[Federal Register Volume 62, Number 212 (Monday, November 3, 1997)]
[Notices]
[Pages 59366-59368]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 97-29030]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Health Care Financing Administration
[OACT-056-N]
RIN 0938-AI10
Medicare Program; Part A Premium for 1998 for the Uninsured Aged
and for Certain Disabled Individuals Who Have Exhausted Other
Entitlement
AGENCY: Health Care Financing Administration (HCFA), HHS.
ACTION: Notice.
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SUMMARY: This notice announces the hospital insurance premium for
calendar year 1998 under Medicare's hospital insurance program (Part A)
for the uninsured aged and for certain disabled individuals who have
exhausted other entitlement. The monthly Medicare Part A premium for
[[Page 59367]]
the 12 months beginning January 1, 1998 for these individuals is $309.
The reduced premium for certain other individuals as described in this
notice is $170. Section 1818(d) of the Social Security Act specifies
the method to be used to determine these amounts.
EFFECTIVE DATE: This notice is effective on January 1, 1998.
FOR FURTHER INFORMATION CONTACT: John Wandishin, (410) 786-6389.
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 who are age 65 and older, uninsured for social security or
railroad retirement benefits and do not otherwise meet the requirements
for entitlement to Medicare Part A. (Persons insured under the Social
Security or Railroad Retirement Acts need not pay premiums for hospital
insurance.)
Section 1818(d) of the Act requires us to estimate, on an average
per capita basis, the amount to be paid from the Federal Hospital
Insurance Trust Fund for services performed and for related
administrative costs incurred in the following year with respect to
individuals age 65 and over who will be entitled to benefits under
Medicare Part A. We must then, during September of each year, determine
the monthly actuarial rate (the per capita amount estimated above
divided by 12) and publish the dollar amount to be applicable for the
monthly premium in the succeeding year. 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). The 1997 premium under this method was $311 and
was effective January 1, 1997. (See 61 FR 56691, November 4, 1996.)
Section 1818(d)(2) of the Act requires us to determine and publish,
during September of each calendar year, the amount of the monthly
premium for the following calendar year for persons who voluntarily
enroll in Medicare Part A.
Section 1818A of the Act provides for voluntary enrollment in
Medicare Part A, subject to payment of a monthly premium, of certain
disabled individuals who have exhausted other entitlement. These
individuals are those not now entitled but who have been entitled under
section 226(b) of the Act, who continue to have the disabling
impairment upon which their entitlement was based, and whose
entitlement ended solely because they had earnings that exceeded the
substantial gainful activity amount (as defined in section 223(d)(4) of
the Act).
Section 1818A(d)(2) of the Act specifies that the premium
determined under section 1818(d)(2) of the Act for the aged will also
apply to certain disabled individuals as described above.
Section 13508 of the Omnibus Budget Reconciliation Act of 1993
(Public Law 103-66, enacted on August 10, 1993) amended section 1818(d)
of the Act to provide for a reduction in the monthly premium amount for
certain voluntary enrollees. The reduction applies for individuals who
are not eligible for social security or railroad retirement benefits
but who:
Had at least 30 quarters of coverage under title II of the
Act;
Were married and had been married for the previous 1-year
period to an individual who had at least 30 quarters of coverage;
Had been married to an individual for at least 1 year at
the time of the individual's death and the individual had at least 30
quarters of coverage; or
Are divorced from an individual who at the time of divorce
had at least 30 quarters of coverage and the marriage lasted at least
10 years.
For calendar year 1998, section 1818(d)(4)(A) of the Act specifies
that the monthly premium that these individuals will pay for calendar
year 1998 will be equal to the monthly premium for aged voluntary
enrollees reduced by 45 percent.
II. Premium Amount for 1998
Under the authority of sections 1818(d)(2) and 1818A(d)(2) of the
Act, the Secretary has determined that the monthly Medicare Part A
hospital insurance premium for the uninsured aged and for certain
disabled individuals who have exhausted other entitlement for the 12
months beginning January 1, 1998, is $309.
The monthly premium for those individuals entitled to a 45-percent
reduction in the monthly premium for the 12-month period beginning
January 1, 1998 is $170.
III. Statement of Actuarial Assumptions and Bases Employed in
Determining the Monthly Premium Rate
As discussed in section I of this notice, the monthly Medicare Part
A premium for 1998 is equal to the estimated monthly actuarial rate for
1998 rounded to the nearest multiple of $1. The monthly actuarial rate
is defined to be one-twelfth of the average per capita amount that the
Secretary estimates will be paid from the Federal Hospital Insurance
Trust Fund for services performed and related administrative costs
incurred in 1998 for individuals age 65 and over who will be entitled
to benefits under the hospital insurance program. Thus, the number of
individuals age 65 and over who will be entitled to hospital insurance
benefits and the costs incurred on behalf of these beneficiaries must
be projected to determine the premium rate.
The principal steps involved in projecting the future costs of the
hospital insurance program are (a) establishing the present cost of
services furnished to beneficiaries, by type of service, to serve as a
projection base; (b) projecting increases in payment amounts for each
of the various service types; and (c) projecting increases in
administrative costs. Establishing historical Medicare Part A
enrollment and projecting future enrollment, by type of beneficiary, is
part of this process.
We have completed all of the above steps, basing our projections
for 1998 on (a) current historical data and (b) projection assumptions
under current law from the Midsession Review of the President's Fiscal
Year 1998 Budget, incorporating the provisions of Public Law 103-66. It
is estimated that in calendar year 1998, 33.032 million people age 65
and over will be entitled to Medicare Part A benefits (without premium
payment), and that these individuals will, in 1998, incur $122.357
billion of benefits for services performed and related administrative
costs. Thus, the estimated monthly average per capita amount is $308.68
and the monthly premium is $309. The monthly premium for those
individuals eligible to pay this premium reduced by 45 percent is $170.
IV. Costs to Beneficiaries
The 1998 Medicare Part A premium is less than 1 percent lower than
the $311 monthly premium amount for the 12-month period beginning
January 1, 1997.
We estimate that there will be, in calendar year 1998,
approximately 344,000 enrollees who will voluntarily enroll in Medicare
Part A by paying the full premium and who do not otherwise meet the
requirements for entitlement. An additional 9,000 enrollees will be
paying the reduced premium. The estimated overall effect of the changes
in the premium will be a savings to these voluntary enrollees of about
$10 million.
[[Page 59368]]
V. Waiver of Notice of Proposed Rulemaking
The Medicare statute, as discussed previously, requires publication
of the Medicare Part A hospital insurance premium for the upcoming
calendar year during September of each year. The amounts are determined
according to the statute. As has been our custom, we use general
notices, rather than formal notice and comment rulemaking procedures,
to make such announcements. In doing so, we acknowledge 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 good
cause that prior notice and comment are impracticable, unnecessary, or
contrary to the public interest. We find that the procedure for notice
and comment is unnecessary because the formula used to calculate the
Part A hospital insurance premium is statutorily directed, and we can
exercise no discretion in following that formula. Moreover, the statute
established the time period for which the premium will apply and
delaying publication of the premium amount would be contrary to the
public interest. Therefore, we find good cause to waive publication of
a proposed notice and solicitation of public comments.
VI. Impact Statement
This notice merely announces amounts required by legislation. This
notice is not a proposed rule or a final rule issued after a proposal,
and it does not alter any regulation or policy. Therefore, we have
determined and certify that no analyses are required under Executive
Order 12866, the Regulatory Flexibility Act (5 U.S.C. 601 through 612),
or section 1102(b) of the Act.
In accordance with the provisions of Executive Order 12866, this
notice was reviewed by the Office of Management and Budget.
Authority: Sections 1818(d)(2) and 1818A(d)(2) of the Social
Security Act (42 U.S.C. 1395i-2(d)(2) and 1395i-2a(d)(2)).
(Catalog of Federal Domestic Assistance Program No. 93.773,
Medicare--Hospital Insurance)
Dated: September 19, 1997.
Nancy-Ann Min DeParle,
Deputy Administrator, Health Care Financing Administration.
Dated: October 7, 1997.
Donna E. Shalala,
Secretary.
[FR Doc. 97-29030 Filed 10-31-97; 8:45 am]
BILLING CODE 4120-01-P