Medicare Program; Medicare Part B Monthly Actuarial Rates, Premium Rate, and Annual Deductible Beginning January 1, 2013
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Notice.
RIN Number: "RIN 0938-AR16"
Citation: "77 FR 69850"
Document Number: "CMS-8048-N"
"Notices"
SUMMARY: This notice announces the monthly actuarial rates for aged (age 65 and over) and disabled (under age 65) beneficiaries enrolled in Part B of the Medicare Supplementary Medical Insurance (SMI) program beginning
DATES:
FOR FURTHER INFORMATION CONTACT:
SUPPLEMENTARY INFORMATION: Part B is the voluntary portion of the
The Secretary of the
The monthly actuarial rates for aged and disabled enrollees are used to determine the correct amount of general revenue financing per beneficiary each month. These amounts, according to actuarial estimates, will equal, respectively, one-half of the expected average monthly cost of Part B for each aged enrollee (age 65 or over) and one-half of the expected average monthly cost of Part B for each disabled enrollee (under age 65).
The Part B deductible to be paid by enrollees is also announced. Prior to the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA) (Pub. L. 108-173), the Part B deductible was set in statute. After setting the 2005 deductible amount at
The monthly Part B premium rate to be paid by aged and disabled enrollees is also announced. (Although the costs to the program per disabled enrollee are different than for the aged, the statute provides that they pay the same premium amount.) Beginning with the passage of section 203 of the Social Security Amendments of 1972 (Pub. L. 92-603), the premium rate, which was determined on a fiscal year basis, was limited to the lesser of the actuarial rate for aged enrollees, or the current monthly premium rate increased by the same percentage as the most recent general increase in monthly Title II social security benefits.
However, the passage of section 124 of the Tax Equity and Fiscal Responsibility Act of 1982 (TEFRA) (Pub. L. 97-248) suspended this premium determination process. Section 124 of TEFRA changed the premium basis to 50 percent of the monthly actuarial rate for aged enrollees (that is, 25 percent of program costs for aged enrollees). Section 606 of the Social Security Amendments of 1983 (Pub. L. 98-21), section 2302 of the Deficit Reduction Act of 1984 (DEFRA 84) (Pub. L. 98-369), section 9313 of the Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA 85) (Pub. L. 99-272), section 4080 of the Omnibus Budget Reconciliation Act of 1987 (OBRA 87) (Pub. L. 100-203), and section 6301 of the Omnibus Budget Reconciliation Act of 1989 (OBRA 89) (Pub. L. 101-239) extended the provision that the premium be based on 50 percent of the monthly actuarial rate for aged enrollees (that is, 25 percent of program costs for aged enrollees). This extension expired at the end of 1990.
The premium rate for 1991 through 1995 was legislated by section 1839(e)(1)(B) of the Act, as added by section 4301 of the Omnibus Budget Reconciliation Act of 1990 (OBRA 90) (Pub. L. 101-508). In
Section 4571 of the Balanced Budget Act of 1997 (BBA) (Pub. L. 105-33) permanently extended the provision that the premium be based on 50 percent of the monthly actuarial rate for aged enrollees (that is, 25 percent of program costs for aged enrollees).
<p> The BBA included a further provision affecting the calculation of the Part B actuarial rates and premiums for 1998 through 2003. Section 4611 of the BBA modified the home health benefit payable under Part A for individuals enrolled in Part B. Under this section, beginning in 1998, expenditures for home health services not considered "post-institutional" are payable under Part B rather than Part A. However, section 4611(e)(1) of the BBA required that there be a transition from 1998 through 2002 for the aggregate amount of the expenditures transferred from Part A to Part B. Section 4611(e)(2) of the BBA also provided a specific yearly proportion for the transferred funds. The proportions were 1/6 for 1998, 1/3 for 1999, 1/2 for 2000, 2/3 for 2001, and 5/6 for 2002. For the purpose of determining the correct amount of financing from general revenues of the Federal Government, it was necessary to include only these transitional amounts in the monthly actuarial rates for both aged and disabled enrollees, rather than the total cost of the home health services being transferred.
Section 4611(e)(3) of the BBA also specified, for the purpose of determining the premium, that the monthly actuarial rate for enrollees age 65 and over be computed as though the transition would occur for 1998 through 2003 and that 1/7 of the cost be transferred in 1998, 2/7 in 1999, 3/7 in 2000, 4/7 in 2001, 5/7 in 2002, and 6/7 in 2003. Therefore, the transition period for incorporating this home health transfer into the premium was 7 years while the transition period for including these services in the actuarial rate was 6 years.
Section 811 of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (Pub. L. 108-173, also known as the Medicare Modernization Act, or MMA), which amended section 1839 of the Act, requires that, starting on
Section 4732(c) of the BBA added section 1933(c) of the Act, which required the Secretary to allocate money from the Part B trust fund to the State Medicaid programs for the purpose of providing Medicare Part B premium assistance from 1998 through 2002 for the low-income
A further provision affecting the calculation of the Part B premium is section 1839(f) of the Act, as amended by section 211 of the Medicare Catastrophic Coverage Act of 1988 (MCCA 88) (Pub. L. 100-360). (The Medicare Catastrophic Coverage Repeal Act of 1989 (Pub. L. 101-234) did not repeal the revisions to section 1839(f) made by MCCA 88.) Section 1839(f) of the Act, referred to as the "hold-harmless" provision, provides that if an individual is entitled to benefits under section 202 or 223 of the Act (the Old-Age and Survivors Insurance Benefit and the Disability Insurance Benefit, respectively) and has the Part B premiums deducted from these benefit payments, the premium increase will be reduced, if necessary, to avoid causing a decrease in the individual's net monthly payment. This decrease in payment occurs if the increase in the individual's social security benefit due to the cost-of-living adjustment under section 215(i) of the Act is less than the increase in the premium. Specifically, the reduction in the premium amount applies if the individual is entitled to benefits under section 202 or 223 of the Act for November and December of a particular year and the individual's Part B premiums for December and the following January are deducted from the respective month's section 202 or 223 benefits. The "hold-harmless" provision does not apply to beneficiaries who are required to pay an income-related monthly adjustment amount.
A check for benefits under section 202 or 223 of the Act is received in the month following the month for which the benefits are due. The Part B premium that is deducted from a particular check is the Part B payment for the month in which the check is received. Therefore, a benefit check for November is not received until December, but has December's Part B premium deducted from it.
Generally, if a beneficiary qualifies for hold-harmless protection, the reduced premium for the individual for that January and for each of the succeeding 11 months is the greater of--
* The monthly premium for January reduced as necessary to make the December monthly benefits, after the deduction of the Part B premium for January, at least equal to the preceding November's monthly benefits, after the deduction of the Part B premium for December; or
* The monthly premium for that individual for that December.
In determining the premium limitations under section 1839(f) of the Act, the monthly benefits to which an individual is entitled under section 202 or 223 of the Act do not include retroactive adjustments or payments and deductions on account of work. Also, once the monthly premium amount is established under section 1839(f) of the Act, it will not be changed during the year even if there are retroactive adjustments or payments and deductions on account of work that apply to the individual's monthly benefits.
Individuals who have enrolled in Part B late or who have re-enrolled after the termination of a coverage period are subject to an increased premium under section 1839(b) of the Act. The increase is a percentage of the premium and is based on the new premium rate before any reductions under section 1839(f) of the Act are made.</p>
II. Provisions of the Notice
A. Notice of Medicare Part B Monthly Actuarial Rates, Monthly Premium Rates, and Annual Deductible
The Medicare Part B monthly actuarial rates applicable for 2013 are
Beneficiaries who Beneficiaries who Income- Total monthly file an individual file a joint tax related monthly premium amount tax return with return with adjustment amount income: income: Less than or equal Less than or equal $0.00 $104.90 to $85,000 to $170,000 Greater than Greater than 42.00 146.90 $85,000 and less $170,000 and less than or equal to than or equal to $107,000 $214,000 Greater than Greater than 104.90 209.80$107,000 and less$214,000 and less than or equal to than or equal to $160,000 $320,000 Greater than Greater than 167.80 272.70$160,000 and less$320,000 and less than or equal to than or equal to $214,000 $428,000 Greater than Greater than 230.80 335.70 $214,000 $428,000
In addition, the monthly premium rates to be paid by beneficiaries who are married and lived with their spouse at any time during the taxable year, but file a separate tax return from their spouse, are listed below.
Beneficiaries who are Income- Total monthly married and lived with related premium amount their spouse at any time monthly during the year, but file adjustment amount a separate tax return from their spouse: Less than or equal to $0.00 $104.90 $85,000 Greater than $85,000 and 167.80 272.70 less than or equal to $129,000 Greater than $129,000 230.80 335.70
The Part B annual deductible for 2013 is
B. Statement of Actuarial Assumptions and Bases Employed in Determining the Monthly Actuarial Rates and the Monthly Premium Rate for Part B Beginning
Except where noted, the actuarial assumptions and bases used to determine the monthly actuarial rates and the monthly premium rates for Part B are established by the
1. Actuarial Status of the Part B Account in the
Under the statute, the starting point for determining the standard monthly premium is the amount that would be necessary to finance Part B on an incurred basis. This is the amount of income that would be sufficient to pay for services furnished during that year (including associated administrative costs) even though payment for some of these services will not be made until after the close of the year. The portion of income required to cover benefits not paid until after the close of the year is added to the trust fund and used when needed.
The premium rates are established prospectively and are, therefore, subject to projection error. Additionally, legislation enacted after the financing was established, but effective for the period in which the financing is set, may affect program costs. As a result, the income to the program may not equal incurred costs. Therefore, trust fund assets must be maintained at a level that is adequate to cover an appropriate degree of variation between actual and projected costs, and the amount of incurred, but unpaid, expenses. Numerous factors determine what level of assets is appropriate to cover variation between actual and projected costs. The three most important of these factors are: (1) The difference from prior years between the actual performance of the program and estimates made at the time financing was established; (2) the likelihood and potential magnitude of expenditure changes resulting from enactment of legislation affecting Part B costs in a year subsequent to the establishment of financing for that year, and (3) the expected relationship between incurred and cash expenditures. These factors are analyzed on an ongoing basis, as the trends can vary over time.
Table 1 summarizes the estimated actuarial status of the trust fund as of the end of the financing period for 2011 and 2012.
Table 1--Estimated Actuarial Status of the Part B Account in theSupplementary Medical Insurance Trust Fund as of the End of the Financing Period Financing period Assets Liabilities Assets less ending (millions) (millions) liabilities (millions) December 31, 2011 $79,693 $15,015 $64,678 December 31, 2012 68,164 17,162 51,002
2. Monthly Actuarial Rate for Enrollees Age 65 and Older
The monthly actuarial rate for enrollees age 65 and older is one-half of the sum of monthly amounts for: (1) The projected cost of benefits; and (2) administrative expenses for each enrollee age 65 and older, after adjustments to this sum to allow for interest earnings on assets in the trust fund and an adequate contingency margin. The contingency margin is an amount appropriate to provide for possible variation between actual and projected costs and to amortize any surplus assets or unfunded liabilities.
The monthly actuarial rate for enrollees age 65 and older for 2013 is determined by first establishing per-enrollee cost by type of service from program data through 2011 and then projecting these costs for subsequent years. The projection factors used for financing periods from
As indicated in Table 3, the projected monthly rate required to pay for one-half of the total of benefits and administrative costs for enrollees age 65 and over for 2013 is
The size of the contingency margin for 2013 is affected by several factors. The largest factor involves the current law formula for physician fees, which is scheduled to result in a reduction in physician fees of nearly 30 percent in 2013. For each year from 2003 through 2012,
As noted, the scheduled physician fee schedule reductions have been legislatively overridden for each year since 2003. During this period, lawmakers enacted physician payment updates that ranged from 0 percent to 2.2 percent; the average increase was 1 percent per year over this period. The 2012
Another factor affecting the size of the contingency margin comes from section 302 of The Budget Control Act of 2011 (Pub. L. 112-25), which mandates a government-wide sequestration process to reduce Federal outlays. The sequestration process will automatically start in
Two other, smaller factors affect the contingency margin for 2013. Starting in 2011, manufacturers and importers of brand-name prescription drugs have paid a fee that is allocated to the Part B account of the SMI trust. For 2013, the total of these brand-name drug fees is estimated to be
Another small factor impacting the contingency margin comes from the requirement that certain payment incentives, to encourage the development and use of health information technology (HIT) by
The traditional goal for the Part B reserve has been that assets minus liabilities at the end of a year should represent between 15 and 20 percent of the following year's total incurred expenditures. To accomplish this goal, a 17 percent reserve has been the normal target used to calculate the Part B premium. In view of the strong likelihood of actual expenditures exceeding estimated levels, due to the likelihood of the enactment of legislation after the financing has been set for 2013 as a result of the scheduled 2013 physician update and, possibly in addition, the scheduled 2013 sequestration, a contingency reserve ratio in excess of 20 percent of the following year's expenditures would better ensure that the assets of the Part B account can adequately cover the cost of incurred-but-not-reported benefits together with variations between actual and estimated cost levels.
The actuarial rate of
3. Monthly Actuarial Rate for Disabled Enrollees
Disabled enrollees are those persons under age 65 who are enrolled in Part B because of entitlement to
As shown in Table 4, the projected monthly rate required to pay for one-half of the total of benefits and administrative costs for disabled enrollees for 2013 is
The actuarial rate of
4. Sensitivity Testing
Several factors contribute to uncertainty about future trends in medical care costs. It is appropriate to test the adequacy of the rates using alternative cost growth rate assumptions. The results of those assumptions are shown in Table 5. One set represents increases that are lower and, therefore, more optimistic than the current estimate. The other set represents increases that are higher and, therefore, more pessimistic than the current estimate. The values for the alternative assumptions were determined from a statistical analysis of the historical variation in the respective increase factors.
As indicated in Table 5, the monthly actuarial rates would result in an excess of assets over liabilities of
Assumptions that are somewhat more pessimistic (and that therefore test the adequacy of the assets to accommodate projection errors) produce a surplus of
The previous analysis indicates that the premium and general revenue financing established for 2013, together with existing Part B account assets would be adequate to cover estimated Part B costs for 2013 under current law, even if actual costs prove to be somewhat greater than expected.
5. Premium Rates and Deductible
As determined in accordance with section 1839 of the Act, listed are the 2013 Part B monthly premium rates to be paid by beneficiaries who file an individual tax return (including those who are single, head of household, qualifying widow(er) with dependent child, or married filing separately who lived apart from their spouse for the entire taxable year), or a joint tax return.
Beneficiaries who Beneficiaries who Income- Total file an individual file a joint tax related monthly monthly tax return with return with adjustment amount premium amount income: income: Less than or equal Less than or equal $0.00 $104.90 to $85,000 to $170,000 Greater than Greater than 42.00 146.90 $85,000 and less $170,000 and less than or equal to than or equal to $107,000 $214,000 Greater than Greater than 104.90 209.80$107,000 and less$214,000 and less than or equal to than or equal to $160,000 $320,000 Greater than Greater than 167.80 272.70$160,000 and less$320,000 and less than or equal to than or equal to $214,000 $428,000 Greater than Greater than 230.80 335.70 $214,000 $428,000
In addition, the monthly premium rates to be paid by beneficiaries who are married and lived with their spouse at any time during the taxable year, but file a separate tax return from their spouse, are listed below.
Beneficiaries who are Income- Total married and lived with related monthly monthly their spouse at any time adjustment amount premium during the year, but file amount a separate tax return from their spouse: Less than or equal to $0.00 $104.90 $85,000 Greater than $85,000 and 167.80 272.70 less than or equal to $129,000 Greater than $129,000 230.80 335.70
Table 2--Projection Factors *1 12-Month Periods EndingDecember 31 of 2010-2013 [In percent] Physicians' services Calendar Fees *2 Residual *3 Durable Carrier lab Other year medical *4 carrier equipment services *5 Aged: 2010 2.5 1.4 1.8 1.4 3.4 2011 0.9 1.8 -3.9 -2.9 4.5 2012 -1.0 2.6 4.4 6.8 3.6 2013 -28.5 8.1 -0.3 2.9 5.0 Disabled: 2010 2.5 2.9 2.7 -3.9 3.2 2011 0.9 1.9 -2.2 3.7 3.5 2012 -1.0 2.5 4.4 21.8 3.5 2013 -28.5 8.0 -0.4 2.8 4.9
Table 2--Projection Factors *1 12-Month Periods EndingDecember 31 of 2010-2013 [In percent] Calendar Outpatient Home health Hospital lab Other Managed care year hospital agency *6 intermediary services *7 Aged: 2010 5.1 2.4 2.2 1.0 -1.8 2011 7.6 -1.6 4.9 4.4 0.9 2012 9.3 0.5 5.1 8.1 2.6 2013 5.6 1.7 1.6 -6.4 4.3 Disabled: 2010 5.4 1.1 0.5 -0.1 -0.9 2011 8.3 -1.4 7.2 0.9 1.3 2012 10.3 2.1 4.3 7.4 0.9 2013 5.5 2.7 1.6 -0.6 4.6 *1 All values for services other than managed care are per fee-for-service enrollee. Managed care values are per managed care enrollee. *2 As recognized for payment under the program. *3 Increase in the number of services received per enrollee and greater relative use of more expensive services. *4 Includes services paid under the lab fee schedule furnished in the physician's office or an independent lab. *5 Includes physician-administered drugs, ambulatory surgical center facility costs, ambulance services, parenteral and enteral drug costs, supplies, etc. *6 Includes services paid under the lab fee schedule furnished in the outpatient department of a hospital. *7 Includes services furnished in dialysis facilities, rural health clinics, Federally qualified health centers, rehabilitation and psychiatric hospitals, etc.
Table 3--Derivation of Monthly Actuarial Rate for Enrollees Age 65 and Over for Financing Periods EndingDecember 31, 2010 ThroughDecember 31, 2013 Financing periods CY 2010 CY 2011 CY 2012 CY 2013 Covered services (at level recognized): Physician fee schedule 80.62 81.75 81.25 62.90 Durable medical equipment 8.94 8.49 8.67 8.66 Carrier lab *1 4.31 4.13 4.32 4.45 Other carrier services *2 21.23 21.89 22.20 23.36 Outpatient hospital 32.93 34.99 37.41 39.58 Home health 11.85 11.50 11.31 11.53 Hospital lab *3 3.66 3.79 3.90 3.97 Other intermediary services *4 14.18 14.62 15.47 14.50 Managed care 54.74 57.06 61.63 64.00 Total services 232.47 238.22 246.16 232.95 Cost sharing: Deductible -5.91 -6.19 -5.37 -5.62 Coinsurance -30.91 -30.92 -31.77 -28.13 HIT payment incentives 0.00 -0.17 -0.74 -0.86 Total pre-sequester benefits 195.64 200.94 208.28 198.34 Pre-sequester administrative expenses 2.94 3.29 3.66 3.43 Sequester 0.00 0.00 0.00 -3.65 Incurred expenditures 198.58 204.23 211.94 198.11 Value of interest -2.74 -2.52 -2.12 -2.38 Contingency margin for projection 25.16 28.99 -10.02 14.07 error and to amortize the surplus or deficit Monthly actuarial rate 221.00 230.70 199.80 209.80 *1 Includes services paid under the lab fee schedule furnished in the physician's office or an independent lab. *2 Includes physician-administered drugs, ambulatory surgical center facility costs, ambulance services, parenteral and enteral drug costs, supplies, etc. *3 Includes services paid under the lab fee schedule furnished in the outpatient department of a hospital. *4 Includes services furnished in dialysis facilities, rural health clinics, Federally qualified health centers, rehabilitation and psychiatric hospitals, etc.
Table 4--Derivation of Monthly Actuarial Rate for Disabled Enrollees for Financing Periods EndingDecember 31, 2010 ThroughDecember 31, 2013 Financing periods CY 2010 CY 2011 CY 2012 CY 2013 Covered services (at level recognized): Physician fee schedule 85.33 86.85 86.45 66.85 Durable medical equipment 16.89 16.24 16.62 16.59 Carrier lab *1 5.84 5.10 6.05 6.24 Other carrier services *2 25.89 26.27 26.38 27.72 Outpatient hospital 46.13 49.37 53.31 56.33 Home health 10.10 9.82 9.82 10.11 Hospital lab *3 5.16 5.38 5.50 5.59 Other intermediary services *4 41.05 41.70 42.66 42.61 Managed care 40.77 43.51 47.40 48.99 Total services 277.16 284.24 294.20 281.03 Cost sharing: Deductible -5.55 -5.81 -5.05 -5.28 Coinsurance -45.71 -46.19 -46.76 -42.62 HIT payment incentives 0.00 -0.18 -0.77 -0.90 Total pre-sequester benefits 225.90 232.05 241.62 232.23 Pre-sequester administrative expenses 3.38 3.80 4.26 3.97 Sequester 0.00 0.00 0.00 -4.27 Incurred expenditures 229.28 235.85 245.87 231.92 Value of interest -4.05 -5.05 -4.52 -4.07 Contingency margin for projection 45.17 35.49 -48.85 7.65 error and to amortize the surplus or deficit Monthly actuarial rate 270.40 266.30 192.50 235.50 *1 Includes services paid under the lab fee schedule furnished in the physician's office or an independent lab. *2 Includes physician-administered drugs, ambulatory surgical center facility costs, ambulance services, parenteral and enteral drug costs, supplies, etc. *3 Includes services paid under the lab fee schedule furnished in the outpatient department of a hospital. *4 Includes services furnished in dialysis facilities, rural health clinics, Federally qualified health centers, rehabilitation and psychiatric hospitals, etc.
Table 5--Actuarial Status of the Part B Account in the SMI Trust Fund Under Three Sets of Assumptions for Financing Periods ThroughDecember 31, 2013 As of December 31, 2011 2012 2013 This projection: Actuarial status (in millions): Assets 79,693 68,164 88,193 Liabilities 15,015 17,162 16,341 Assets less liabilities 64,678 51,002 71,851 Ratio (in percent) *1 26.6 21.7 28.5 Low cost projection: Actuarial status (in millions): Assets 79,693 77,325 111,554 Liabilities 15,015 16,144 15,542 Assets less liabilities 64,678 61,180 96,011 Ratio (in percent) *1 27.8 28.2 42.0 High cost projection: Actuarial status (in millions): Assets 79,693 57,291 55,997 Liabilities 15,015 18,370 17,158 Assets less liabilities 64,678 38,921 38,839 Ratio (in percent) *1 25.3 15.2 13.8 *1 Ratio of assets less liabilities at the end of the year to the total incurred expenditures during the following year, expressed as a percent. These estimates are based on the assumption that all provisions of current law will be implemented in full, including (i) the approximately 28.0-percent reduction inMedicare payment rates to physicians required by the statutory "sustainable growth rate" formula, and (ii) the sequestration of up to 2 percent of allMedicare payments to providers and plans as required by the Budget Control Act of 2011. Under the intermediate projection assumptions (as shown in table 2), if the 2013 physician payment reduction were overridden through new legislation, then the Part B asset reserve ratio forDecember 31, 2013 would be approximately 9.3 percentage points lower than shown here. If, in addition, the 2013 sequestration were similarly overridden, then the reserve ratios at the end of 2013 would be reduced by approximately another 2 percentage points. The impacts of these potential overrides on the 2013 reserve ratio for the low cost and high cost projections would be similar.
III. Regulatory Impact Analysis
A. Statement of Need
Section 1839 of the Act requires us to annually announce (that is by
B. Overall Impact
We have examined the impacts of this rule as required by Executive Order 12866 on Regulatory Planning and Review (
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 notice with economically significant effects (
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
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. We have determined that this notice will not have a significant effect on a substantial number of small entities or on the operations of a substantial number of small rural hospitals. Therefore, we are not preparing analyses for either the RFA or section 1102(b) of the Act.
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
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.
This notice announces that the monthly actuarial rates applicable for 2013 are
Beneficiaries who Beneficiaries who Income- Total file an individual file a joint tax related monthly tax return with return with monthly premium income: income: adjustment amount amount Less than or equal Less than or equal $0.00 $104.90 to $85,000 to $170,000 Greater than Greater than 42.00 146.90 $85,000 and less $170,000 and less than or equal to than or equal to $107,000 $214,000 Greater than Greater than 104.90 209.80$107,000 and less$214,000 and less than or equal to than or equal to $160,000 $320,000 Greater than Greater than 167.80 272.70$160,000 and less$320,000 and less than or equal to than or equal to $214,000 $428,000 Greater than Greater than 230.80 335.70 $214,000 $428,000
In addition, the monthly premium rates to be paid by beneficiaries who are married and lived with their spouse at any time during the taxable year, but file a separate tax return from their spouse, are also announced and listed in the following chart.
Beneficiaries who are Income- Total married and lived with related monthly their spouse at any time monthly premium during the year, but file adjustment amount a separate tax return amount from their spouse: Less than or equal to $0.00 $104.90 $85,000 Greater than $85,000 and 167.80 272.70 less than or equal to $129,000 Greater than $129,000 230.80 335.70
The standard Part B premium rate of
In accordance with the provisions of Executive Order 12866, this notice was reviewed by the
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. 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:
Acting Administrator,
Approved:
Secretary.
[FR Doc. 2012-28275 Filed 11-16-12;
BILLING CODE 4120-01-P
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