81 FR 80060 - Medicare Program; CY 2017 Inpatient Hospital Deductible and Hospital and Extended Care Services Coinsurance Amounts
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services Federal Register Volume 81, Issue 220 (November 15, 2016)
Centers for Medicare & Medicaid Services
Federal Register Volume 81, Issue 220 (November 15, 2016)
| Page Range | 80060-80063 | |
| FR Document | 2016-27389 |
[Federal Register Volume 81, Number 220 (Tuesday, November 15, 2016)] [Notices] [Pages 80060-80063] From the Federal Register Online [www.thefederalregister.org] [FR Doc No: 2016-27389] ----------------------------------------------------------------------- DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services [CMS-8062-N] RIN 0938-AS70 Medicare Program; CY 2017 Inpatient Hospital Deductible and Hospital and Extended Care Services Coinsurance Amounts AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS. ACTION: Notice. ----------------------------------------------------------------------- SUMMARY: This notice announces the inpatient hospital deductible and the hospital and extended care services coinsurance amounts for services furnished in calendar year (CY) 2017 under Medicare's Hospital Insurance Program (Medicare Part A). The Medicare statute specifies the formulae used to determine these amounts. For CY 2017, the inpatient hospital deductible will be $1,316. The daily coinsurance amounts for CY 2017 will be: (1) $329 for the 61st through 90th day of hospitalization in a benefit period; (2) $658 for lifetime reserve days; and (3) $164.50 for the 21st through 100th day of extended care services in a skilled nursing facility in a benefit period. DATES: Effective Date: This notice is effective on January 1, 2017. FOR FURTHER INFORMATION CONTACT: Clare McFarland, (410) 786-6390 for general information. [[Page 80061]] Gregory J. Savord, (410) 786-1521 for case-mix analysis. SUPPLEMENTARY INFORMATION: I. Background Section 1813 of the Social Security Act (the Act) provides for an inpatient hospital deductible to be subtracted from the amount payable by Medicare for inpatient hospital services furnished to a beneficiary. It also provides for certain coinsurance amounts to be subtracted from the amounts payable by Medicare for inpatient hospital and extended care services. Section 1813(b)(2) of the Act requires us to determine and publish each year the amount of the inpatient hospital deductible and the hospital and extended care services coinsurance amounts applicable for services furnished in the following calendar year (CY). II. Computing the Inpatient Hospital Deductible for CY 2017 Section 1813(b) of the Act prescribes the method for computing the amount of the inpatient hospital deductible. The inpatient hospital deductible is an amount equal to the inpatient hospital deductible for the preceding CY, adjusted by our best estimate of the payment-weighted average of the applicable percentage increases (as defined in section 1886(b)(3)(B) of the Act) used for updating the payment rates to hospitals for discharges in the fiscal year (FY) that begins on October 1 of the same preceding CY, and adjusted to reflect changes in real case-mix. The adjustment to reflect real case-mix is determined on the basis of the most recent case-mix data available. The amount determined under this formula is rounded to the nearest multiple of $4 (or, if midway between two multiples of $4, to the next higher multiple of $4). Under section 1886(b)(3)(B)(i)(XX) of the Act, the percentage increase used to update the payment rates for FY 2017 for hospitals paid under the inpatient prospective payment system is the market basket percentage increase, otherwise known as the market basket update, reduced by 0.75 percentage points (see section 1886(b)(3)(B)(xii)(V) of the Act), and an adjustment based on changes in the economy-wide productivity (the multifactor productivity (MFP) adjustment) (see section 1886(b)(3)(B)(xi)(II) of the Act). Under section 1886(b)(3)(B)(viii) of the Act, for FY 2017, the applicable percentage increase for hospitals that do not submit quality data as specified by the Secretary of the Department of Health and Human Services (the Secretary) is reduced by one quarter of the market basket update. We are estimating that after accounting for those hospitals receiving the lower market basket update in the payment-weighted average update, the calculated deductible will not be affected, since the majority of hospitals submit quality data and receive the full market basket update. Section 1886(b)(3)(B)(ix) of the Act requires that any hospital that is not a meaningful electronic health record (EHR) user (as defined in section 1886(n)(3) of the Act) will have three-quarters of the market basket update reduced by 66\2/3\ percent for FY 2016, 100 percent for FY 2017, and 100 percent for FY 2018 and each subsequent fiscal year. We are estimating that after accounting for these hospitals receiving the lower market basket update, the calculated deductible will not be affected, since the majority of hospitals are meaningful EHR users and are expected to receive the full market basket update. Under section 1886 of the Act, the percentage increase used to update the payment rates for FY 2017 for hospitals excluded from the inpatient prospective payment system is as follows:The percentage increase for long term care hospitals is the market basket percentage increase reduced by 0.75 percentage points and the MFP adjustment (see sections 1886(m)(3)(A) and 1886(m)(4)(F) of the Act). In addition, these hospitals may also be impacted by the quality reporting adjustments and the site-neutral payment rates (see sections 1886(m)(5) and 1886(m)(6) of the Act). The percentage increase for inpatient rehabilitation facilities is the market basket percentage increase reduced by 0.75 percentage points and the MFP adjustment (see sections 1886(j)(3)(C) and 1886(j)(3)(D)(v) of the Act). In addition, these hospitals may also be impacted by the quality reporting adjustments (see section 1886(j)(7) of the Act). The percentage increase used to update the payment rate for inpatient psychiatric facilities is the market basket percentage increase reduced by 0.2 percentage points and the MFP adjustment (see sections 1886(s)(2)(A)(i), 1886(s)(2)(A)(ii), and 1886(s)(3)(E) of the Act). In addition, these hospitals may also be impacted by the quality reporting adjustments (see section 1886(s)(4) of the Act). The percentage increase for other types of hospitals excluded from the inpatient hospital prospective payment system (cancer hospitals, children's hospitals, and hospitals located outside the 50 States, the District of Columbia, and Puerto Rico) is the market basket percentage increase (see section 1886(b)(3)(B)(ii)(VIII) of the Act). The Inpatient Prospective Payment System market basket percentage increase for FY 2017 is 2.7 percent and the MFP adjustment is -0.3 percentage point, as announced in the final rule that appeared in the Federal Register on August 22, 2016 entitled, ``Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System and Fiscal Year 2017 Rates'' (81 FR 56762). Therefore, the percentage increase for hospitals paid under the inpatient prospective payment system that submit quality data and are meaningful EHR users is 1.65 percent (that is, the FY 2017 market basket update of 2.7 percent less the MFP adjustment of 0.3 percentage point and less 0.75 percentage point). The average payment percentage increase for hospitals excluded from the inpatient prospective payment system is 2.0 percent. This average includes long term care hospitals, inpatient rehabilitation facilities, and other hospitals excluded from the inpatient hospital prospective payment system. Weighting these percentages in accordance with payment volume, our best estimate of the payment-weighted average of the increases in the payment rates for FY 2017 is 1.70 percent. To develop the adjustment to reflect changes in real case-mix, we first calculated an average case-mix for each hospital that reflects the relative costliness of that hospital's mix of cases compared to those of other hospitals. We then computed the change in average case- mix for hospitals paid under the Medicare prospective payment system in FY 2016 compared to FY 2015. (We excluded from this calculation hospitals whose payments are not based on the inpatient prospective payment system because their payments are based on alternate prospective payment systems or reasonable costs.) We used Medicare bills from prospective payment hospitals that we received as of July 2016. These bills represent a total of about 7.4 million Medicare discharges for FY 2016 and provide the most recent case-mix data available at this time. Based on these bills, the change in average case-mix in FY 2016 is 2.61 percent. Based on these bills and past experience, we expect the overall case mix change to be 2.7 percent as the year progresses and more FY 2016 data become available. Section 1813 of the Act requires that the inpatient hospital deductible be adjusted only by that portion of the case-mix change that is determined to [[Page 80062]] be real. Real case-mix is that portion of case-mix that is due to changes in the mix of cases in the hospital and not due to coding optimization. Over the past several years, we have seen case mix increases of about 0.5 percent per year. (In some years there were larger increases in case mix due to much lower discharges for that year.) For 2016, we expect the increase in real case mix to continue to be 0.5 percent. Most of the observed FY 2016 case mix increase is likely due to artifacts of the implementation of ICD-10 which affects the calculated case mix level, but does not measure the actual increase in real case mix. Therefore, we expect that much of the change in average case-mix will not be real and estimate that this real change will be 0.5 percent. Thus as stated above, the estimate of the payment-weighted average of the applicable percentage increases used for updating the payment rates is 1.70 percent, and the real case-mix adjustment factor for the deductible is 0.5 percent. Therefore, using the statutory formula as stated in section 1813(b) of the Act, we calculate the inpatient hospital deductible for services furnished in CY 2017 to be $1,316. This deductible amount is determined by multiplying $1,288 (the inpatient hospital deductible for CY 2016 (81 FR 56762)) by the payment-weighted average increase in the payment rates of 1.017 multiplied by the increase in real case-mix of 1.005, which equals $1,316.45 and is rounded to $1,316. III. Computing the Inpatient Hospital and Extended Care Services Coinsurance Amounts for CY 2017 The coinsurance amounts provided for in section 1813 of the Act are defined as fixed percentages of the inpatient hospital deductible for services furnished in the same CY. The increase in the deductible generates increases in the coinsurance amounts. For inpatient hospital and extended care services furnished in CY 2017, in accordance with the fixed percentages defined in the law, the daily coinsurance for the 61st through 90th day of hospitalization in a benefit period will be $329 (one-fourth of the inpatient hospital deductible as stated in section 1813(a)(1)(A) of the Act); the daily coinsurance for lifetime reserve days will be $658 (one-half of the inpatient hospital deductible as stated in section 1813(a)(1)(B) of the Act); and the daily coinsurance for the 21st through 100th day of extended care services in a skilled nursing facility in a benefit period will be $164.50 (one-eighth of the inpatient hospital deductible as stated in section 1813(a)(3) of the Act). IV. Cost to Medicare Beneficiaries Table 1 below summarizes the deductible and coinsurance amounts for CYs 2016 and 2017, as well as the number of each that is estimated to be paid. Table 1--Part A Deductible and Coinsurance Amounts for Calendar Years 2016 and 2017 Type of Cost Sharing ---------------------------------------------------------------------------------------------------------------- Value Number paid (in millions) --------------------------------------------------------------- 2016 2017 2016 2017 ---------------------------------------------------------------------------------------------------------------- Inpatient hospital deductible................... $1288 $1316 7.15 7.26 Daily coinsurance for 61st-90th Day............. 322 329 1.77 1.80 Daily coinsurance for lifetime reserve days..... 644 658 0.87 0.88 SNF coinsurance................................. 161 164.50 40.56 41.83 ---------------------------------------------------------------------------------------------------------------- The estimated total increase in costs to beneficiaries is about $740 million (rounded to the nearest $10 million) due to: (1) The increase in the deductible and coinsurance amounts; and (2) the increase in the number of deductibles and daily coinsurance amounts paid. We determine the increase in cost to beneficiaries by calculating the difference between the 2016 and 2017 deductible and coinsurance amounts multiplied by the estimated increase in the number of deductible and coinsurance amounts paid. V. Waiver of Proposed Notice and Comment Period Section 1813(b)(2) of the Act requires publication of the inpatient hospital deductible and all coinsurance amounts--the hospital and extended care services coinsurance amounts--between September 1 and September 15 of the year preceding the year to which they will apply. These amounts are determined according to the statute as discussed above. As has been our custom, we use general notices, rather than notice and comment rulemaking procedures, to make the announcements. 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. 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 here, because the formulae used to calculate the inpatient hospital deductible and hospital and extended care services coinsurance amounts are statutorily directed, and we can exercise no discretion in following the formulae. Moreover, the statute establishes the time period for which the deductible and coinsurance amounts will apply and delaying publication 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. 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 1813(b)(2) of the Act requires the Secretary to publish, between September 1 and September 15 of each year, the amounts of the inpatient hospital deductible and hospital and extended care services coinsurance applicable for services furnished in the following CY. [[Page 80063]] B. Overall Impact We have examined the impact of this notice 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 total increase in costs to beneficiaries associated with this notice is about $740 million due to: (1) The increase in the deductible and coinsurance amounts; and (2) the increase in the number of deductibles and daily coinsurance amounts paid. As a result, this notice is economically significant under section 3(f)(1) of Executive Order 12866 and is 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 http://www.sba.gov/sites/default/files/files/Size_Standards_Table.pdf). Individuals and states are not included in the definition of a small entity. As discussed above, this annual notice announces the inpatient hospital deductible and the hospital and extended care services coinsurance amounts for services furnished in CY 2017 under Medicare's Hospital Insurance Program (Medicare Part A). 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. For 2016, that threshold accounting for inflation is approximately $146 million. This notice does not impose mandates that will have a consequential effect of $146 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, preempt state law, or have Federalism implications, the requirements of Executive Order 13132 are not applicable. Dated: September 23, 2016. Andrew M. Slavitt, Acting Administrator, Centers for Medicare & Medicaid Services. Dated: November 8, 2016. Sylvia M. Burwell, Secretary, Department of Health and Human Services. [FR Doc. 2016-27389 Filed 11-10-16; 4:15 pm] BILLING CODE 4120-01-P
![80060 Federal Register / Vol. 81, No. 220 / Tuesday, November 15, 2016 / Notices
Proposed Project alcohol-related attitudes and behaviors to 300 individuals will be screened to
Reframing How We Talk About because the range of knowledge and obtain 54 individuals who will
Alcohol: Public Perceptions of beliefs about excessive alcohol use and participate in 90-minute in-depth
Excessive Alcohol Use and Related its risks is not well understood. Despite interviews or triads. All data will be
Harms—NEW—National Center on Birth the fact that public health experts collected only one time. Respondents
Defects and Developmental Disabilities recommend that alcohol screening and who will participate in these interviews
(NCBDD), Centers for Disease Control brief counseling be provided to adults in and triads will be selected purposively
and Prevention (CDC). primary care settings, data indicate that to inform the development of a
only one of six U.S. adults reported ever messaging strategy. Topics addressed
Background and Brief Description discussing alcohol use with a health may include alcohol and its related
Excessive alcohol consumption leads professional. To develop an effective, harms, language used when talking
to a variety of negative health and social consistent messaging strategy, a deeper about alcohol, how people talk about
consequences. Those who drink heavily understanding of how the public thinks alcohol with their health care providers,
have an increased risk for certain and talks about alcohol is required. The and sources of information about
chronic diseases, such as hypertension, research will be used to inform the alcohol.
psychological disorders, and various development of patient and provider
The information gathered through this
forms of cancer. Excessive alcohol use materials and messages about excessive
data collection will allow CDC to
also can result in societal harms, such alcohol use and related harms.
The one-year study proposes a series develop an effective messaging strategy
as unintentional injuries, violence, and
of individual in-depth interviews and that reframes the way the public thinks
high economic costs.
Fortunately effective prevention triads (small group discussions with and communicates about excessive
strategies are available to reduce three participants) with 54 participants alcohol use. Participation is voluntary,
excessive alcohol use and its related identified by contractor staff and and there is no cost to respondents other
harms. However, it is difficult to craft professional recruiting firms. Data will than their time.
public health messages and be collected through one-time, 90- The total estimated annualized
communication strategies to change minute in-depth interviews or triads. Up burden hours are 132.
ESTIMATED ANNUALIZED BURDEN HOURS
Average
Number of
Number of burden per Total burden
Respondents Form name responses per
respondents response hours
respondent (in hours)
Persons aged 21–55 ......................... Study screener ................................. 300 1 10/60 50
In-depth interviews
Phase 1 (Descriptive) ....................... 9 1 1.5 14
Phase 2 (Prescriptive) ...................... 9 1 1.5 14
Triads
Phase 1 (Descriptive) ....................... 18 1 1.5 27
Phase 2 (Prescriptive) ...................... 18 1 1.5 27
Total ........................................... ........................................................... ........................ ........................ ........................ 132
Leroy A. Richardson, DEPARTMENT OF HEALTH AND furnished in calendar year (CY) 2017
Chief, Information Collection Review Office, HUMAN SERVICES under Medicare’s Hospital Insurance
Office of Scientific Integrity, Office of the Program (Medicare Part A). The
Associate Director for Science, Office of the Centers for Medicare & Medicaid Medicare statute specifies the formulae
Director, Centers for Disease Control and Services used to determine these amounts. For
Prevention. CY 2017, the inpatient hospital
[FR Doc. 2016–27395 Filed 11–14–16; 8:45 am] [CMS–8062–N]
deductible will be $1,316. The daily
BILLING CODE 4163–18–P RIN 0938–AS70 coinsurance amounts for CY 2017 will
be: (1) $329 for the 61st through 90th
Medicare Program; CY 2017 Inpatient day of hospitalization in a benefit
Hospital Deductible and Hospital and period; (2) $658 for lifetime reserve
Extended Care Services Coinsurance days; and (3) $164.50 for the 21st
Amounts through 100th day of extended care
services in a skilled nursing facility in
Centers for Medicare &
mstockstill on DSK3G9T082PROD with NOTICES
AGENCY:
a benefit period.
Medicaid Services (CMS), HHS.
ACTION: Notice. DATES: Effective Date: This notice is
effective on January 1, 2017.
SUMMARY: This notice announces the
inpatient hospital deductible and the FOR FURTHER INFORMATION CONTACT:
hospital and extended care services Clare McFarland, (410) 786–6390 for
coinsurance amounts for services general information.
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![Federal Register / Vol. 81, No. 220 / Tuesday, November 15, 2016 / Notices 80063
B. Overall Impact 2017 under Medicare’s Hospital DEPARTMENT OF HEALTH AND
We have examined the impact of this Insurance Program (Medicare Part A). HUMAN SERVICES
notice as required by Executive Order As a result, we are not preparing an
12866 on Regulatory Planning and analysis for the RFA because the Centers for Medicare & Medicaid
Review (September 30, 1993), Executive Secretary has determined that this Services
Order 13563 on Improving Regulation notice will not have a significant [CMS–8064–N]
and Regulatory Review (January 18, economic impact on a substantial
number of small entities. RIN 0938–AS72
2011), the Regulatory Flexibility Act
(RFA) (September 19, 1980, Pub. L. 96– In addition, section 1102(b) of the Medicare Program; Medicare Part B
354), section 1102(b) of the Social Social Security Act requires us to Monthly Actuarial Rates, Premium
Security Act, section 202 of the prepare a regulatory impact analysis if Rate, and Annual Deductible
Unfunded Mandates Reform Act of 1995 a rule may have a significant impact on Beginning January 1, 2017
(March 22, 1995; Pub. L. 104–4), the operations of a substantial number
Executive Order 13132 on Federalism of small rural hospitals. This analysis AGENCY: Centers for Medicare &
(August 4, 1999) and the Congressional must conform to the provisions of Medicaid Services (CMS), HHS.
Review Act (5 U.S.C., Part I, Ch. 8). section 604 of the RFA. For purposes of ACTION: Notice.
Executive Orders 12866 and 13563 section 1102(b) of the Act, we define a
direct agencies to assess all costs and SUMMARY: This notice announces the
small rural hospital as a hospital that is
benefits of available regulatory monthly actuarial rates for aged (age 65
located outside of a Metropolitan
alternatives and, if regulation is and over) and disabled (under age 65)
Statistical Area for Medicare payment
necessary, to select regulatory beneficiaries enrolled in Part B of the
regulations and has fewer than 100
approaches that maximize net benefits Medicare Supplementary Medical
beds. As discussed above, we are not
(including potential economic, Insurance (SMI) program beginning
preparing an analysis for section 1102(b)
environmental, public health and safety January 1, 2017. In addition, this notice
of the Act because the Secretary has
effects, distributive impacts, and announces the monthly premium for
determined that this notice will not
equity). A regulatory impact analysis aged and disabled beneficiaries, the
have a significant impact on the
(RIA) must be prepared for major deductible for 2017, and the income-
operations of a substantial number of
notices with economically significant related monthly adjustment amounts to
small rural hospitals.
effects ($100 million or more in any 1 be paid by beneficiaries with modified
Section 202 of the Unfunded adjusted gross income above certain
year). As stated in section IV of this Mandates Reform Act of 1995 also
notice, we estimate that the total threshold amounts. The monthly
requires that agencies assess anticipated actuarial rates for 2017 are $261.90 for
increase in costs to beneficiaries costs and benefits before issuing any
associated with this notice is about $740 aged enrollees and $254.20 for disabled
rule whose mandates require spending enrollees. The standard monthly Part B
million due to: (1) The increase in the in any 1 year of $100 million in 1995
deductible and coinsurance amounts; premium rate for all enrollees for 2017
dollars, updated annually for inflation. is $134.00, which is equal to 50 percent
and (2) the increase in the number of For 2016, that threshold accounting for
deductibles and daily coinsurance of the monthly actuarial rate for aged
inflation is approximately $146 million. enrollees (or approximately 25 percent
amounts paid. As a result, this notice is This notice does not impose mandates
economically significant under section of the expected average total cost of Part
that will have a consequential effect of B coverage for aged enrollees) plus
3(f)(1) of Executive Order 12866 and is $146 million or more on state, local, or
a major action under the Congressional $3.00. (The 2016 standard premium rate
tribal governments or on the private was $121.80, which includes the $3.00
Review Act. In accordance with the sector.
provisions of Executive Order 12866, repayment amount.) The Part B
this notice was reviewed by the Office Executive Order 13132 establishes deductible for 2017 is $183.00 for all
of Management and Budget. certain requirements that an agency Part B beneficiaries. If a beneficiary has
The RFA requires agencies to analyze must meet when it promulgates a to pay an income-related monthly
options for regulatory relief of small proposed rule (and subsequent final adjustment, they will have to pay a total
entities, if a rule has a significant impact rule) that imposes substantial direct monthly premium of about 35, 50, 65,
on a substantial number of small requirement costs on state and local or 80 percent of the total cost of Part B
entities. For purposes of the RFA, small governments, preempts state law, or coverage plus $4.20, $6.00, $7.80, or
entities include small businesses, otherwise has Federalism implications. $9.60.
nonprofit organizations, and small Since this notice does not impose any DATES: Effective Date: January 1, 2017.
governmental jurisdictions. Most costs on state or local governments, FOR FURTHER INFORMATION CONTACT: M.
hospitals and most other providers and preempt state law, or have Federalism Kent Clemens, (410) 786–6391.
suppliers are small entities, either by implications, the requirements of SUPPLEMENTARY INFORMATION:
nonprofit status or by having revenues Executive Order 13132 are not
of less than $7.5 million to $38.5 applicable. I. Background
million in any 1 year (for details, see the Dated: September 23, 2016. Part B is the voluntary portion of the
Small Business Administration’s Web Andrew M. Slavitt, Medicare program that pays all or part
site at http://www.sba.gov/sites/default/ of the costs for physicians’ services,
Acting Administrator, Centers for Medicare
files/files/Size_Standards_Table.pdf). outpatient hospital services, certain
mstockstill on DSK3G9T082PROD with NOTICES
& Medicaid Services.
Individuals and states are not included home health services, services furnished
Dated: November 8, 2016.
in the definition of a small entity. As by rural health clinics, ambulatory
discussed above, this annual notice Sylvia M. Burwell, surgical centers, comprehensive
announces the inpatient hospital Secretary, Department of Health and Human outpatient rehabilitation facilities, and
deductible and the hospital and Services. certain other medical and health
extended care services coinsurance [FR Doc. 2016–27389 Filed 11–10–16; 4:15 pm] services not covered by Medicare Part
amounts for services furnished in CY BILLING CODE 4120–01–P A, Hospital Insurance. Medicare Part B
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Document Created: 2016-11-15 00:48:27
Document Modified: 2016-11-15 00:48:27
| Category | Regulatory Information | |
| Collection | Federal Register | |
| sudoc Class | AE 2.7: GS 4.107: AE 2.106: | |
| Publisher | Office of the Federal Register, National Archives and Records Administration | |
| Section | Notices | |
| Action | Notice. | |
| Contact | Clare McFarland, (410) 786-6390 for general information. | |
| FR Citation | 81 FR 80060 | |
| RIN Number | 0938-AS70 |
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