Department of Health and Human Services, Centers for Medicare and Medicaid Services: Medicare Program; Part A Premium for Calendar Year 2009 for the Uninsured Aged and for Certain Disabled Individuals Who Have Exhausted Other Entitlement

GAO-09-69R: Oct 6, 2008

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GAO reviewed the Department of Health and Human Services, Centers for Medicare and Medicaid Services (CMS) new rule on the Medicare Program, part A premium for calendar 2009 for the uninsured aged and for certain disabled individuals who have exhausted other entitlement. GAO found that (1) the rule announces Medicare's Hospital Insurance premium for uninsured enrollees in calendar year 2009, the premium for the 12 months beginning January 1, 2009, for these individuals will be $443, and the reduced premium for certain other individuals will be $244; and (2) CMS complied with applicable requirements in promulgating the rule.

Department of Health and Human Services, Centers for Medicare and Medicaid Services: Medicare Program; Part A Premium for Calendar Year 2009 for the Uninsured Aged and for Certain Disabled Individuals Who Have Exhausted Other Entitlement, GAO-09-69R, October 6, 2008

B-317194

October 6, 2008

The Honorable Max Baucus
Chairman
The Honorable Charles E. Grassley
Ranking Minority Member
Committee on Finance
United States Senate

The Honorable Charles B. Rangel
Chairman
The Honorable Jim McCrery
Ranking Minority Member
Committee on Ways and Means
House of Representatives

Subject: Department of Health and Human Services, Centers for Medicare and Medicaid Services: Medicare Program; Part A Premium for Calendar Year 2009 for the Uninsured Aged and for Certain Disabled Individuals Who Have Exhausted Other Entitlement

Pursuant to section 801(a)(2)(A) of title 5, United States Code, this is our report on a major rule promulgated by the Department of Health and Human Services, Centers for Medicare and Medicaid Services (CMS), entitled –Medicare Program; Part A Premium for Calendar Year 2009 for the Uninsured Aged and for Certain Disabled Individuals Who Have Exhausted Other Entitlement (RIN: 0938-AP04). We received the rule on September 19, 2008. It was published in the Federal Register as a notice on September 24, 2008. 73 Fed. Reg. 55,096.

The notice announces Medicare's Hospital Insurance (Part A) premium for uninsured enrollees in calendar year (CY) 2009. This premium is to be paid by enrollees age 65 and over who are not otherwise eligible for benefits under Medicare Part A and by certain disabled individuals who have exhausted other entitlement.

The monthly Part A premium for the 12 months beginning January 1, 2009, for these individuals will be $443. The reduced premium for certain other individuals will be $244.

Enclosed is our assessment of the CMS's compliance with the procedural steps required by section 801(a)(1)(B)(i) through (iv) of title 5 with respect to the rule. Our review indicates that CMS complied with the applicable requirements.

If you have any questions about this report or wish to contact GAO officials responsible for the evaluation work relating to the subject matter of the rule, please contact Michael R. Volpe, Assistant General Counsel, at (202) 512-8236.

signed

Robert J. Cramer
Associate General Counsel

Enclosure

cc: Ann Stallion
Program Manager
Department of Health and
Human Services


ENCLOSURE

REPORT UNDER 5 U.S.C. sect. 801(a)(2)(A) ON A MAJOR RULE
ISSUED BY THE
DEPARTMENT OF HEALTH AND HUMAN SERVICES,
CENTERS FOR MEDICARE AND MEDICAID SERVICES
ENTITLED
"MEDICARE PROGRAM; PART A PREMIUM FOR CALENDAR YEAR 2009
FOR THE UNINSURED AGED AND FOR CERTAIN DISABLED INDIVIDUALS
WHO HAVE EXHAUSTED OTHER ENTITLEMENT"
(RIN: 0938-AP04)

(i) Cost-benefit analysis

CMS estimates that the aggregate cost to enrollees paying the premiums will be about $142 million in calendar year 2009 over the amount paid in 2008.

(ii) Agency actions relevant to the Regulatory Flexibility Act, 5 U.S.C. sections 603-605, 607, and 609

CMS has determined that the notice will not have a significant economic impact on a substantial number of small entities or on the operations of a substantial number of small rural hospitals.

(iii) Agency actions relevant to sections 202-205 of the Unfunded Mandates Reform Act of 1995, 2 U.S.C. sections 1532-1535

CMS has determined that the notice has no consequential effect on state, local, or tribal governments or on the private sector.

(iv) Other relevant information or requirements under acts and executive orders

Administrative Procedure Act, 5 U.S.C. sections 551 et seq.

CMS published a general notice and waived notice and comment rulemaking because the premium is dictated by a statutory formula.

Paperwork Reduction Act, 44 U.S.C. sections 3501-3520

The notice does not contain any information collections that are subject to review by the Office of Management and Budget (OMB) under the Paperwork Reduction Act.

Statutory authorization for the rule

The notice is issued pursuant to the authority contained in section 1818 of the Social Security Act (42 U.S.C. 1395i-2).

Executive Order No. 12,866

The notice was deemed economically significant under Executive Order No. 12,866 and was reviewed by OMB.

Executive Order No. 13,132 (Federalism)

CMS has determined that the notice does not have federalism implications.

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