Medicare Program; CY 2020 Part A Premiums for the Uninsured Aged and for Certain Disabled Individuals Who Have Exhausted Other Entitlement
Notice.
RIN Number: "RIN 0938-AT77"
Citation: "84 FR 61622"
Document Number: "CMS-8072-N"
Page Number: "61622"
"Notices"
Agency: "
SUMMARY: This annual notice announces Medicare's
DATES:
The premium announced in this notice is effective on
FOR FURTHER INFORMATION CONTACT: Yaminee Thaker, (410) 786-7921.
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
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
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 2020 will be equal to the premium for uninsured aged enrollees reduced by 45 percent.
Section 1818(g) of the Act requires the Secretary, at the request of a state, to enter into a Part A buy-in agreement with a state to pay Medicare Part A premiums for Qualified Medicare Beneficiaries (QMBs). Under the QMB program, state Medicaid agencies must pay the Medicare Part A premium for those not eligible for premium-free Part A. (Entering into a Part A buy-in agreement would permit a state to avoid any Medicare late enrollment penalties that the individual may owe and would allow states to enroll persons in Part A at any time of the year (without regard to Medicare enrollment periods)).
II. Monthly Premium Amount for CY 2020
The monthly premium for the uninsured aged and certain disabled individuals who have exhausted other entitlement for the 12 months beginning
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 2020 rounded to the nearest multiple of
The steps involved in projecting these future costs to the
* 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 2020 on--(1) current historical data; and (2) projection assumptions derived from current law and the Mid-Session Review of the President's Fiscal Year 2020 Budget.
We estimate that in CY 2020, 53,313,570 people aged 65 years and over will be entitled to (enrolled in) benefits (without premium payment) and that they will incur about
IV. Costs to Beneficiaries
The CY 2020 premium of
V. Waiver of Proposed Rulemaking
We ordinarily publish a notice of proposed rulemaking in the
The annual Part A premium announcement set forth in this notice does not establish or change a substantive legal standard regarding the matters enumerated by the statute or constitute a substantive rule which would be subject to the notice requirements in section 553(b) of the APA. However, to the extent that an opportunity for public notice and comment could be construed as required for this notice, we find good cause to waive this requirement.
Section 1818(d) of the Act requires the Secretary during September of each year to determine and publish the amount to be paid, on an average per capita basis, from the
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
VII. Regulatory Impact Analysis
A. Statement of Need
Section 1818(d) of the Act requires the Secretary of the
B. Overall Impact
We have examined the impacts of this notice in accordance with 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). Section 3(f) of Executive Order 12866 defines a "significant regulatory action" as an action that is likely to result in a rule: (1) Having an annual effect on the economy of
A regulatory impact analysis (RIA) must be prepared for major rules with economically significant effects (
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 being nonprofit organizations or by meeting the
In addition, section 1102(b) of the Act requires us to prepare an RIA 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. This annual notice announces the Medicare Part A premiums for CY 2020 and will have an impact on certain Medicare beneficiaries. As a result, 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
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. This notice will not have a substantial direct effect on state or local governments, preempt state law, or otherwise have federalism implications.
Executive Order 13771, titled "Reducing Regulation and Controlling Regulatory Costs," was issued on
In accordance with the provisions of Executive Order 12866, this notice was reviewed by the
Consistent with the Congressional Review Act provisions of the Small Business Regulatory Enforcement Fairness Act of 1996 (5 U.S.C.
Although this notice does not constitute a substantive rule, we nevertheless prepared this Impact Analysis section in the interest of ensuring that the impacts of this notice are fully understood.
Dated:
Administrator,
Dated:
Alex M. Azar II,
Secretary,
[FR Doc. 2019-24439 Filed 11-8-19;
BILLING CODE 4120-01-P
New Tax Plan Proving To Be A Boon For Businesses
Powell To Testify Before Congress As Fed Pauses Rate Cuts
Advisor News
Annuity News
Health/Employee Benefits News
Life Insurance News