Medicare Program; CY 2016 Part A Premiums for the Uninsured Aged and for Certain Disabled Individuals Who Have Exhausted Other Entitlement, 70805-70807 [2015-29176]
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Federal Register / Vol. 80, No. 220 / Monday, November 16, 2015 / Notices
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Dated: November 9, 2015.
Karen White,
Executive Assistant.
[FR Doc. 2015–29002 Filed 11–13–15; 8:45 am]
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DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Centers for Medicare & Medicaid
Services
[CMS–8060–N]
RIN 0938–AS37
Medicare Program; CY 2016 Part A
Premiums 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) 2016. 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, 2016, for
these individuals will be $411. The
premium for certain other individuals as
described in this notice will be $226.
DATES: Effective Date: This notice is
effective on January 1, 2016.
FOR FURTHER INFORMATION CONTACT:
Clare McFarland, (410) 786–6390.
SUPPLEMENTARY INFORMATION:
SUMMARY:
I. Background
Section 1818 of the Social Security
Act (the Act) provides for voluntary
enrollment in the Medicare Hospital
Insurance Program (Medicare Part A),
subject to payment of a monthly
premium, of certain persons aged 65
and older who are uninsured under the
Old-Age, Survivors, and Disability
Insurance (OASDI) program or the
Railroad Retirement Act and do not
otherwise meet the requirements for
entitlement to Medicare Part A. These
‘‘uninsured aged’’ individuals are
uninsured under the OASDI program or
the Railroad Retirement Act, because
they do not have 40 quarters of coverage
under Title II of the Act (or are/were not
married to someone who did). (Persons
insured under the OASDI program or
the Railroad Retirement Act and certain
others do not have to pay premiums for
Medicare Part A.)
Section 1818A of the Act provides for
voluntary enrollment in Medicare Part
A, subject to payment of a monthly
premium for certain disabled
individuals who have exhausted other
entitlement. These are individuals who
were entitled to coverage due to a
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70805
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)(1) 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 2016 will be
equal to the premium for uninsured
aged enrollees reduced by 45 percent.
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Federal Register / Vol. 80, No. 220 / Monday, November 16, 2015 / Notices
II. Monthly Premium Amount for CY
2016
The monthly premium for the
uninsured aged and certain disabled
individuals who have exhausted other
entitlement for the 12 months beginning
January 1, 2016, is $411.
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 $226.
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 2016
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 Medicare
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 2016
on—(1) current historical data; and (2)
projection assumptions derived from
current law and the Mid-Session Review
of the President’s Fiscal Year 2016
Budget.
We estimate that in CY 2016,
47,251,107 people aged 65 years and
over will be entitled to benefits (without
premium payment) and that they will
incur about $233.221 billion in benefits
and related administrative costs. Thus,
the estimated monthly average per
capita amount is $411.31 and the
monthly premium is $411.
Subsequently, the full monthly
premium reduced by 45 percent is $226.
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IV. Costs to Beneficiaries
The CY 2016 premium of $411 is
approximately 1 percent higher than the
CY 2015 premium of $407. We estimate
that approximately 652,000 enrollees
will voluntarily enroll in Medicare Part
A, by paying the full premium.
Furthermore, the CY 2016 reduced
premium of $226 is approximately 0.9
percent higher than the CY 2015
premium of $224. We estimate an
additional 61,000 enrollees will pay the
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reduced premium. Therefore, we
estimate that the total aggregate cost to
enrollees paying these premiums in CY
2016, compared to the amount that they
paid in CY 2015, will be about $32
million.
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.
V. Waiver of Proposed Notice and
Comment Period
B. Overall Impact
We have examined the impact 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 cost to voluntary
enrollees (section 1818 and section
1818A of the Act) of about $32 million.
As a result, this notice is noneconomically significant under section
3(f)(1) of Executive Order 12866 and is
not 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 $7.5 million to $38.5
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
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 2016
as that procedure is unnecessary
because of the lack of discretion in the
statutory formula that is used to
calculate the premium and the solely
ministerial function that this notice
serves. The APA permits agencies to
waive notice and comment rulemaking
when notice and public comment
thereon are unnecessary. On this basis,
we waive publication of a proposed
notice and a solicitation of public
comments.
VI. Collection of Information
Requirements
This document does not impose
information collection requirements,
that is, reporting, recordkeeping or
third-party disclosure requirements.
Consequently, there is no need for
review by the Office of Management and
Budget under the authority of the
Paperwork Reduction Act of 1995 (44
U.S.C. 3501 et seq.).
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
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Federal Register / Vol. 80, No. 220 / Monday, November 16, 2015 / Notices
tkelley on DSK3SPTVN1PROD with NOTICES
entity. As discussed above, this annual
notice announces Medicare’s Hospital
Insurance (Part A) premium for
uninsured enrollees in calendar year
(CY) 2016. 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 2015, that threshold is approximately
$144 million. This notice does not
impose mandates that will have a
consequential effect of $144 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.
Dated: November 6, 2015.
Andrew M. Slavitt,
Acting Administrator, Centers for Medicare
& Medicaid Services.
Dated: November 9, 2015
Sylvia M. Burwell,
Secretary, Department of Health and Human
Services.
[FR Doc. 2015–29176 Filed 11–10–15; 4:15 pm]
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DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Centers for Medicare & Medicaid
Services
[Document Identifiers: CMS–3427]
Agency Information Collection
Activities: Proposed Collection;
Comment Request
Centers for Medicare &
Medicaid Services.
ACTION: Notice.
AGENCY:
The Centers for Medicare &
Medicaid Services (CMS) is announcing
an opportunity for the public to
comment on CMS’ intention to collect
information from the public. Under the
Paperwork Reduction Act of 1995 (the
PRA), federal agencies are required to
publish notice in the Federal Register
concerning each proposed collection of
information (including each proposed
extension or reinstatement of an existing
collection of information) and to allow
60 days for public comment on the
proposed action. Interested persons are
invited to send comments regarding our
burden estimates or any other aspect of
this collection of information, including
any of the following subjects: (1) The
necessity and utility of the proposed
information collection for the proper
performance of the agency’s functions;
(2) the accuracy of the estimated
burden; (3) ways to enhance the quality,
utility, and clarity of the information to
be collected; and (4) the use of
automated collection techniques or
other forms of information technology to
minimize the information collection
burden.
DATES: Comments must be received by
January 15, 2016.
ADDRESSES: When commenting, please
reference the document identifier or
OMB control number. To be assured
consideration, comments and
recommendations must be submitted in
any one of the following ways:
1. Electronically. You may send your
comments electronically to https://
www.regulations.gov. Follow the
instructions for ‘‘Comment or
Submission’’ or ‘‘More Search Options’’
to find the information collection
document(s) that are accepting
comments.
2. By regular mail. You may mail
written comments to the following
address: CMS, Office of Strategic
Operations and Regulatory Affairs,
Division of Regulations Development,
Attention: Document Identifier/OMB
Control Number lll, Room C4–26–
05, 7500 Security Boulevard, Baltimore,
Maryland 21244–1850.
SUMMARY:
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70807
To obtain copies of a supporting
statement and any related forms for the
proposed collection(s) summarized in
this notice, you may make your request
using one of following:
1. Access CMS’ Web site address at
https://www.cms.hhs.gov/
PaperworkReductionActof1995.
2. Email your request, including your
address, phone number, OMB number,
and CMS document identifier, to
Paperwork@cms.hhs.gov.
3. Call the Reports Clearance Office at
(410) 786–1326.
FOR FURTHER INFORMATION CONTACT:
Reports Clearance Office at (410) 786–
1326.
SUPPLEMENTARY INFORMATION:
Contents
This notice sets out a summary of the
use and burden associated with the
following information collections. More
detailed information can be found in
each collection’s supporting statement
and associated materials (see
ADDRESSES).
CMS–3427 End Stage Renal Disease
Application and Survey and
Certification Report
Under the PRA (44 U.S.C. 3501–
3520), federal agencies must obtain
approval from the Office of Management
and Budget (OMB) for each collection of
information they conduct or sponsor.
The term ‘‘collection of information’’ is
defined in 44 U.S.C. 3502(3) and 5 CFR
1320.3(c) and includes agency requests
or requirements that members of the
public submit reports, keep records, or
provide information to a third party.
Section 3506(c)(2)(A) of the PRA
requires federal agencies to publish a
60-day notice in the Federal Register
concerning each proposed collection of
information, including each proposed
extension or reinstatement of an existing
collection of information, before
submitting the collection to OMB for
approval. To comply with this
requirement, CMS is publishing this
notice.
Information Collection
1. Type of Information Collection
Request: Reinstatement with change of a
previously approved collection; Title of
Information Collection: End Stage Renal
Disease Application and Survey and
Certification Report; Use: Part I of this
form is a facility identification and
screening measurement used to initiate
the certification and recertification of
ESRD facilities. Part II is completed by
the Medicare/Medicaid State survey
agency to determine facility compliance
with ESRD conditions for coverage.
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]]>Agencies
[Federal Register Volume 80, Number 220 (Monday, November 16, 2015)]
[Notices]
[Pages 70805-70807]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2015-29176]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
[CMS-8060-N]
RIN 0938-AS37
Medicare Program; CY 2016 Part A Premiums 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) 2016.
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, 2016, for these individuals will be $411.
The premium for certain other individuals as described in this notice
will be $226.
DATES: Effective Date: This notice is effective on January 1, 2016.
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)(1) 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 2016 will be equal to the premium for
uninsured aged enrollees reduced by 45 percent.
[[Page 70806]]
II. Monthly Premium Amount for CY 2016
The monthly premium for the uninsured aged and certain disabled
individuals who have exhausted other entitlement for the 12 months
beginning January 1, 2016, is $411.
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 $226.
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 2016
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 Medicare 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 2016 on--(1) current historical
data; and (2) projection assumptions derived from current law and the
Mid-Session Review of the President's Fiscal Year 2016 Budget.
We estimate that in CY 2016, 47,251,107 people aged 65 years and
over will be entitled to benefits (without premium payment) and that
they will incur about $233.221 billion in benefits and related
administrative costs. Thus, the estimated monthly average per capita
amount is $411.31 and the monthly premium is $411. Subsequently, the
full monthly premium reduced by 45 percent is $226.
IV. Costs to Beneficiaries
The CY 2016 premium of $411 is approximately 1 percent higher than
the CY 2015 premium of $407. We estimate that approximately 652,000
enrollees will voluntarily enroll in Medicare Part A, by paying the
full premium. Furthermore, the CY 2016 reduced premium of $226 is
approximately 0.9 percent higher than the CY 2015 premium of $224. We
estimate an additional 61,000 enrollees will pay the reduced premium.
Therefore, we estimate that the total aggregate cost to enrollees
paying these premiums in CY 2016, compared to the amount that they paid
in CY 2015, will be about $32 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 2016 as that procedure is
unnecessary because of the lack of discretion in the statutory formula
that is used to calculate the premium and the solely ministerial
function that this notice serves. The APA permits agencies to waive
notice and comment rulemaking when notice and public comment thereon
are unnecessary. On this basis, we waive publication of a proposed
notice and a solicitation of public comments.
VI. Collection of Information Requirements
This document does not impose information collection requirements,
that is, reporting, recordkeeping or third-party disclosure
requirements. Consequently, there is no need for review by the Office
of Management and Budget under the authority of the Paperwork Reduction
Act of 1995 (44 U.S.C. 3501 et seq.).
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 impact 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 cost to
voluntary enrollees (section 1818 and section 1818A of the Act) of
about $32 million. As a result, this notice is non-economically
significant under section 3(f)(1) of Executive Order 12866 and is not 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 $7.5 million to $38.5 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
[[Page 70807]]
entity. As discussed above, this annual notice announces Medicare's
Hospital Insurance (Part A) premium for uninsured enrollees in calendar
year (CY) 2016. 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 2015, that
threshold is approximately $144 million. This notice does not impose
mandates that will have a consequential effect of $144 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.
Dated: November 6, 2015.
Andrew M. Slavitt,
Acting Administrator, Centers for Medicare & Medicaid Services.
Dated: November 9, 2015
Sylvia M. Burwell,
Secretary, Department of Health and Human Services.
[FR Doc. 2015-29176 Filed 11-10-15; 4:15 pm]
BILLING CODE 4120-01-P
