woman as
husband and wife, and the word
‘spouse’ refers only to a person of the
opposite sex who is a husband or a
wife.’’ However, in June 2013, the
United States Supreme Court ruled that
Section 3 of DOMA is unconstitutional.
United States v. Windsor, 570 U.S. 12,
133 S. Ct. 2675 (2013) (‘‘Windsor’’).
After the Supreme Court’s opinion in
Windsor, section 3 of DOMA no longer
prohibits the Federal government from
recognizing same-sex marriages when
administering Federal statutes and
programs and no longer controls the
definition and recognition of a marital
relationship in that context.
Marital status is relevant to certain
Medicare entitlements, premiums,
benefits, and enrollment provisions.
This Ruling provides binding CMS
policy for the application of these
provisions in the context of a same-sex
marriage.
RULING
This Ruling states the CMS policies
for implementing United States v.
Windsor, 570 U.S. 12, 133 S. Ct. 2675
(2013) for purposes of certain
entitlement, eligibility and enrollment
provisions for Medicare. Note that the
rules for recognizing a same-sex
marriage (and treatment of a same-sex
relationship that is not a marriage) for
purposes of eligibility and entitlement
controlled by Title II of the Social
Security Act (the Act) are different than
the rules for recognizing a same-sex
marriage (and treatment of a same-sex
relationship that is not a marriage) for
benefits provided under Title XVIII of
the Act.
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POLICY
Because section 3 of DOMA is
unconstitutional, it no longer defines or
controls the recognition of a marital
relationship by the Federal government.
In the absence of controlling law to the
contrary, the Department of Health and
Human Services (HHS) has adopted a
policy of treating same-sex marriages on
the same terms as opposite-sex
marriages to the greatest extent
reasonably possible and of recognizing
marriages between individuals of the
same sex who were lawfully married
under the law of the state, territory, or
foreign jurisdiction where the marriage
was entered into (‘‘celebration rule’’),
regardless of where the couple resides.
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As a general matter, for determinations
made solely under Title II of the Act, we
note that rules applicable specifically to
Title II of the Act apply. In addition, for
determinations made under Title XVIII,
we note that rules applicable
specifically to Title XVIII of the Act
apply.
Title II Provisions
Title II determinations within the
scope of this Ruling are eligibility for
Medicare based on age or end-stage
renal disease under sections 226 and
226A of the Act. Section 216 of the Act
explicitly provides the definitions of
terms describing the marital
relationship and directs recognition and
deeming of marital relationships for all
of Title II of the Act. As a result, section
216 of the Act is the controlling
provision in determining family and
marital status for purposes of eligibility
for Medicare when eligibility is based
on a provision under Title II of the Act.
Section 216(h)(1)(A)(i) explicitly
controls recognition of a marriage:
An applicant is the wife, husband,
widow, or widower of a fully or
currently insured individual for
purposes of this subchapter if the courts
of the State in which such insured
individual is domiciled at the time such
applicant files an application, or, if such
insured individual is dead, the courts of
the State in which he was domiciled at
the time of death, or, if such insured
individual is or was not so domiciled in
any State, the courts of the District of
Columbia, would find that such
applicant and such insured individual
were validly married at the time such
applicant files such application or, if
such insured individual is dead, at the
time he died.
The Social Security Administration
(SSA) has issued policies interpreting
and implementing section 216 of the
Act in the context of same-sex marriages
and other relationships. Generally, such
policies look to the law of the domicile
of the social security number holder to
determine whether to recognize a
marriage. Such interpretations of section
216(h) are applicable for purposes of
entitlement and eligibility
determinations under sections 226 and
226A. The SSA has interpreted and
directed the application of section
216(h) in the following Program
Operations Manual System (POMS)
sections issued by SSA:
• GN 00210.002: Same-Sex
Marriage—Determining Marital Status
for Title II and Medicare Benefits.
• GN 00210.003: Same-Sex
Marriage—Dates States Permitted or
Recognized Same-Sex Marriage.
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Frm 00010
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• GN 00210.004: Non-Marital
Relationships (Such as Civil Unions and
Domestic Partnerships).
• GN 00210.006: Same-Sex Marriages
Celebrated in Foreign Jurisdictions.
CMS follows SSA interpretations on
the application of section 216(h) to same
sex marriages and same sex spouses for
purposes of Title II. CMS policy
illustrating the application of these
policies to determinations made under
sections 226 and 226A is articulated in
the following POMS sections issued by
SSA:
Entitlement under section 226 and 42
CFR 406.5 and 406.10:
• GN 00210.100: Same-Sex Marriage
and Non-Marital Legal Relationships—
Benefits for Aged Spouses.
• GN 00210.400: Same-Sex
Marriage—Benefits for Surviving
Spouses.
Entitlement under section 226A and
42 CFR 406.5 and 406.13:
• GN 00210.705: Same-Sex
Marriage—Medicare Based on End-Stage
Renal Disease (ESRD).
Title XVIII Provisions
There are no controlling provisions in
Title XVIII of the Act or regulations
implementing the Title XVIII provisions
within the scope of this Ruling that
define or direct recognition or deeming
of marital relationships. Therefore, CMS
has adopted a policy of interpreting
sections 1818(d), 1837(i) and 1839 of the
Act in a manner that treats same-sex
marriages on the same terms as
opposite-sex marriages to the greatest
extent reasonably possible and uses a
celebration rule where possible.
‘‘Celebration rule’’ means that a samesex marriage is recognized and treated
as a lawful marriage (where marital
status is relevant to a determination of
entitlement) if the same-sex marriage
was lawful where and when it occurred.
Individuals in non-marital same-sex
relationships (such as domestic
partnerships or civil unions that are not
marriages) are not considered married.
The SSA processes applications and
initial eligibility determinations under
these statutes by applying CMS policy.
CMS policy for the implementation of
Windsor in the context of these Title
XVIII provisions is articulated in the
POMS sections issued by the SSA as
follows:
Calculation of hospital insurance
(Part A) premium under section 1818(d)
and 42 CFR 406.32(c):
• GN 00210.706: Same-Sex
Marriage—HI Premium Reduction for
Aged and Disabled Individuals.
Eligibility for a special enrollment
period based on enrollment in a group
health plan by reason of a spouse’s
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Federal Register / Vol. 80, No. 30 / Friday, February 13, 2015 / Rules and Regulations
adjacent television band as
expeditiously as possible.
DATES: Effective February 13, 2015.
FOR FURTHER INFORMATION CONTACT:
Jeremy Miller, Jeremy.Miller@fcc.gov,
Media Bureau, (202) 418–1507.
SUPPLEMENTARY INFORMATION: This is a
synopsis of the Commission’s Report
and Order, MB Docket No. 14–245,
adopted February 9, 2015, and released
February 9, 2015. The full text of this
document is available for public
inspection and copying during normal
business hours in the FCC’s Reference
Information Center at Portals II, CY–
A257, 445 12th Street SW., Washington,
EFFECTIVE DATE
DC 20554. This document will also be
This Ruling is effective on February 9, available via ECFS (https://
fjallfoss.fcc.gov/ecfs/). To request
2015, with respect to appeals on,
materials in accessible formats for
initiated, or reopened in accordance
people with disabilities (braille, large
with applicable rules after February 9,
print, electronic files, audio format),
2015, for entitlement and enrollment
send an email to fcc504@fcc.gov or call
determinations made on or after June
the Consumer & Governmental Affairs
26, 2013. This ruling does not apply to
Bureau at 202–418–0530 (voice), 202–
appeals of entitlement and enrollment
418–0432 (tty).
determinations made before June 26,
This document does not contain
2013.
information collection requirements
Dated: February 9, 2015
llllllllllllllllll
l subject to the Paperwork Reduction Act
of 1995, Public Law 104–13. In addition,
Marilyn Tavenner,
therefore, it does not contain any
Administrator, Centers for Medicare &
information collection burden ‘‘for
Medicaid Services.
small business concerns with fewer than
[FR Doc. 2015–03069 Filed 2–12–15; 8:45 am]
25 employees,’’ pursuant to the Small
BILLING CODE 4120–01–P
Business Paperwork Relief Act of 2002,
Public Law 107–198, see 44 U.S.C.
3506(c)(4). Provisions of the Regulatory
FEDERAL COMMUNICATIONS
Flexibility Act of 1980 do not apply to
COMMISSION
this proceeding.
The Commission will send a copy of
47 CFR Part 73
the Report and Order in a report to be
sent to Congress and the Government
[MB Docket No. 14–245, RM–11740; DA 15–
Accountability Office pursuant to the
150]
Congressional review Act, see 5 U.S.C.
801(a)(1)(A).
Television Broadcasting Services;
Longview, Texas
List of Subjects in 47 CFR Part 73
current employment under sections
1818(c) and 1837(i) and 42 CFR 406.24,
407.20, 407.22, 407.25, and 407.27:
• GN 00210.700: Same-Sex
Marriage—Eligibility for Medicare
Special Enrollment Period (SEP).
Calculation of late enrollment penalty
for premium hospital insurance
(Premium Part A) and supplemental
medical insurance (Part B) under
section 1818(c) and 1839 and 42 CFR
406.32(d), 406.33, 406.34, 408.22, and
408.24:
• GN 00210.701: Same-Sex
Marriage—Premium Surcharge
Rollback.
Federal Communications
Commission.
ACTION: Final rule.
AGENCY:
A petition for rulemaking was
filed by KCEB License Company, LLC
(‘‘KCEB License’’), the licensee of
KCEB(TV), channel 51, Longview,
Texas, requesting the substitution of
channel 26 for channel 51 at Longview.
KCEB License filed comments
reaffirming its interest in the proposed
channel substitution and explained that
the channel substitution will replicate
KCEB(TV)’s current coverage area on
channel 51 and serve 34,104 more
persons than the current channel 51
facility. This will eliminate any
potential interference with wireless
operations in the Lower 700 MHz A
Block and facilitate the clearing of the
SUMMARY:
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Television.
VerDate Sep<11>2014
11:18 Feb 12, 2015
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Federal Communications Commission.
Barbara A. Kreisman,
Chief, Video Division, Media Bureau.
For the reasons discussed in the
preamble, the Federal Communications
Commission amends 47 CFR part 73 as
follows:
PART 73—RADIO BROADCAST
SERVICES
1. The authority citation for part 73
continues to read as follows:
■
Authority: 47 U.S.C. 154, 303, 334, 336,
and 339.
§ 73.622
[Amended]
2. Section 73.622(i), the PostTransition Table of DTV Allotments
■
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7977
under Texas is amended by removing
channel 51 and adding channel 26 at
Longview.
[FR Doc. 2015–03168 Filed 2–12–15; 8:45 am]
BILLING CODE 6712–01–P
DEPARTMENT OF COMMERCE
National Oceanic and Atmospheric
Administration
50 CFR Parts 223 and 224
[Docket No. 130404330–5117–03]
RIN 0648–BC76
Endangered and Threatened Species;
Designation of Critical Habitat for the
Puget Sound/Georgia Basin Distinct
Population Segments of Yelloweye
Rockfish, Canary Rockfish and
Bocaccio; Correction
National Marine Fisheries
Service (NMFS), National Oceanic and
Atmospheric Administration (NOAA),
Commerce.
ACTION: Correcting amendment.
AGENCY:
This action corrects an
omission in the final rule to designate
critical habitat for three DPSs of rockfish
from the Puget Sound/Georgia Basin.
The final rule for ‘‘Designation of
Critical Habitat for the Puget Sound/
Georgia Basin Distinct Population
Segments of Yelloweye Rockfish,
Canary Rockfish and Bocaccio’’ failed to
update the columns labeled ‘‘Critical
habitat,’’ in the tables of threatened and
endangered species to cross reference
these new rules. Therefore, this
document corrects the tables by citing
the critical habitat designations in the
columns of the tables.
DATES: This final rule is effective
February 11, 2015.
ADDRESSES: Information regarding this
final rule may be obtained by contacting
NMFS, Endangered Species Division,
1315 East West Highway, Silver Spring,
MD 20910.
FOR FURTHER INFORMATION CONTACT: Dr.
Dwayne Meadows, NMFS, Office of
Protected Resources (301) 427–8403.
SUPPLEMENTARY INFORMATION:
SUMMARY:
Need for Correction
In a final rule NMFS published on
November 13, 2014 (79 FR 68041) to
designate critical habitat for 3 DPSs of
rockfishes, we did not update the
columns labeled ‘‘Critical habitat’’ in
the tables of threatened and endangered
species in 50 CFR 223.102(e) and 50
CFR 224.101(h), respectively, to cross
reference these new rules.
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Agencies
[Federal Register Volume 80, Number 30 (Friday, February 13, 2015)]
[Rules and Regulations]
[Pages 7975-7977]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2015-03069]
=======================================================================
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
42 CFR Parts 406, 407, and 408
[CMS-4176-NR]
Announcement of Ruling: Implementing United States v. Windsor for
Purposes of Entitlement and Enrollment in Medicare Hospital Insurance
and Supplementary Medical Insurance
AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS.
ACTION: Notice of CMS ruling.
-----------------------------------------------------------------------
SUMMARY: This document announces a CMS Ruling that states the CMS
policies for implementing United States v. Windsor (``Windsor''), in
which the Supreme Court held that section 3 of the Defense of Marriage
Act (DOMA), enacted in 1996, is unconstitutional. Section 3 of DOMA
defined ``marriage'' and ``spouse'' as excluding same-sex marriages and
same-sex spouses, and effectively precluded the Federal government from
recognizing same-sex marriages and spouses.
DATES: The CMS ruling announced in this document is applicable
beginning February 9, 2015, with respect to appeals pending on,
initiated, or reopened in accordance with applicable rules after
February 9, 2015, for entitlement and enrollment determinations made on
or after June 26, 2013. This ruling does not apply to appeals of
entitlement and enrollment determinations made before June 26, 2013.
FOR FURTHER INFORMATION CONTACT: Patty Helphenstine (410) 786-0622.
SUPPLEMENTARY INFORMATION: In ``Windsor,'' (570 U.S. 12, 133 S. Ct.
2675 (2013), the Supreme Court held that section 3 of the Defense of
Marriage Act (DOMA), enacted in 1996 (codified at 1 U.S.C. 7), is
unconstitutional.
The CMS Administrator signed Ruling CMS-4176-R on February 9, 2015.
This CMS Ruling, as well as other CMS Rulings are available at https://www.cms.gov/Regulations-and-Guidance/Guidance/Rulings/. For
the readers' convenience, the text of the CMS Ruling 4176-R is set
forth in the Appendix to this notice of CMS ruling.
(Catalog of Federal Domestic Assistance Program No. 93.773,
Medicare--Hospital Insurance; and Program No. 93.774, Medicare--
Supplementary Medical Insurance Program)
Dated: February 9, 2015.
Marilyn Tavenner,
Administrator, Centers for Medicare & Medicaid Services.
APPENDIX
CMS Rulings
Department of Health and Human Services
Centers for Medicare & Medicaid Services
Ruling No.: CMS-4176-R
Date: February 9, 2015
Centers for Medicare & Medicaid Services (CMS) Rulings are
decisions of the Administrator of CMS that serve as precedential final
opinions, orders and statements of policy and interpretation. They
provide clarification and interpretation of complex provisions of the
law or regulations relating to Medicare, Medicaid, Utilization and
Quality Control Peer Review, private health insurance, and related
matters. They are published under the authority of the Administrator.
CMS Rulings are binding on all CMS components, Part A and Part B
Medicare Administrative Contractors (MACs), Qualified Independent
Contractors (QICs), the Provider Reimbursement Review Board, the
Medicare Geographic Classification Review Board, and on the Medicare
Appeals Council and Administrative Law Judges (ALJs) who hear Medicare
appeals. Rulings promote consistency in interpretation of policy and
adjudication of disputes.
This Ruling states the CMS policies for implementing United States
v. Windsor, 570 U.S. 12, 133 S. Ct. 2675 (2013) (``Windsor''), in which
the Supreme Court held that section 3 of the Defense of Marriage Act
(DOMA), enacted in 1996 (codified at 1 U.S.C. 7), is unconstitutional.
Section 3 of DOMA defined ``marriage'' and ``spouse'' as excluding
same-sex marriages and same-sex spouses, and effectively precluded the
Federal government from recognizing same-sex marriages and spouses.
MEDICARE PROGRAM
Entitlement and Enrollment in Medicare Hospital Insurance (Part A)
and Medicare Supplementary Medical Insurance (Part B)
CITATIONS: Sections 216(h), 226, 226A, 1818(c)-(d), 1837(i) and
1839 of the Social Security Act (42 U.S.C. Sections 416, 426, 426-1,
1395i-2, 1395p and 1395r); 42 CFR 406.5, 406.10, 406.13, 406.24,
406.32(c)-(d), 406.33, 406.34, 407.20, 407.22(a)(5), 407.25(c),
407.27(b), 408.22 and 408.24.
[[Page 7976]]
BACKGROUND
Section 3 of the Defense of Marriage Act (DOMA), enacted in 1996
(codified at 1 U.S.C. 7), defined ``marriage'' and ``spouse'' as
follows: ``The word `marriage' means only a legal union between one man
and one woman as husband and wife, and the word `spouse' refers only to
a person of the opposite sex who is a husband or a wife.'' However, in
June 2013, the United States Supreme Court ruled that Section 3 of DOMA
is unconstitutional. United States v. Windsor, 570 U.S. 12, 133 S. Ct.
2675 (2013) (``Windsor''). After the Supreme Court's opinion in
Windsor, section 3 of DOMA no longer prohibits the Federal government
from recognizing same-sex marriages when administering Federal statutes
and programs and no longer controls the definition and recognition of a
marital relationship in that context.
Marital status is relevant to certain Medicare entitlements,
premiums, benefits, and enrollment provisions. This Ruling provides
binding CMS policy for the application of these provisions in the
context of a same-sex marriage.
RULING
This Ruling states the CMS policies for implementing United States
v. Windsor, 570 U.S. 12, 133 S. Ct. 2675 (2013) for purposes of certain
entitlement, eligibility and enrollment provisions for Medicare. Note
that the rules for recognizing a same-sex marriage (and treatment of a
same-sex relationship that is not a marriage) for purposes of
eligibility and entitlement controlled by Title II of the Social
Security Act (the Act) are different than the rules for recognizing a
same-sex marriage (and treatment of a same-sex relationship that is not
a marriage) for benefits provided under Title XVIII of the Act.
POLICY
Because section 3 of DOMA is unconstitutional, it no longer defines
or controls the recognition of a marital relationship by the Federal
government. In the absence of controlling law to the contrary, the
Department of Health and Human Services (HHS) has adopted a policy of
treating same-sex marriages on the same terms as opposite-sex marriages
to the greatest extent reasonably possible and of recognizing marriages
between individuals of the same sex who were lawfully married under the
law of the state, territory, or foreign jurisdiction where the marriage
was entered into (``celebration rule''), regardless of where the couple
resides. As a general matter, for determinations made solely under
Title II of the Act, we note that rules applicable specifically to
Title II of the Act apply. In addition, for determinations made under
Title XVIII, we note that rules applicable specifically to Title XVIII
of the Act apply.
Title II Provisions
Title II determinations within the scope of this Ruling are
eligibility for Medicare based on age or end-stage renal disease under
sections 226 and 226A of the Act. Section 216 of the Act explicitly
provides the definitions of terms describing the marital relationship
and directs recognition and deeming of marital relationships for all of
Title II of the Act. As a result, section 216 of the Act is the
controlling provision in determining family and marital status for
purposes of eligibility for Medicare when eligibility is based on a
provision under Title II of the Act. Section 216(h)(1)(A)(i) explicitly
controls recognition of a marriage:
An applicant is the wife, husband, widow, or widower of a fully or
currently insured individual for purposes of this subchapter if the
courts of the State in which such insured individual is domiciled at
the time such applicant files an application, or, if such insured
individual is dead, the courts of the State in which he was domiciled
at the time of death, or, if such insured individual is or was not so
domiciled in any State, the courts of the District of Columbia, would
find that such applicant and such insured individual were validly
married at the time such applicant files such application or, if such
insured individual is dead, at the time he died.
The Social Security Administration (SSA) has issued policies
interpreting and implementing section 216 of the Act in the context of
same-sex marriages and other relationships. Generally, such policies
look to the law of the domicile of the social security number holder to
determine whether to recognize a marriage. Such interpretations of
section 216(h) are applicable for purposes of entitlement and
eligibility determinations under sections 226 and 226A. The SSA has
interpreted and directed the application of section 216(h) in the
following Program Operations Manual System (POMS) sections issued by
SSA:
GN 00210.002: Same-Sex Marriage--Determining Marital
Status for Title II and Medicare Benefits.
GN 00210.003: Same-Sex Marriage--Dates States Permitted or
Recognized Same-Sex Marriage.
GN 00210.004: Non-Marital Relationships (Such as Civil
Unions and Domestic Partnerships).
GN 00210.006: Same-Sex Marriages Celebrated in Foreign
Jurisdictions.
CMS follows SSA interpretations on the application of section
216(h) to same sex marriages and same sex spouses for purposes of Title
II. CMS policy illustrating the application of these policies to
determinations made under sections 226 and 226A is articulated in the
following POMS sections issued by SSA:
Entitlement under section 226 and 42 CFR 406.5 and 406.10:
GN 00210.100: Same-Sex Marriage and Non-Marital Legal
Relationships--Benefits for Aged Spouses.
GN 00210.400: Same-Sex Marriage--Benefits for Surviving
Spouses.
Entitlement under section 226A and 42 CFR 406.5 and 406.13:
GN 00210.705: Same-Sex Marriage--Medicare Based on End-
Stage Renal Disease (ESRD).
Title XVIII Provisions
There are no controlling provisions in Title XVIII of the Act or
regulations implementing the Title XVIII provisions within the scope of
this Ruling that define or direct recognition or deeming of marital
relationships. Therefore, CMS has adopted a policy of interpreting
sections 1818(d), 1837(i) and 1839 of the Act in a manner that treats
same-sex marriages on the same terms as opposite-sex marriages to the
greatest extent reasonably possible and uses a celebration rule where
possible. ``Celebration rule'' means that a same-sex marriage is
recognized and treated as a lawful marriage (where marital status is
relevant to a determination of entitlement) if the same-sex marriage
was lawful where and when it occurred. Individuals in non-marital same-
sex relationships (such as domestic partnerships or civil unions that
are not marriages) are not considered married.
The SSA processes applications and initial eligibility
determinations under these statutes by applying CMS policy. CMS policy
for the implementation of Windsor in the context of these Title XVIII
provisions is articulated in the POMS sections issued by the SSA as
follows:
Calculation of hospital insurance (Part A) premium under section
1818(d) and 42 CFR 406.32(c):
GN 00210.706: Same-Sex Marriage--HI Premium Reduction for
Aged and Disabled Individuals.
Eligibility for a special enrollment period based on enrollment in
a group health plan by reason of a spouse's
[[Page 7977]]
current employment under sections 1818(c) and 1837(i) and 42 CFR
406.24, 407.20, 407.22, 407.25, and 407.27:
GN 00210.700: Same-Sex Marriage--Eligibility for Medicare
Special Enrollment Period (SEP).
Calculation of late enrollment penalty for premium hospital
insurance (Premium Part A) and supplemental medical insurance (Part B)
under section 1818(c) and 1839 and 42 CFR 406.32(d), 406.33, 406.34,
408.22, and 408.24:
GN 00210.701: Same-Sex Marriage--Premium Surcharge
Rollback.
EFFECTIVE DATE
This Ruling is effective on February 9, 2015, with respect to
appeals on, initiated, or reopened in accordance with applicable rules
after February 9, 2015, for entitlement and enrollment determinations
made on or after June 26, 2013. This ruling does not apply to appeals
of entitlement and enrollment determinations made before June 26, 2013.
Dated: February 9, 2015
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Marilyn Tavenner,
Administrator, Centers for Medicare & Medicaid Services.
[FR Doc. 2015-03069 Filed 2-12-15; 8:45 am]
BILLING CODE 4120-01-P