75884 Federal Register / Vol. 75, No. 234 / Tuesday, December 7, 2010 / Rules and Regulations 

AD into the limitations section of aircraft 

maintenance manual. 

FAA AD Differences 

Note: This AD differs from the MCAI and/ 

or service information as follows: No 

differences. 

Other FAA AD Provisions 

(g) The following provisions also apply to 

this AD: 

(1) Alternative Methods of Compliance 

(AMOCs): The Manager, Standards Office, 

FAA, has the authority to approve AMOCs 

for this AD, if requested using the procedures 

found in 14 CFR 39.19. Send information to 

ATTN: Taylor Martin, Aerospace Engineer, 

FAA, Small Airplane Directorate, 901 Locust, 

Room 301, Kansas City, Missouri 64106; 

telephone: (816) 329–4138; fax: (816) 329– 

4090; e-mail: taylor.martin@faa.gov. Before 

using any approved AMOC on any airplane 

to which the AMOC applies, notify your 

appropriate principal inspector (PI) in the 

FAA Flight Standards District Office (FSDO), 

or lacking a PI, your local FSDO. 

(2) Airworthy Product: For any requirement 

in this AD to obtain corrective actions from 

a manufacturer or other source, use these 

actions if they are FAA-approved. Corrective 

actions are considered FAA-approved if they 

are approved by the State of Design Authority 

(or their delegated agent). You are required 

to assure the product is airworthy before it 

is returned to service. 

(3) Reporting Requirements: For any 

reporting requirement in this AD, under the 

provisions of the Paperwork Reduction Act 

(44 U.S.C. 3501 et seq.), the Office of 

Management and Budget (OMB) has 

approved the information collection 

requirements and has assigned OMB Control 

Number 2120–0056. 

Related Information 

(h) Refer to MCAI European Aviation 

Safety Agency (EASA) AD No.: 

2010–0162, dated August 4, 2010; BAE 

Systems British Aerospace Jetstream Series 

3100 & 3200 Service Bulletin 

05–JA090143, dated April 30, 2009; and 

British Aerospace Regional Aircraft British 

Aerospace Jetstream Series 3100 & 3200 

Service Bulletin 32–JA990142, dated March 

26, 1999, for related information. 

Material Incorporated by Reference 

(i) You must use BAE Systems British 

Aerospace Jetstream Series 3100 & 3200 

Service Bulletin 05–JA090143, dated April 

30, 2009; and British Aerospace Regional 

Aircraft British Aerospace Jetstream Series 

3100 & 3200 Service Bulletin 32–JA990142, 

dated March 26, 1999, to do the actions 

required by this AD, unless the AD specifies 

otherwise. 

(1) The Director of the Federal Register 

approved the incorporation by reference of 

this service information under 5 U.S.C. 

552(a) and 1 CFR part 51. 

(2) For service information identified in 

this AD, contact BAE Systems (Operations) 

Ltd, Customer Information Department, 

Prestwick International Airport, Ayrshire, 

KA9 2RW, Scotland, United Kingdom; 

telephone +44 1292 675207, fax: +44 1292 

675704; e-mail: 

RApublications@baesystems.com. 

(3) You may review copies of the 

referenced service information at the FAA, 

Small Airplane Directorate, 901 Locust, 

Kansas City, Missouri 64106. For information 

on the availability of this material at the 

FAA, call 816–329–4148. 

(4) You may also review copies of the 

service information incorporated by reference 

for this AD at the National Archives and 

Records Administration (NARA). For 

information on the availability of this 

material at NARA, call (202) 741–6030, or go 

to: http://www.archives.gov/federal_register/ 

code_of_federal_regulations/ 

ibr_locations.html. 

Issued in Kansas City, Missouri, on 

November 23, 2010. 

Earl Lawrence, 

Manager, Small Airplane Directorate, Aircraft 

Certification Service. 

[FR Doc. 2010–30197 Filed 12–6–10; 8:45 am] 

BILLING CODE 4910–13–P 

SOCIAL SECURITY ADMINISTRATION 

20 CFR Part 418 

[Docket No. SSA–2010–0029] 

RIN 0960–AH22 

Regulations Regarding Income-Related 

Monthly Adjustment Amounts to 

Medicare Beneficiaries’ Prescription 

Drug Coverage Premiums 

AGENCY: Social Security Administration. 

ACTION: Interim final rule with request 

for comments. 

SUMMARY: We are adding a new subpart 

to our regulations, which contains the 

rules we will apply to determine the 

income-related monthly adjustment 

amount for Medicare prescription drug 

coverage premiums. This new subpart 

implements changes made to the Social 

Security Act (Act) by the Affordable 

Care Act. These rules parallel the rules 

in subpart B of this part, which 

describes the rules we apply when we 

determine the income-related monthly 

adjustment amount for certain Medicare 

Part B (medical insurance) beneficiaries. 

These rules describe the new subpart; 

what information we will use to 

determine whether you will pay an 

income-related monthly adjustment 

amount and the amount of the 

adjustment when applicable; when we 

will consider a major life-changing 

event that results in a significant 

reduction in your modified adjusted 

gross income; and how you can appeal 

our determination about your incomerelated monthly adjustment amount. 

These rules will allow us to implement 

the provisions of the Affordable Care 

Act on time that relate to the incomerelated monthly adjustment amount for 

Medicare prescription drug coverage 

premiums, when they go into effect on 

January 1, 2011. 

DATES: Effective date: This interim final 

rule will be effective on December 7, 

2010. Comment date: To ensure that 

your comments are considered, we must 

receive them no later than February 7, 

2011. 

ADDRESSES: You may submit comments 

by any one of three methods—Internet, 

fax, or mail. Do not submit the same 

comments multiple times or by more 

than one method. Regardless of which 

method you choose, please state that 

your comments refer to Docket No. 

SSA–2010–0029 so that we may 

associate your comments with the 

correct regulation. 

Caution: You should be careful to 

include in your comments only 

information that you wish to make 

publicly available. We strongly urge you 

not to include in your comments any 

personal information, such as Social 

Security numbers or medical 

information. 

1. Internet: We strongly recommend 

that you submit your comments via the 

Internet. Please visit the Federal 

eRulemaking portal at http:// 

www.regulations.gov. Use the Search 

function to find docket number SSA– 

2010–0029. The system will issue a 

tracking number to confirm your 

submission. You will not be able to 

view your comment immediately 

because we must post each comment 

manually. It may take up to a week for 

your comment to be viewable. 

2. Fax: Fax comments to (410) 966– 

2830. 

3. Mail: Mail your comments to the 

Office of Regulations, Social Security 

Administration, 107 Altmeyer Building, 

6401 Security Boulevard, Baltimore, 

Maryland 21235–6401. 

Comments are available for public 

viewing on the Federal eRulemaking 

portal at http://www.regulations.gov or 

in person, during regular business 

hours, by arranging with the contact 

person identified below. 

FOR FURTHER INFORMATION CONTACT: 

Craig Streett, Office of Income Security 

Programs, Social Security 

Administration, 2–R–24 Operations 

Building, 6401 Security Boulevard, 

Baltimore, MD 21235–6401, (410) 965– 

9793. For information on eligibility or 

filing for benefits, call our national tollfree number, 1–800–772–1213 or TTY 

1–800–325–0778, or visit our Internet 

site, Social Security Online, at http:// 

www.socialsecurity.gov. 

SUPPLEMENTARY INFORMATION: 


srobinson on DSKHWCL6B1PROD with RULES
Federal Register / Vol. 75, No. 234 / Tuesday, December 7, 2010 / Rules and Regulations 75885 

1Public Law 111–148 § 3308(a). 

2 Id. 

3 § 1860D–13(a)(7)(C) of the Act. 

4 § 1839(i)(4)(A) of the Act. 

5 § 1839(i)(4)(B), (C) of the Act; § 1860D– 

13(a)(7)(C) of the Act. 

6 § 1839(i)(4)(B) of the Act. 

7 § 1839(i)(4)(B) of the Act. 

8 § 1839(i)(4)(C) of the Act. 

9 § 1860D–13(a)(7)(A) of the Act. 

Electronic Version 

The electronic file of this document is 

available on the date of publication in 

the Federal Register at http:// 

www.gpoaccess.gov/fr/index.html. 

Background 

Medicare prescription drug coverage 

(also known as Medicare Part D) is a 

voluntary program that covers 

prescription drugs, as explained in 42 

CFR Part 423. These regulations cover 

participants in Medicare prescription 

drug coverage plans as defined in 42 

CFR 423.4, including standalone 

Medicare prescription drug plans, 

Medicare Advantage plans with 

prescription drug coverage, Programs of 

All-Inclusive Care for the Elderly plans, 

and cost plans offering prescription 

drug coverage. We will refer to these 

plans collectively as Medicare 

prescription drug coverage plans. 

Beneficiaries enrolled in Medicare 

prescription drug coverage are 

responsible for deductibles, costsharing, and monthly premiums. Costs 

vary by plan. Beneficiaries with limited 

income and resources may qualify for 

‘‘Extra Help’’ with their monthly 

premiums, deductibles, and costsharing. 

The Centers for Medicare & Medicaid 

Services (CMS) promulgates rules and 

regulations concerning the Medicare 

program. CMS sets the Medicare 

prescription drug coverage base 

beneficiary premium, which covers 

approximately 25.5 percent of the cost 

of the basic Medicare prescription drug 

coverage. The Federal Government 

subsidizes approximately 74.5 percent 

of the cost of this basic Medicare 

prescription drug coverage with 

contributions from the Medicare 

Prescription Drug Account in the 

Federal Supplementary Medical 

Insurance Trust Fund. 

In March 2010, Congress passed the 

Affordable Care Act, which establishes 

an income-related adjustment to 

Medicare prescription drug coverage 

premiums.1 The Affordable Care Act 

contains rules for determining when, 

based on income, a beneficiary’s 

monthly premium for Medicare 

prescription drug coverage will include 

a monthly adjustment amount.2 The 

changes made to the Act by section 

3308(a) of the Affordable Care Act are 

effective for months after December 

2010. Beginning in January 2011, an 

estimated 1.05 million of the 

approximately 29.2 million beneficiaries 

enrolled in the Medicare prescription 

drug coverage program will be assessed 

an income-related monthly adjustment 

amount. 

Generally, beneficiaries who have a 

modified adjusted gross income above 

the threshold level in their most 

recently filed tax return (usually the tax 

year 2 years prior to the effective year 

of our determination) will pay an 

income-related monthly adjustment 

amount for their Medicare prescription 

drug coverage, resulting in these 

beneficiaries paying more of the cost of 

their Medicare prescription drug 

coverage. The income-related monthly 

adjustment amount applied is in 

addition to the Medicare Prescription 

drug coverage plan sponsor’s monthly 

premium and any applicable premium 

increase for late enrollment or 

reenrollment. We are responsible for 

making any determination necessary to 

carry out the income-related increase in 

beneficiary premiums. 

How This Will Affect You 

The phrase ‘‘modified adjusted gross 

income’’ has the same meaning given to 

that term in section 1839(i)(4)(A) of the 

Act.3 The phrase ‘‘modified adjusted 

gross income’’ means your ‘‘adjusted 

gross income,’’ as defined in section 62 

of the Internal Revenue Code of 1986, 

plus certain other forms of income that 

may be excluded from adjusted gross 

income for the purpose of determining 

the amount of Federal income tax that 

you must pay.4

We determine the taxable year to use 

for purposes of determining your 

modified adjusted gross income.5 Your 

modified adjusted gross income is 

generally determined for the ‘‘last 

taxable year beginning in the second 

calendar year proceeding the year 

involved.’’ 6 Thus, in general, we will 

use your modified adjusted gross 

income provided by the Internal 

Revenue Service (IRS) for the tax year 

2 years prior to the effective year of the 

income-related monthly adjustment 

amount determination we make. 

However, an exception allows us to 

use your modified adjusted gross 

income for the tax year 3 years prior to 

the effective year of the income-related 

monthly adjustment amount 

determination.7 In addition, there are 

certain circumstances in which we may 

use a more recent taxable year than the 

taxable year we would otherwise use to 

determine modified adjusted gross 

income when your income for the more 

recent year is significantly less than the 

income for the taxable year we normally 

would use. The situations that allow us 

to use data from a more recent taxable 

year are when you have experienced the 

death of your spouse, a marriage or 

divorce, or other major life-changing 

events that we specify in our 

regulations.8

The payment of the full amount of the 

income-related monthly adjustment 

amount will begin in January 2011.9 If 

you are enrolled in Medicare 

prescription drug coverage prior to 

January 1, 2011, and you will be 

required to pay an income-related 

monthly adjustment amount in 2011, we 

will notify you by sending you a letter 

at the end of 2010 about the additional 

income-related monthly adjustment 

amount. If you receive Social Security 

monthly benefits, we will also send a 

letter explaining how the incomerelated monthly adjustment amount will 

affect the amount of those benefits. If 

you receive Railroad Retirement or Civil 

Service annuity payments, you will 

receive a letter from the agency that 

pays your annuity explaining how the 

income-related monthly adjustment 

amount will affect the amount of those 

benefits. 

If you enroll in Medicare prescription 

drug coverage after January 1, 2011, 

your Medicare prescription drug 

coverage premium may not initially 

include an income-related monthly 

adjustment amount. If we subsequently 

determine that you must pay an incomerelated monthly adjustment amount for 

your Medicare prescription drug 

coverage, we will notify you shortly 

after you enroll in Medicare 

prescription drug coverage. You will be 

responsible for your income-related 

monthly adjustment amounts for those 

months after December 2010 for which 

you are enrolled in Medicare 

prescription drug coverage. If you are 

enrolled in Medicare prescription drug 

coverage during 2011 or after, we will 

notify you prior to the start of each year 

if you must pay an income-related 

monthly adjustment amount in that year 

and how much it will be. 

How We Determine Your IncomeRelated Monthly Adjustment Amount 

The amount of your modified 

adjusted gross income for the applicable 

tax year will determine if you must pay 

an income-related monthly adjustment 

amount. The modified adjusted gross 

income threshold amount for 2011 

through 2019 is $85,000 for individuals 

who designated a filing status on their 


srobinson on DSKHWCL6B1PROD with RULES
75886 Federal Register / Vol. 75, No. 234 / Tuesday, December 7, 2010 / Rules and Regulations 

10Section 1839(i)(2) of the Act. 11Section 1839(i)(4)(B)(iii) of the Act. 

Federal income tax return of single, 

married filing separately, head of 

household, or qualifying widow(er) with 

dependent child; and the corresponding 

threshold is $170,000 for individuals 

who file a joint income tax return with 

their spouse.10 After 2019, these 

thresholds will resume adjustment for 

inflation as required by section 

1839(i)(5) of the Act. 

We will ask the IRS to send us Federal 

income tax return information about 

your modified adjusted gross income for 

the tax year 2 years before the effective 

year of our determination of whether an 

income-related monthly adjustment 

amount will apply. If modified adjusted 

gross income information is not 

available from the IRS for the tax year 

2 years before the effective year of our 

determination, the IRS will send us 

modified adjusted gross income 

information for the tax year 3 years 

before the effective year, if it exceeds 

the threshold. The IRS will return 

modified adjusted gross income 

information only for those Medicare 

beneficiaries whose modified adjusted 

gross income exceeds the threshold for 

their income tax filing status. 

We will not ask the IRS for 

information about your modified 

adjusted gross income if we have 

determined that you are participating in 

the Medicare prescription drug coverage 

low-income subsidy program described 

in subpart D of this part, if you receive 

Supplemental Security Income 

payments under title XVI of the Act, or 

if CMS has determined that you are 

deemed eligible for a full Medicare 

prescription drug coverage subsidy 

under section 1860D–14(a)(3)(B)(v) of 

the Act, as further explained in 42 CFR 

423.773(c)(1). 

We will use information for the tax 

year 3 years prior to the effective year 

of our determination to determine 

whether you must pay an incomerelated monthly adjustment amount 

only until we obtain information for the 

tax year 2 years prior to the effective 

year of our determination. When we use 

such information to make a 

determination, we will make retroactive 

corrections that will apply to all months 

that you paid an incorrect incomerelated monthly adjustment amount. If 

we use information from the IRS for the 

tax year 3 years before the effective year 

of our determination, you may request 

that we use information that you 

provide for the tax year 2 years before 

the effective year of our determination. 

In some cases, you may pay a higher 

premium based on your information 

from the tax year 2 years prior to the 

effective year of our determination. 

However, providing that information to 

us, rather than having us receive 

information later from the IRS, will help 

you avoid a retroactive correction. In 

order for us to make an initial 

determination based on such a request, 

you must provide a copy of your Federal 

income tax return for that year by 

providing us with either your retained 

copy of your Federal income tax return, 

a copy that you request from the IRS, or 

an IRS transcript of your return. If you 

provide your retained copy of your tax 

return, we will verify this information 

with the IRS. 

If we receive information from the IRS 

that shows that you had modified 

adjusted gross income that exceeded the 

established threshold for a tax year for 

which you did not file a tax return, we 

will make a determination about your 

income-related monthly adjustment 

amount for that year. We will apply the 

highest applicable percentage 

adjustment based on that information, 

as required by statute.11 Beginning in 

2011, if the IRS provides information to 

us to indicate a change in your modified 

adjusted gross income for a prior tax 

year, we will use this information to 

establish corrections for the appropriate 

effective years, regardless of when we 

receive such information. 

The Sliding Scale Formula and How It 

Applies to You 

CMS will use a sliding scale formula 

to establish the four income-related 

monthly adjustment amounts annually 

beginning in 2011. The use of this 

sliding scale formula is prescribed in 

section 1839(i)(3) of the Act. CMS will 

provide each of the income-related 

monthly adjustment amounts to be used 

to SSA. The income-related monthly 

adjustment amount will be the 

adjustment from the approximately 25.5 

percent base beneficiary premium 

multiplied by a specified percentage. 

The percentage used in the calculation 

changes as the amount of modified 

adjusted gross income increases within 

the ranges used to set the incomerelated monthly adjustment amount. We 

will use your modified adjusted gross 

income and your Federal income tax 

filing status (e.g., single, married filing 

jointly, married filing separately) to 

determine whether you must pay an 

income-related monthly adjustment 

amount, and if so, what your incomerelated monthly adjustment amount will 

be. 

The modified adjusted gross income 

ranges are contained in section 

1839(i)(3)(C) of the Act as adjusted by 

section 1839(i)(5) and by 1839(i)(6), as 

amended by the Affordable Care Act. 

The range amounts for individuals who 

are married filing jointly are double the 

range amounts for single income tax 

filers. The IRS recognizes three 

additional filing statuses: head of 

household, qualifying widow(er) with 

dependent child, and married filing 

separately. If you file as a head of 

household, a qualifying widow(er) with 

a dependent child, or married filing 

separately, we will apply the modified 

adjusted gross income range applicable 

to individuals who file their Federal 

income tax return with a filing status of 

single. 

Individuals with a filing status of 

married, filing separately, who must pay 

an income-related monthly adjustment 

amount because their tax information 

reflects modified adjusted gross income 

under section 1839(i)(3)(C)(iii) of the 

Act and who lived with their spouse at 

any time during the year, will pay either 

the third or fourth range of incomerelated monthly adjustment amount as 

described in section 1839(i)(3)(C)(i) of 

the Act. Starting in 2010 for calendar 

year 2011, and annually thereafter for 

each following calendar year, CMS will 

publish the annual modified adjusted 

gross income ranges and income-related 

monthly adjustment amounts that are 

associated with each range. We will use 

this published information to determine 

which amount applies to you based on 

your tax filing status in the tax year we 

are using to determine your incomerelated monthly adjustment amount. 

If you filed an amended tax return for 

the tax year we used to make a 

determination of your income-related 

monthly adjustment amount, you may 

request that we use your amended tax 

return for that year. You must provide 

us with proof that you filed an amended 

tax return with the IRS, including your 

retained copy of the amended tax return 

and a letter from the IRS verifying 

receipt of the return or an IRS transcript 

of your amended tax return. 

If you believe that the IRS provided 

incorrect modified adjusted gross 

income information and we used that 

information to determine your incomerelated monthly adjustment amount, 

you may request that we make a new 

income-related monthly adjustment 

amount determination. You must 

provide proof of the error in the IRS 

data and evidence of your actual 

modified adjusted gross income, such as 

a copy of the return that you obtain from 

the IRS. When we use information from 

your amended or corrected Federal 

income tax return to make a 

determination, we will make retroactive 

adjustments that will apply to all 


srobinson on DSKHWCL6B1PROD with RULES
Federal Register / Vol. 75, No. 234 / Tuesday, December 7, 2010 / Rules and Regulations 75887 

12Section 1839(i)(4)(C) of the Act. 13Section 1839(i)(4)(C) of the Act. 14Section 1839(i)(4)(C)(ii) of the Act. 

months that you paid an incorrect 

income-related monthly adjustment 

amount. 

If you believe our determination that 

you must pay an income-related 

monthly adjustment amount for your 

Medicare prescription drug coverage is 

incorrect because you do not have that 

coverage, you must contact CMS to get 

your records corrected. We will use the 

corrected information we receive from 

CMS to correct our records and make all 

necessary adjustments. We will initiate 

a retroactive refund after we correct our 

records. 

Inflation Adjustment of the IncomeRelated Monthly Adjustment Amount 

The annual inflation adjustment of 

the thresholds and the modified 

adjusted gross income ranges used to 

determine whether you must pay an 

income-related monthly adjustment 

amount is temporarily set aside by 

section 3402 of the Affordable Care Act. 

From January 1, 2011 through December 

31, 2019, the dollar amounts used for 

2010 will be the thresholds used to 

determine if an income-related monthly 

adjustment amount will apply. The 

2010 thresholds in effect until the end 

of 2019 will be modified adjusted gross 

income of $170,000 for beneficiaries 

who file their Federal income taxes as 

married, filing jointly, and $85,000 for 

beneficiaries who file their Federal 

income taxes with any other filing 

status. CMS will publish the amounts 

within each range of income in the 

sliding scale adjusted for inflation each 

year. After 2019, these thresholds will 

resume adjustment for inflation as 

required by section 1839(i)(5) of the Act. 

Changes in Your Modified Adjusted 

Gross Income 

In consultation with the Secretary of 

the Treasury, we are required to 

establish procedures for determining 

your modified adjusted gross income for 

a tax year more recent than the 

information ordinarily provided by the 

IRS.12

The statute requires that we grant 

your request to use a more recent tax 

year to determine your income-related 

monthly adjustment amount only when 

all of the following conditions are met: 

• You experience a major lifechanging event; 

• That major life-changing event 

results in a significant reduction in your 

modified adjusted gross income; 

• You request that we use a more 

recent tax year’s modified adjusted gross 

income; and 

• You provide evidence of the event 

and the reduction in your modified 

adjusted gross income.13

These rules also contain the 

requirements that you must meet in 

order for us to use a more recent tax 

year’s modified adjusted gross income 

to determine whether you must pay an 

income-related monthly adjustment 

amount and what your income-related 

monthly adjustment amount will be. 

These rules define qualifying major lifechanging events and explain what 

constitutes a significant reduction in 

your modified adjusted gross income by 

reference to the rules we follow under 

subpart B of this part. We also specify 

the evidence we will require to establish 

major life-changing events and the 

resulting reduction in your modified 

adjusted gross income by reference to 

the rules we follow under subpart B of 

this part. 

Major life-changing events include 

marriage, divorce, and death of a spouse 

under section 1839(i)(4)(C)(ii)(II) of the 

Act. We have discretion to include in 

our regulations additional major lifechanging events that would allow us to 

grant your request that we use 

information from a more recent tax year 

to determine your income-related 

monthly adjustment amount. As noted 

above, these rules include explanation 

of the situations when we will 

determine that you have experienced a 

major life-changing event for purposes 

of our rules in subpart B of part 418. 

The following are the categories of 

qualifying major life-changing events 

that we currently recognize: 

• Death of a spouse; 

• Marriage; 

• Marriage ended by divorce or 

annulment; 

• Partial or full work stoppage; 

• You or your spouse experiences a 

loss of income-producing property, 

provided the loss is not at the direction 

of you or your spouse (e.g., due to the 

sale or transfer of the property) and is 

not a result of the ordinary risk of 

investment. Examples of the type of 

property loss include, but are not 

limited to: loss of real property within 

a Presidentially or Gubernatoriallydeclared disaster area, destruction of 

livestock or crops by natural disaster or 

disease, loss from real property due to 

arson, or loss of investment property as 

a result of fraud or theft due to a 

criminal act by a third party; 

• You or your spouse experiences a 

scheduled cessation, termination, or 

reorganization of an employer’s pension 

plan; 

• You or your spouse receives a 

settlement from an employer or former 

employer because of the employer’s 

closure, bankruptcy, or reorganization. 

In these rules, we determine what 

constitutes a significant reduction in 

your income by reference to the rules 

we follow under section 418.1215. 

Under those rules, we define a 

significant reduction in your modified 

adjusted gross income as any change 

that results in a reduction or elimination 

of your income-related monthly 

adjustment amount. Therefore, a 

significant reduction in your modified 

adjusted gross income is any change 

that lowers your income below the 

threshold amount or lowers the 

modified adjusted gross income range in 

which your income falls. We may grant 

your request to use a more recent tax 

year’s modified adjusted gross income 

to determine your income-related 

monthly adjustment amount only if you 

provide us with a copy of a filed Federal 

income tax return or equivalent 

document.14

When we make an income-related 

monthly adjustment amount 

determination based on your request 

due to a qualifying major life-changing 

event, the determination will be 

effective generally on January 1 of the 

calendar year for which we make the 

determination. If you enrolled in 

Medicare prescription drug coverage 

after January 1 of the year for which we 

make an income-related monthly 

adjustment amount determination based 

on your request due to a major lifechanging event, the determination will 

be effective the month your Medicare 

prescription drug coverage enrollment 

becomes effective. 

When we make an income-related 

monthly adjustment amount 

determination following a major lifechanging event using your more recent 

tax-year’s modified adjusted gross 

income, we will continue trying to get 

IRS data for that tax year. When we 

receive modified adjusted gross income 

information from the IRS for that tax 

year, we will use the information from 

the IRS to determine the correct incomerelated monthly adjustment amount for 

the year or years for which we used 

information that you provided, and we 

will make retroactive corrections, if 

necessary. Retroactive corrections will 

apply to all months for which you paid 

an incorrect income-related monthly 

adjustment amount. 


srobinson on DSKHWCL6B1PROD with RULES
75888 Federal Register / Vol. 75, No. 234 / Tuesday, December 7, 2010 / Rules and Regulations 

If You Disagree With Our 

Determination of Your Income-Related 

Monthly Adjustment Amount 

We will determine whether you must 

pay an income-related monthly 

adjustment, and the amount of any 

adjustment, based on information we 

receive from the IRS or you. We will 

send you a notice of our initial 

determination of your income-related 

monthly adjustment amount and the 

basis for our determination. The notice 

will explain that, if you disagree with 

our determination, you may request that 

we reconsider it within 60 days after the 

date you receive notice of our initial 

determination. The notice will also 

explain that you may request a new 

initial determination, rather than a 

reconsideration, if you believe the 

information we used in our initial 

determination was correct, but you want 

us to use different information about 

your modified adjusted gross income. If 

you have Medicare Part B without 

Medicare prescription drug coverage, 

and you enroll later that same year in 

Medicare prescription drug coverage, 

we will apply our income-related 

monthly adjustment amount 

determination for Medicare Part B to 

determine your corresponding incomerelated monthly adjustment amount for 

your Medicare prescription drug 

coverage. When this subsequent action 

results in increased deductions and a 

change in the net amount of benefits 

payable, you will get a letter notifying 

you of the change in your benefits and 

information on your appeal rights. 

For purposes of this subpart, in 

making initial determinations and 

reconsiderations, we will use the rules 

for the administrative review process 

that we use for determinations of your 

rights regarding nonmedical issues 

under title II of the Act. However, in 

order to expedite the processing of 

requests for reconsideration under these 

rules, we may accept requests for 

reconsideration that are filed by 

electronic or other means that we 

determine to be appropriate, other than 

a request in writing, as our title II 

regulations provide. 

If you are dissatisfied with our 

reconsidered determination, you may 

request further review, including a 

hearing before an administrative law 

judge (ALJ) from the Office of Medicare 

Hearings and Appeals (OMHA) at the 

Department of Health and Human 

Services (HHS), review by the Medicare 

Appeals Council (MAC) in HHS, and 

judicial review, consistent with the 

CMS regulations at 42 CFR part 423. 

You may request that we use a 

modified adjusted gross income for a 

more recent tax year if you have had a 

major life-changing event that 

significantly reduces your income, or if 

the IRS has provided to us modified 

adjusted gross income information from 

3 years prior to the premium effective 

year. You may also request that we 

make a new initial determination when 

you have amended your Federal income 

tax return or when you can furnish 

proof that the IRS has provided 

incorrect information about your 

modified adjusted gross income for the 

year that we used to determine your 

income-related monthly adjustment 

amount. These additional options do 

not affect your right to appeal an initial 

determination that we make that you 

must pay an income-related monthly 

adjustment amount, but allow you to 

choose an alternative or additional 

method to request that we use other 

information to make a new initial 

determination. 

Explanation of the New Subpart 

We are adding a new subpart C, 

Medicare Prescription Drug Coverage 

Income-Related Monthly Adjustment 

Amount, to part 418 of our rules. 

Subpart C contains the rules that we 

will use to determine when you will be 

required to pay an income-related 

monthly adjustment amount in addition 

to your Medicare prescription drug 

coverage monthly premium plus any 

applicable premium increase for late 

enrollment or reenrollment. Following 

is a description of each section for 

subpart C. 

Introduction, General Provisions, and 

Definitions 

• Section 418.2001 describes what 

provisions subpart C contains, lists the 

groups of sections in the subpart, and 

the subject of each group. 

• Section 418.2005 explains the 

purpose of the income-related monthly 

adjustment amount and how we will 

administer the income-related monthly 

adjustment amount. 

• Section 418.2010 contains 

definitions of terms used throughout 

this subpart. 

Determination of the Income-Related 

Monthly Adjustment Amount 

• Section 418.2101 explains what the 

income-related monthly adjustment 

amount is and when it is applied. 

• Section 418.2105 defines the 

modified adjusted gross income 

thresholds and what the modified 

adjusted gross income threshold 

amounts will be in the years 2011–2019. 

It also describes how threshold amounts 

will change in later years. 

• Section 418.2110 describes the 

effective date of our initial 

determination about the income-related 

monthly adjustment amount. 

• Section 418.2112 describes how 

you will pay your income-related 

monthly adjustment amount. 

• Section 418.2115 defines modified 

adjusted gross income ranges and 

explains how we will use those ranges 

and your tax filing status to determine 

the amount of your income-related 

monthly adjustment amount when 

applicable, and what effect Federal 

income tax filing status has on the 

ranges. 

• Section 418.2120 explains how we 

will determine your income-related 

monthly adjustment amount. 

• Section 418.2125 explains how the 

income-related monthly adjustment 

amount will affect what you pay for 

Medicare prescription drug coverage. 

• Section 418.2135 describes what 

modified adjusted gross income 

information we will use to determine 

your income-related monthly 

adjustment amount by reference to our 

rules in section 418.1135. 

• Section 418.2140 describes what 

will happen if the modified adjusted 

gross income that we later receive from 

the IRS is different from the information 

that we previously used to make a 

determination of your income-related 

monthly adjustment amount by 

reference to our rules in section 

418.1140. 

• Section 418.2145 describes how we 

will determine the income-related 

monthly adjustment amount if the IRS 

does not provide your modified 

adjusted gross income information by 

reference to our rules in section 

418.1145. 

• Section 418.2150 describes when 

we will use a copy of your amended 

Federal income tax return filed with the 

IRS to determine the income-related 

monthly adjustment amount by 

reference to our rules in section 

418.1150. 

Determinations Using a More Recent 

Tax Year’s Modified Adjusted Gross 

Income 

• Section 418.2201 explains when we 

will use modified adjusted gross income 

information for a more recent tax year 

to determine your income-related 

monthly adjustment amount by 

reference to our rules in section 

418.1201. 

• Section 418.2205 describes what is 

considered a major life-changing event 

that would justify using information 

from a more recent tax year by reference 

to our rules in section 418.1205. 


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• Section 418.2210 explains what is 

not considered a major life-changing 

event that would justify using 

information from a more recent tax year 

by reference to our rules in section 

418.1210. 

• Section 418.2215 explains what we 

consider a significant reduction in your 

income for the purpose of these rules by 

reference to our rules in section 

418.1215. 

• Section 418.2220 explains what we 

do not consider a significant reduction 

in your income for the purpose of these 

rules by reference to our rules in section 

418.1220. 

• Section 418.2225 explains which 

more recent tax years we may use to 

determine whether you must pay an 

income-related monthly adjustment 

amount and the amount of that 

adjustment by reference to our rules in 

section 418.1225. 

• Section 418.2230 explains the 

effective date of our income-related 

monthly adjustment amount 

determination based on your request to 

use a more recent tax year by reference 

to our rules in section 418.1230. 

• Section 418.2235 explains when we 

will stop using your modified adjusted 

gross income from a more recent tax 

year for income-related monthly 

adjustment amount determinations by 

reference to our rules in section 

418.1235. 

• Section 418.2240 explains what you 

should do if your modified adjusted 

gross income for the more recent tax 

year changes by reference to our rules in 

section 418.1240. 

• Section 418.2245 explains what 

will happen if you notify us of a change 

in your modified adjusted gross income 

for the more recent tax year. 

• Section 418.2250 explains what 

evidence you will need to support your 

request for us to use a more recent tax 

year to determine your income-related 

monthly adjustment amount by 

reference to our rules in section 

418.1250. 

• Section 418.2255 describes what 

evidence of a major life-changing event 

you will need to provide to support 

your request to use a more recent tax 

year by reference to our rules in section 

418.1255. 

• Section 418.2260 describes the 

types of evidence of a major lifechanging event that we will not accept 

by reference to our rules in section 

418.1260. 

• Section 418.2265 describes what 

evidence of a significant reduction in 

your modified adjusted gross income 

you will need to provide to support 

your request to use a more recent tax 

year by reference to our rules in section 

418.1265. 

• Section 418.2270 explains what 

evidence we will not accept of a 

significant reduction in your modified 

adjusted gross income by reference to 

our rules in section 418.1270. 

Determinations and the Administrative 

Review Process 

• Section 418.2301 explains what is 

an initial determination regarding your 

income-related monthly adjustment, 

and provides examples of 

determinations that are initial 

determinations for the purposes of these 

rules by reference to our rules in section 

418.1301. 

• Section 418.2305 explains that 

administrative actions that are not 

initial determinations are not subject to 

the administrative review process by 

reference to our rules in section 

418.1305. 

• Section 418.2310 explains when 

you may request that we make a new 

initial determination by reference to our 

rules in section 418.1310. 

• Section 418.2315 explains how we 

will notify you when we make an initial 

determination, and what information 

the notice will contain by reference to 

our rules in section 418.1315. 

• Section 418.2320 explains the effect 

of an initial determination. 

• Section 418.2322 explains how a 

Medicare Part B income-related monthly 

adjustment amount determination will 

apply to your Medicare prescription 

drug coverage. 

• Section 418.2325 explains when 

you may request a reconsideration by 

reference to our rules in section 

418.1325. 

• Section 418.2330 explains what 

will happen if you request a 

reconsideration because you believe that 

the IRS information we used to make an 

initial determination about your 

income-related monthly adjustment 

amount is incorrect. 

• Section 418.2332 explains what you 

can do if you believe that the CMS 

information we used is incorrect. 

• Section 418.2335 explains what to 

do if you believe that we based our 

initial determination on incorrect 

modified adjusted gross income 

information by reference to our rules in 

section 418.1335. 

• Section 418.2340 tells you the rules 

for the administrative review process by 

reference to our rules in section 

418.1340. 

• Section 418.2345 tells you the rules 

we will use to decide if reopening a 

prior initial or reconsidered 

determination made by us is appropriate 

by reference to our rules in section 

418.1345. 

• Section 418.2350 explains that the 

HHS rules will apply for review of a 

reconsidered determination, an ALJ 

decision, or a decision by the MAC. 

• Section 418.2355 explains that the 

rules for reopening a prior decision 

made by an ALJ of the OMHA or by the 

MAC will follow the HHS rules 

governing reopening. 

Change to Medicare Part B IncomeRelated Monthly Adjustment Amounts 

We are also amending our rules on the 

Medicare Part B (supplementary 

medical insurance) income-related 

monthly adjustment amounts to add 

section 418.1322. In order to provide 

consistency with the rules at final 

section 418.2322, this new section 

explains that if we make an incomerelated monthly adjustment amount 

determination for you for the effective 

year for purposes of the Medicare 

prescription drug coverage program, we 

will apply that income-related monthly 

adjustment amount determination for 

purposes of determining your incomerelated monthly adjustment amount for 

Medicare Part B for the same effective 

year. As a result, if you have Medicare 

prescription drug coverage without 

Medicare Part B and you enroll later 

that same year in Medicare Part B, the 

income-related monthly adjustment 

amount determination for your 

Medicare prescription drug coverage 

will also apply to your Medicare Part B. 

If we were to delay our determination 

when you enroll in Medicare Part B 

later in that year, the delay could cause 

confusion and larger retroactive 

corrections. Conveying your incomerelated monthly adjustment amount 

determination for Medicare prescription 

drug coverage or Medicare Part B to the 

other program when enrollment occurs 

later in that year will simplify 

processing and minimize delays in 

collections of adjustments. 

The new rule will facilitate applying 

the administrative review decision or 

new initial determination to both 

programs sooner, because this change 

will eliminate delays in applying the 

income-related monthly adjustment 

amount determination to both Medicare 

prescription drug coverage and 

Medicare Part B when you enroll in one 

of these programs later in the year than 

the other program. We will not request 

information from the IRS about your 

modified adjusted gross income under 

the following circumstances: if you are 

eligible for the low-income subsidy for 

your Medicare prescription drug 

coverage described in Subpart D of this 

Part, if you receive supplemental 


srobinson on DSKHWCL6B1PROD with RULES
75890 Federal Register / Vol. 75, No. 234 / Tuesday, December 7, 2010 / Rules and Regulations 

15 5 U.S.C. 553(b)(B). 16See 5 U.S.C. 553(d)(3). 

security income payments, or CMS has 

determined that you are deemed full 

Medicare prescription drug coverage 

subsidy eligible under § 1860D– 

14(a)(3)(B)(v) of the Act as further 

explained in 42 CFR 423.773(c)(1). 

Clarity of These Rules 

Executive Order 12866 requires each 

agency to write all rules in plain 

language. In addition to your 

substantive comments on this proposed 

rule, we invite your comments on how 

to make rules easier to understand. 

For example: 

• Would more, but shorter, sections 

be better? 

• Are the requirements in the rule 

clearly stated? 

• Have we organized the material to 

suit your needs? 

• Could we improve clarity by adding 

tables, lists, or diagrams? 

• What else could we do to make the 

rule easier to understand? 

• Does the rule contain technical 

language or jargon that is not clear? 

• Would a different format make the 

rule easier to understand, e.g. grouping 

and order of sections, use of headings, 

paragraphing? 

When will we start to use this rule? 

We will start to use these rules on the 

date shown under the ‘‘Effective Date’’ 

section earlier in this preamble. 

However, we are also inviting public 

comments on the changes made by these 

rules. We will consider any relevant 

comments we receive, and plan to 

publish another final rule document to 

respond to any such comments we 

receive, and to make any changes to the 

rules as appropriate based on the 

comments. 

Regulatory Procedures 

We follow the Administrative 

Procedure Act (APA) rulemaking 

procedures specified in 5 U.S.C. 553 

when we develop regulations. 

Generally, the APA requires that an 

agency provide prior notice and 

opportunity for public comment before 

issuing a final regulation. The APA 

provides exceptions to its notice and 

public comment procedures when an 

agency finds good cause for dispensing 

with such procedures because they are 

impracticable, unnecessary, or contrary 

to the public interest and incorporates a 

statement of the finding and its reasons 

in the rule issued.15

With respect to the new rules we are 

adding under subpart C of part 418 of 

our rules, we must begin to administer 

the income-related monthly adjustment 

amounts to Medicare prescription drug 

coverage on January 1, 2011, in 

accordance with section 3308(a) of the 

Affordable Care Act. In light of the 

March 23, 2010, enactment date of the 

Affordable Care Act and our need to 

have authority in place to make and 

issue notices of determinations to start 

collecting income-related monthly 

adjustment amounts for Medicare 

prescription drug coverage beginning 

January 1, 2011, we do not have 

sufficient time to provide a notice and 

comment period before promulgating 

final rules in order to begin 

administering the program in a timely 

manner. Thus, we find that the use of 

the APA’s notice and comment 

rulemaking procedures would be 

impracticable in this situation. 

With respect to the addition of 

§ 418.1322, we find that good cause 

exists for proceeding without prior 

public notice and comment because 

these changes allow us to avoid delay in 

making a second income-related 

monthly adjustment amount 

determination for Medicare Part B when 

a Medicare prescription drug coverage 

beneficiary enrolls in Medicare Part B 

later in the effective year. Avoiding such 

delay by applying an income-related 

monthly adjustment amount 

determination that is based on the same 

income threshold and ranges simplifies 

processing and minimizes the need for 

us to make unnecessary retroactive 

corrections. Accordingly, we find that 

prior public comment would be 

contrary to the public interest with 

respect to the changes we are making to 

our rules in subpart B of part 418. 

Although we are issuing this rule as 

an interim final rule, we are inviting 

public comment on the rule, and we 

will consider any responsive comments 

we receive within 60 days of the 

publication of the rule. 

In addition, for the reasons cited 

above, we also find good cause for 

dispensing with the 30-day delay in the 

effective date of this rule.16 Because we 

find that it is impracticable to delay the 

effective date of our rule changes in 

order to begin administering the 

program by the statutory deadline, we 

are making this rule effective upon 

publication. 

Executive Order 12866 

We have consulted with the Office of 

Management and Budget (OMB) and 

determined that this rule meets the 

criteria for a significant regulatory 

action under Executive Order 12866. 

Therefore, OMB reviewed it. 

Regulatory Flexibility Act 

We certify that this rule will not have 

a significant economic impact on a 

substantial number of small entities 

because it affects individuals only. 

Therefore, a regulatory flexibility 

analysis is not required under the 

Regulatory Flexibility Act, as amended. 

Paperwork Reduction Act 

We solicited public comment and 

received OMB approval for the public 

reporting burdens contained in these 

rules in a separate Information 

Collection Request. 

(Catalog of Federal Domestic Assistance 

Program Nos. 93.774 Medicare 

Supplementary Medical Insurance; 96.002 

Social Security—Retirement Insurance.) 

List of Subjects in 20 CFR Part 418 

Administrative practice and 

procedure, Aged, Blind, Disability 

benefits, Public assistance programs, 

Reporting and recordkeeping 

requirements, Supplemental Security 

Income (SSI), Medicare subsidies. 

Dated: November 23, 2010. 

Michael J. Astrue, 

Commissioner of Social Security. 

■ For the reasons set out in the 

preamble, we amend 20 CFR chapter III, 

part 418 as set forth below: 

■ 1. The authority citation for subpart B 

of part 418 continues to read as follows: 

Authority: Secs. 702(a)(5) and 1839(i) of 

the Social Security Act (42 U.S.C. 902(a)(5) 

and 1395r(i)). 

■ 2. Add § 418.1322 to read as follows: 

§ 418.1322 How will a Medicare 

prescription drug coverage income-related 

monthly adjustment amount determination 

for the effective year affect your Medicare 

Part B? 

If we make an income-related 

monthly adjustment amount 

determination for you for the effective 

year under subpart C of this part 

(Medicare Prescription Drug Coverage 

Income-Related Monthly Adjustment 

Amount), we will apply that incomerelated monthly adjustment amount 

determination under this subpart to 

determine your Part D income-related 

monthly adjustment amount for the 

same effective year. Therefore, if you 

become enrolled in Medicare Part B in 

the effective year after we make an 

income-related monthly adjustment 

amount determination about your 

Medicare prescription drug coverage, 

the income-related monthly adjustment 

amount determination for your 

Medicare prescription drug coverage 

will also be used to determine your 

Medicare Part B income-related monthly 

adjustment amount. Any change in your 


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Federal Register / Vol. 75, No. 234 / Tuesday, December 7, 2010 / Rules and Regulations 75891 

net benefit due will be accompanied by 

a letter explaining the change in your 

net benefit and your right to appeal the 

change. 

■ 3. Add subpart C to Part 418 to read 

as follows: 

Subpart C—Income-Related Monthly 

Adjustments to Medicare Prescription 

Drug Coverage Premiums 

Sec. 

Introduction, General Provisions, and 

Definitions 

418.2001 What is this subpart about? 

418.2005 Purpose and administration. 

418.2010 Definitions. 

Determination of the Income-Related 

Monthly Adjustment Amount 

418.2101 What is the income-related 

monthly adjustment amount? 

418.2105 What is the threshold? 

418.2110 What is the effective date of our 

initial determination about your incomerelated monthly adjustment amount? 

418.2112 Paying your income-related 

monthly adjustment amount. 

418.2115 What are the modified adjusted 

gross income ranges? 

418.2120 How do we determine your 

income-related monthly adjustment 

amount? 

418.2125 How will the income-related 

monthly adjustment amount affect your 

total Medicare prescription drug 

coverage premium? 

418.2135 What modified adjusted gross 

income information will we use to 

determine your income-related monthly 

adjustment amount? 

418.2140 What will happen if the modified 

adjusted gross income information from 

the IRS is different from the modified 

adjusted gross income information we 

used to determine your income-related 

monthly adjustment amount? 

418.2145 How do we determine your 

income-related monthly adjustment 

amount if the IRS does not provide 

information about your modified 

adjusted gross income? 

418.2150 When will we use your amended 

tax return filed with the IRS? 

Determinations Using a More Recent Tax 

Year’s Modified Adjusted Gross Income 

418.2201 When will we determine your 

income-related monthly adjustment 

amount based on the modified adjusted 

gross income information that you 

provide for a more recent tax year? 

418.2205 What is a major life-changing 

event? 

418.2210 What is not a major life-changing 

event? 

418.2215 What is a significant reduction in 

your income? 

418.2220 What is not a significant 

reduction in your income? 

418.2225 Which more recent tax year will 

we use? 

418.2230 What is the effective date of an 

income-related monthly adjustment 

amount initial determination based on a 

more recent tax year? 

418.2235 When will we stop using your 

more recent tax year’s modified adjusted 

gross income to determine your incomerelated monthly adjustment amount? 

418.2240 Should you notify us if the 

information you gave us about your 

modified adjusted gross income for the 

more recent tax year changes? 

418.2245 What will happen if you notify us 

that your modified adjusted gross 

income for the more recent tax year 

changes? 

418.2250 What evidence will you need to 

support your request that we use a more 

recent tax year? 

418.2255 What kind of evidence of a major 

life-changing event will you need to 

support your request for us to use a more 

recent tax year? 

418.2260 What major life-changing event 

evidence will we not accept? 

418.2265 What kind of evidence of a 

significant modified adjusted gross 

income reduction will you need to 

support your request? 

418.2270 What modified adjusted gross 

income evidence will we not accept? 

Determinations and the Administrative 

Review Process 

418.2301 What is an initial determination 

regarding your income-related monthly 

adjustment amount? 

418.2305 What is not an initial 

determination regarding your incomerelated monthly adjustment amount? 

418.2310 When may you request that we 

make a new initial determination? 

418.2315 How will we notify you and what 

information will we provide about our 

initial determination? 

418.2320 What is the effect of an initial 

determination? 

418.2322 How will a Medicare Part B 

income-related monthly adjustment 

amount determination for the effective 

year affect your Medicare prescription 

drug coverage? 

418.2325 When may you request a 

reconsideration? 

418.2330 Can you request a reconsideration 

when you believe that the IRS 

information we used is incorrect? 

418.2332 Can you request a reconsideration 

when you believe that the CMS 

information we used is incorrect? 

418.2335 What should you do if we base 

our initial determination on modified 

adjusted gross income information you 

believe to be incorrect? 

418.2340 What are the rules for our 

administrative review process? 

418.2345 Is reopening of an initial or 

reconsidered determination made by us 

ever appropriate? 

418.2350 What are the rules for review of a 

reconsidered determination or an ALJ 

decision? 

418.2355 What are the rules for reopening 

a decision by an ALJ of the Office of 

Medicare Hearings and Appeals (OMHA) 

or by the Medicare Appeals Council 

(MAC)? 

Authority: Secs. 702(a)(5), 1860D–13(a) 

and (c) of the Social Security Act (42 U.S.C. 

902(a)(5), 1395w–113(a) and (c)). 

Introduction, General Provisions, and 

Definitions 

§ 418.2001 What is this subpart about? 

This subpart implements sections 

1860D–13(a)(7) and 1860D–13(c)(4) of 

the Social Security Act (the Act), as 

added by section 3308 of the Affordable 

Care Act (Pub. L. 111–148). Section 

3308(a) establishes an income-related 

monthly adjustment to Medicare 

prescription drug coverage premiums. 

Persons enrolled in Medicare 

prescription drug plans, Medicare 

Advantage plans with prescription drug 

coverage, Programs of All-Inclusive Care 

for the Elderly plans, and cost plans 

offering prescription drug coverage who 

have modified adjusted gross income 

over a threshold amount established in 

the statute will pay an income-related 

monthly adjustment amount in addition 

to their Medicare prescription drug 

coverage plan’s monthly premium and 

any applicable premium increases as 

described in 42 CFR 423.286. The 

regulations in this subpart explain how 

we determine whether you are required 

to pay an income-related monthly 

adjustment amount, and if you are, the 

amount of your adjustment. We have 

divided the rules into the following 

groups of sections: 

(a) Sections 418.2001 through 

418.2010 contain the introduction, a 

statement of the general purpose of the 

income-related monthly adjustment 

amount, general provisions that apply to 

the income-related monthly adjustment 

amount, and definitions of terms that 

we use in this subpart. 

(b) Sections 418.2101 through 

418.2150 describe what information 

about your modified adjusted gross 

income we will use to determine if you 

are required to pay an income-related 

monthly adjustment amount. In these 

sections, we also describe how the 

income-related monthly adjustment 

amount will affect your total Medicare 

prescription drug coverage premium. 

(c) Sections 418.2201 through 

418.2270 contain an explanation of the 

standards that you must meet for us to 

grant your request to use modified 

adjusted gross income information that 

you provide for a more recent tax year 

rather than the information described in 

paragraph (b) of this section. These 

sections explain when we may consider 

such a request, and the evidence that 

you will be required to provide. These 

sections also explain when an incomerelated monthly adjustment amount 

determination based on information you 

provide will be effective, and how long 


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it will remain in effect. Additionally, 

these sections describe how we make 

retroactive adjustments of the incomerelated monthly adjustment amount 

based on information you provide, 

updated information you provide, and 

information we later receive from the 

Internal Revenue Service. 

(d) Sections 418.2301 through 

418.2355 explain how we will notify 

you of our determination regarding your 

income-related monthly adjustment 

amount and contain the rules that we 

will apply when you disagree with our 

determination. These sections explain 

your appeal rights and the 

circumstances under which you may 

request that we make a new initial 

determination of your income-related 

monthly adjustment amount. 

§ 418.2005 Purpose and administration. 

(a) The purpose of the income-related 

monthly adjustment amount is for 

beneficiaries who have modified 

adjusted gross income above an 

established threshold to reimburse the 

Federal Government for a portion of the 

Federal subsidy of the Medicare 

prescription drug coverage. Persons who 

have modified adjusted gross income 

above the thresholds described in 

§ 418.2105 will pay an income-related 

monthly adjustment amount in addition 

to the premium for their prescription 

drug coverage. The income-related 

monthly adjustment amount due will be 

determined based on the base 

beneficiary premium amount that 

represents 25.5 percent of the cost of the 

basic Medicare prescription drug 

coverage. The application of an incomerelated monthly adjustment amount 

results in an increase in the total 

amount that those who are affected pay 

for Medicare prescription drug coverage 

plans. A person who has modified 

adjusted gross income above the 

threshold amount will pay: 

(1) The Medicare prescription drug 

coverage plan monthly premium; plus 

(2) Any applicable increase for late 

enrollment or reenrollment; 

(3) An income-related monthly 

adjustment amount; and 

(b) The Centers for Medicare & 

Medicaid Services in the Department of 

Health and Human Services establishes 

rules for eligibility for Medicare 

prescription drug coverage and 

enrollment in Medicare prescription 

drug coverage plans, as well as premium 

penalties for late enrollment or 

reenrollment (42 CFR 423.30 through 

423.56). 

(c) We use information from CMS 

about enrollment in Medicare 

prescription drug coverage plans to 

determine the records that we must 

send to the IRS. 

(d) We use information that we get 

from the IRS to determine if persons 

enrolled in Medicare prescription drug 

coverage plans are required to pay an 

income-related monthly adjustment 

amount. We also change income-related 

monthly adjustment amount 

determinations using information you 

provide under certain circumstances. In 

addition, we notify beneficiaries when 

the social security benefit amounts they 

receive will change based on our 

income-related monthly adjustment 

amount determination. 

§ 418.2010 Definitions. 

(a) Terms relating to the Act and 

regulations. For the purposes of this 

subpart: 

(1) Administrator means the 

Administrator of CMS in HHS. 

(2) ALJ means administrative law 

judge. 

(3) CMS means the Centers for 

Medicare & Medicaid Services in HHS. 

(4) Commissioner means the 

Commissioner of Social Security. 

(5) HHS means the Department of 

Health and Human Services, which 

oversees the Centers for Medicare & 

Medicaid Services (CMS), the Office of 

Medicare Hearings and Appeals 

(OMHA) and the Medicare Appeals 

Council (MAC) 

(6) IRS means the Internal Revenue 

Service in the Department of the 

Treasury. 

(7) MAC means the Medicare Appeals 

Council in HHS. 

(8) Medicare Prescription Drug 

Coverage Plan means a Medicare 

prescription drug plan, a Medicare 

Advantage plan with prescription drug 

coverage, a Program for All-inclusive 

Care for the Elderly plan offering 

qualified prescription drug coverage, or 

a cost plan offering qualified 

prescription drug coverage. 

(9) OMHA means the Office of 

Medicare Hearings and Appeals in HHS. 

(10) Section means a section of the 

regulations in this part unless the 

context indicates otherwise. 

(11) The Act means the Social 

Security Act, as amended. 

(12) Title means a title of the Act. 

(13) We, our, or us means the Social 

Security Administration (SSA). 

(b) Miscellaneous. For the purposes of 

this subpart: 

(1) Amended tax return means a 

Federal income tax return for which an 

individual or couple has filed an 

amended tax return that has been 

accepted by the IRS. 

(2) Effective year means the calendar 

year for which we make an incomerelated monthly adjustment amount 

determination. 

(3) Federal premium subsidy is the 

portion of the cost of providing 

Medicare prescription drug coverage 

that is paid by the Federal Government. 

The Federal Government pays this 

amount to Medicare Prescription Drug 

coverage Plans from payments made 

into the Medicare Prescription Drug 

Account in the Federal Supplementary 

Medical Insurance Trust Fund. 

(4) Income-related monthly 

adjustment amount is an additional 

amount of premium that you will pay 

for Medicare prescription drug coverage 

if you have modified adjusted gross 

income above the threshold described in 

418.2105. 

(5) Modified Adjusted Gross Income is 

your adjusted gross income as defined 

by the Internal Revenue Code, plus the 

following forms of tax-exempt income: 

(i) Tax-exempt interest income; 

(ii) Income from United States savings 

bonds used to pay higher education 

tuition and fees; 

(iii) Foreign earned income; 

(iv) Income derived from sources 

within Guam, American Samoa, or the 

Northern Mariana Islands; and 

(v) Income from sources within Puerto 

Rico. 

(6) Modified adjusted gross income 

ranges are the groupings of modified 

adjusted gross income above the 

threshold. There are four ranges for 

most individuals, based on their tax 

filing status. There are two ranges for 

those with a tax filing status of married, 

filing separately, who also lived with 

their spouse for part of the year. The 

dollar amounts of the modified adjusted 

gross income ranges are specified in 

§ 418.2115. 

(7) Premium is a payment that an 

enrolled beneficiary pays for Medicare 

prescription drug coverage to a 

Medicare prescription drug plan, a 

Medicare Advantage plan with 

prescription drug coverage, a Program of 

All-Inclusive Care for the Elderly Plan 

offering qualified prescription drug 

coverage, or a cost plan offering 

qualified prescription drug coverage. 

The rules that CMS use annually to 

establish premium amounts for 

Medicare prescription drug coverage are 

contained in 42 CFR 423.286. 

(8) Representative means, for the 

purposes of the initial determination 

and reconsidered determination, an 

individual as defined in § 404.1703 of 

this chapter, and for purposes of an ALJ 

hearing or review by the MAC, an 

individual as defined in 42 CFR 

423.560. 

(9) Tax filing status means the filing 

status shown on your individual income 


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Federal Register / Vol. 75, No. 234 / Tuesday, December 7, 2010 / Rules and Regulations 75893 

tax return. It may be single, married 

filing jointly, married filing separately, 

head of household, or qualifying 

widow(er) with dependent child. 

(10) Tax year means the year for 

which you have filed or will file your 

Federal income tax return with the IRS. 

(11) Threshold means a modified 

adjusted gross income amount above 

which you will have to pay an incomerelated monthly adjustment amount 

described in paragraph (b)(4) of this 

section. The dollar amount of the 

threshold is specified in § 418.2105. 

(12) You or your means the person or 

representative of the person who is 

subject to the income-related monthly 

adjustment amount. 

Determination of the Income-Related 

Monthly Adjustment Amount 

§ 418.2101 What is the income-related 

monthly adjustment amount? 

(a) The income-related monthly 

adjustment amount is an amount that 

you will pay in addition to the Medicare 

prescription drug coverage plan 

monthly premium, plus any applicable 

increase in that premium as described 

in 42 CFR 423.286, for your Medicare 

prescription drug coverage plan when 

your modified adjusted gross income is 

above the threshold described in 

§ 418.2105. 

(b) Your income-related monthly 

adjustment amount is based on your 

applicable modified adjusted gross 

income as described in § 418.2115 and 

your tax filing status. 

(c) We will determine your incomerelated monthly adjustment amount 

using the method described in 

§ 418.2120. 

§ 418.2105 What is the threshold? 

(a) The threshold is a level of 

modified adjusted gross income above 

which you will have to pay the incomerelated monthly adjustment amount. 

(b) For calendar years 2011 through 

and including 2019, the modified 

adjusted gross income threshold is 

$85,000 for individuals with a Federal 

income tax filing status of single, 

married filing separately, head of 

household, and qualifying widow(er) 

with dependent child. The threshold is 

$170,000 for individuals with a Federal 

income tax filing status of married filing 

jointly. 

(c) Starting at the end of calendar year 

2019 and for each calendar year 

thereafter, CMS will set the threshold 

amounts for the following year. CMS 

will publish the threshold amounts 

annually in the Federal Register. 

Published threshold amounts will be 

effective January 1 of the next calendar 

year, and remain unchanged for the full 

calendar year. 

§ 418.2110 What is the effective date of our 

initial determination about your incomerelated monthly adjustment amount? 

(a) Generally, an income-related 

monthly adjustment amount 

determination will be effective for all 

months that you are enrolled in a 

prescription drug coverage plan during 

the year for which we determine you 

must pay an income-related monthly 

adjustment amount. 

(b) When we have used modified 

adjusted gross income information from 

the IRS for the tax year 3 years prior to 

the effective year to determine your 

income-related monthly adjustment 

amount, and modified adjusted gross 

income information for the tax year 2 

years prior later becomes available from 

the IRS, we will review the new 

information to determine if we should 

revise our initial determination 

concerning the income-related monthly 

adjustment amount. If we revise our 

initial determination, the effective date 

of the new initial determination will be 

January 1 of the effective year, or the 

first month your enrollment or reenrollment in a Medicare prescription 

drug coverage plan became effective if 

later than January. 

(c) When we use your amended tax 

return, as described in § 418.2150, the 

effective date will be January 1 of the 

year(s) that is affected, or the first month 

in that year that your enrollment or reenrollment in a Medicare prescription 

drug coverage plan became effective if 

later than January. 

Example: You are enrolled in Medicare 

prescription drug coverage throughout 2011. 

We use your 2009 modified adjusted gross 

income as reported to us by the IRS to 

determine your 2011 income-related monthly 

adjustment amount. In 2012, you submit to 

us a copy of your 2009 amended tax return 

that you filed with the IRS. The modified 

adjusted gross income reported on your 2009 

amended tax return is significantly less than 

originally reported to the IRS. We use the 

modified adjusted gross income reported on 

your 2009 amended tax return to determine 

your income-related monthly adjustment 

amount. That income-related monthly 

adjustment amount is effective January 1, 

2011. We will retroactively correct any 

differences between the amount paid in 2011 

and the amount you should have paid based 

on the amended tax return. 

(d) When we use evidence that you 

provide to proves the IRS modified 

adjusted gross income information we 

used was incorrect, as described in 

§ 418.2335, the effective date will be 

January of the year(s) that is affected or 

the first month in that year that your 

enrollment or re-enrollment in a 

Medicare prescription drug coverage 

plan became effective if later than 

January. 

(e) When we use information from a 

more recent tax year that you provide 

due to a major life-changing event, as 

described in § 418.2201, the effective 

date is described in § 418.2230. 

§ 418.2112 Paying your income-related 

monthly adjustment amount. 

(a) We will deduct the income-related 

monthly adjustment amount from your 

Social Security benefits if they are 

sufficient to cover the amount owed. If 

the amount of your Social Security 

benefits is not sufficient to pay the full 

amount of your income-related monthly 

adjustment amount, CMS will bill you 

for the full amount owed. 

(b) If you do not receive Social 

Security or Railroad Retirement Board 

benefits, but you receive benefits from 

the Office of Personnel Management, the 

Office of Personnel Management will 

deduct the income-related monthly 

adjustment amount from your benefits if 

they are sufficient to cover the amount 

owed. If the amount of your Office of 

Personnel Management benefits is not 

sufficient to pay the full amount of your 

income-related monthly adjustment 

amount, CMS will bill you for the full 

amount owed. 

(c) If you do not receive Social 

Security, Railroad Retirement Board, or 

Office of Personnel Management 

benefits, CMS will bill you for your 

income-related monthly adjustment 

amount. 

§ 418.2115 What are the modified adjusted 

gross income ranges? 

(a) We list the modified adjusted gross 

income ranges for the calendar years 

2011 through and including 2019 for 

each Federal tax filing category in 

paragraphs (b), (c) and (d) of this 

section. We will use your modified 

adjusted gross income amount together 

with your tax filing status to determine 

the amount of your income-related 

monthly adjustment for these calendar 

years. 

(b) For calendar years 2011 through 

and including 2019, the modified 

adjusted gross income ranges for 

individuals with a Federal tax filing 

status of single, head of household, 

qualifying widow(er) with dependent 

child, and married filing separately 

when the individual has lived apart 

from his/her spouse for the entire tax 

year for the year we use to make our 

income-related monthly adjustment 

amount determination are as follows: 

(1) Greater than $85,000 and less than 

or equal to $107,000; 

(2) Greater than $107,000 and less 

than or equal to $160,000; 


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(3) Greater than $160,000 and less 

than or equal to $214,000; and 

(4) Greater than $214,000. 

(c) For calendar years 2011 through 

and including 2019, the modified 

adjusted gross income ranges for 

individuals who are married and filed a 

joint tax return for the tax year we use 

to make the income-related monthly 

adjustment amount determination are as 

follows: 

(1) Greater than $170,000 and less 

than or equal to $214,000; 

(2) Greater than $214,000 and less 

than or equal to $320,000; 

(3) Greater than $320,000 and less 

than or equal to $428,000; and 

(4) Greater than $428,000. 

(d) For calendar years 2011 through 

and including 2019, the modified 

adjusted gross income ranges for 

married individuals who file a separate 

return and have lived with their spouse 

at any time during the tax year we use 

to make the income-related monthly 

adjustment amount determination are as 

follows: 

(1) Greater than $85,000 and less than 

or equal to $129,000; and 

(2) Greater than $129,000. 

(e) In 2019, CMS will set all modified 

adjusted gross income ranges for 2020 

and publish them in the Federal 

Register. In each year thereafter, CMS 

will set all modified adjusted gross 

income ranges and publish the amounts 

for each range prior to the beginning of 

each subsequent year. 

§ 418.2120 How do we determine your 

income-related monthly adjustment 

amount? 

(a) We will determine your incomerelated monthly adjustment amount by 

using your tax filing status and modified 

adjusted gross income. 

(b) Tables of applicable percentage. 

The tables in paragraphs (b)(1) through 

(b)(3) of this section contain the 

modified adjusted gross income ranges 

for calendar years 2011 through and 

including 2019, and the corresponding 

percentage of the cost of basic Medicare 

prescription drug coverage that 

individuals with modified adjusted 

gross incomes that fall within each of 

the ranges will pay. The monthly dollar 

amounts will be determined by CMS 

using the formula in § 1860D–13(a)(7)(B) 

of the Act. Based on your tax filing 

status for the tax year we use to make 

a determination about your incomerelated monthly adjustment amount, we 

will determine which table is applicable 

to you. We will use your modified 

adjusted gross income to determine 

which income-related monthly 

adjustment amount to apply to you. The 

dollar amounts used for each of the 

ranges of income-related monthly 

adjustment will be set annually after 

2019 as described in paragraph (c) of 

this section. The modified adjusted 

gross income ranges will be adjusted 

annually after 2019 as described in 

§ 418.2115(e). 

(1) General table of applicable 

percentages. If your filing status for your 

Federal income taxes for the tax year we 

use is single; head of household; 

qualifying widow(er) with dependent 

child; or married filing separately and 

you lived apart from your spouse for the 

entire tax year, we will use the general 

table of applicable percentages. When 

your modified adjusted gross income for 

the year we use is in the range listed in 

the left column in the following table, 

you will pay an amount based on the 

percentage listed in the right column, 

which represents a percentage of the 

cost of basic Medicare prescription drug 

coverage. 

Modified adjusted gross income effective in 2011–2019 

Beneficiary 

percentage 

(percent) 

More than $85,000 but less 

than or equal to $107,000 35 

More than $107,000 but less 

than or equal to $160,000 50 

More than $160,000 but less 

than or equal to $214,000 65 

More than $214,000 ............. 80 

(2) Table of applicable percentages for 

joint returns. If your Federal tax filing 

status is married filing jointly for the tax 

year we use and your modified adjusted 

gross income for that tax year is in the 

range listed in the left column in the 

following table, you will pay an amount 

based on the percentage listed in the 

right column, which represents a 

percentage of the cost of basic Medicare 

prescription drug coverage. 

Modified adjusted gross income effective in 2011–2019 

Beneficiary 

percentage 

(percent) 

More than $170,000 but less 

than or equal to $214,000 35 

More than $214,000 but less 

than or equal to $320,000 50 

More than $320,000 but less 

than or equal to $428,000 65 

More than $428,000 ............. 80 

(3) Table of applicable percentages for 

married individuals filing separate 

returns. If, for the tax year we use, your 

Federal tax filing status is married filing 

separately, you lived with your spouse 

at some time during that tax year, and 

your modified adjusted gross income is 

in the range listed in the left column in 

the following table, you will pay an 

amount based on the percentage listed 

in the right column, which represents a 

percentage of the cost of basic Medicare 

prescription drug coverage. 

Modified adjusted gross income effective in 2011–2019 

Beneficiary 

percentage 

(percent) 

More than $85,000 but less 

than or equal to $129,000 65 

More than $129,000 ............. 80 

(c) For each year after 2019, CMS will 

announce the modified adjusted gross 

income ranges for the income-related 

monthly adjustment amount described 

in paragraph (b) of this section. 

§ 418.2125 How will the income-related 

monthly adjustment amount affect your 

total Medicare prescription drug coverage 

premium? 

(a) If you must pay an income-related 

monthly adjustment amount, your total 

Medicare prescription drug coverage 

premium will be the sum of: 

(1) Your prescription drug coverage 

monthly premium, as determined by 

your plan; plus 

(2) Any applicable increase in the 

prescription drug coverage monthly 

premium as described in 42 CFR 

423.286; plus 

(3) Your income-related monthly 

adjustment amount. 

(b) Regardless of the method you use 

to pay your Medicare prescription drug 

coverage premiums to your Medicare 

prescription drug coverage plan, you 

will pay any income-related monthly 

adjustment amount you owe using the 

method described in 418.2112. 

§ 418.2135 What modified adjusted gross 

income information will we use to 

determine your income-related monthly 

adjustment amount? 

We will follow the rules in 

§ 418.1135, except that any references in 

that section to regulations in subpart B 

of this part shall be treated as references 

to the corresponding regulation in this 

subpart. 

§ 418.2140 What will happen if the 

modified adjusted gross income 

information from the IRS is different from 

the modified adjusted gross income 

information we used to determine your 

income-related monthly adjustment 

amount? 

We will follow the rules in 

§ 418.1140, except that any references in 

that section to regulations in subpart B 

of this part shall be treated as references 

to the corresponding regulation in this 

subpart. 


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§ 418.2145 How do we determine your 

income-related monthly adjustment amount 

if the IRS does not provide information 

about your modified adjusted gross 

income? 

We will follow the rules in 

§ 418.1145, except that any references in 

that section to regulations in subpart B 

of this part shall be treated as references 

to the corresponding regulation in this 

subpart. 

§ 418.2150 When will we use your 

amended tax return filed with the IRS? 

We will follow the rules in 

§ 418.1150, except that any references in 

that section to regulations in subpart B 

of this part shall be treated as references 

to the corresponding regulation in this 

subpart. 

Determinations Using a More Recent 

Tax Year’s Modified Adjusted Gross 

Income 

§ 418.2201 When will we determine your 

income-related monthly adjustment amount 

based on the modified adjusted gross 

income information that you provide for a 

more recent tax year? 

We will follow the rules in 

§ 418.1201, except that any references in 

that section to regulations in subpart B 

of this part shall be treated as references 

to the corresponding regulation in this 

subpart. 

§ 418.2205 What is a major life-changing 

event? 

We will follow the rules in 

§ 418.1205, except that any references in 

that section to regulations in subpart B 

of this part shall be treated as references 

to the corresponding regulation in this 

subpart. 

§ 418.2210 What is not a major lifechanging event? 

We will follow the rules in 

§ 418.1210, except that any references in 

that section to regulations in subpart B 

of this part shall be treated as references 

to the corresponding regulation in this 

subpart. 

§ 418.2215 What is a significant reduction 

in your income? 

We will follow the rules in 

§ 418.1215, except that any references in 

that section to regulations in subpart B 

of this part shall be treated as references 

to the corresponding regulation in this 

subpart. 

§ 418.2220 What is not a significant 

reduction in your income? 

We will follow the rules in 

§ 418.1220, except that any references in 

that section to regulations in subpart B 

of this part shall be treated as references 

to the corresponding regulation in this 

subpart. 

§ 418.2225 Which more recent tax year will 

we use? 

We will follow the rules in 

§ 418.1225, except that any references in 

that section to regulations in subpart B 

of this part shall be treated as references 

to the corresponding regulation in this 

subpart. 

§ 418.2230 What is the effective date of an 

income-related monthly adjustment amount 

initial determination based on a more recent 

tax year? 

We will follow the rules in 

§ 418.1230, except that any references in 

that section to regulations in subpart B 

of this part shall be treated as references 

to the corresponding regulation in this 

subpart. 

§ 418.2235 When will we stop using your 

more recent tax year’s modified adjusted 

gross income to determine your incomerelated monthly adjustment amount? 

We will follow the rules in 

§ 418.1235, except that any references in 

that section to regulations in subpart B 

of this part shall be treated as references 

to the corresponding regulation in this 

subpart. 

§ 418.2240 Should you notify us if the 

information you gave us about your 

modified adjusted gross income for the 

more recent tax year changes? 

We will follow the rules in 

§ 418.1240, except that any references in 

that section to regulations in subpart B 

of this part shall be treated as references 

to the corresponding regulation in this 

subpart. 

§ 418.2245 What will happen if you notify 

us that your modified adjusted gross 

income for the more recent tax year 

changes? 

(a) If you notify us that your modified 

adjusted gross income for the more 

recent tax year has changed from what 

is in our records, we may make a new 

initial determination for each effective 

year involved. To make a new initial 

determination(s) we will take into 

account: 

(1) The new modified adjusted gross 

income information for the more recent 

tax year you provide; and 

(2) Any modified adjusted gross 

income information from the IRS, as 

described in § 418.2135, that we have 

available for each effective year; and 

(3) Any modified adjusted gross 

income information from you, as 

described in § 418.2135, that we have 

available for each effective year. 

(b) For each new initial determination 

that results in a change in your incomerelated monthly adjustment amount, we 

will make retroactive corrections that 

will apply to all enrolled months of the 

effective year. 

(c) We will continue to use a new 

initial determination described in 

paragraph (a) of this section to 

determine additional yearly incomerelated monthly adjustment amount(s) 

until an event described in § 418.2235 

occurs. 

(d) We will make a new determination 

about your income-related monthly 

adjustment amount when we receive 

modified adjusted gross income for the 

effective year from the IRS, as described 

in § 418.1140(d). 

§ 418.2250 What evidence will you need to 

support your request that we use a more 

recent tax year? 

We will follow the rules in 

§ 418.1250, except that any references in 

that section to regulations in subpart B 

of this part shall be treated as references 

to the corresponding regulation in this 

subpart. 

§ 418.2255 What kind of evidence of a 

major life-changing event will you need to 

support your request for us to use a more 

recent tax year? 

We will follow the rules in 

§ 418.1255, except that any references in 

that section to regulations in subpart B 

of this part shall be treated as references 

to the corresponding regulation in this 

subpart. 

§ 418.2260 What major life-changing event 

evidence will we not accept? 

We will follow the rules in 

§ 418.1260, except that any references in 

that section to regulations in subpart B 

of this part shall be treated as references 

to the corresponding regulation in this 

subpart. 

§ 418.2265 What kind of evidence of a 

significant modified adjusted gross income 

reduction will you need to support your 

request? 

We will follow the rules in 

§ 418.1265, except that any references in 

that section to regulations in subpart B 

of this part shall be treated as references 

to the corresponding regulation in this 

subpart. 

§ 418.2270 What modified adjusted gross 

income evidence will we not accept? 

We will follow the rules in 

§ 418.1270, except that any references in 

that section to regulations in subpart B 

of this part shall be treated as references 

to the corresponding regulation in this 

subpart. 

Determinations and the Administrative 

Review Process 

§ 418.2301 What is an initial determination 

regarding your income-related monthly 

adjustment amount? 

We will follow the rules in 

§ 418.1301, except that any references in 


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75896 Federal Register / Vol. 75, No. 234 / Tuesday, December 7, 2010 / Rules and Regulations 

that section to regulations in subpart B 

of this part shall be treated as references 

to the corresponding regulation in this 

subpart. 

§ 418.2305 What is not an initial 

determination regarding your incomerelated monthly adjustment amount? 

We will follow the rules in 

§ 418.1305, except that any references in 

that section to regulations in subpart B 

of this part shall be treated as references 

to the corresponding regulation in this 

subpart. 

§ 418.2310 When may you request that we 

make a new initial determination? 

We will follow the rules in 

§ 418.1310, except that any references in 

that section to regulations in subpart B 

of this part shall be treated as references 

to the corresponding regulation in this 

subpart. 

§ 418.2315 How will we notify you and 

what information will we provide about our 

initial determination? 

We will follow the rules in 

§ 418.1315, except that any references in 

that section to regulations in subpart B 

of this part shall be treated as references 

to the corresponding regulation in this 

subpart. 

§ 418.2320 What is the effect of an initial 

determination? 

We will follow the rules in 

§ 418.1320, except that any references in 

that section to regulations in subpart B 

of this part shall be treated as references 

to the corresponding regulation in this 

subpart. 

§ 418.2322 How will a Medicare Part B 

income-related monthly adjustment amount 

determination for the effective year affect 

your Medicare prescription drug coverage? 

If we make an income-related 

monthly adjustment amount 

determination for you for the effective 

year under subpart B of this part 

(Medicare Part B Income-Related 

Monthly Adjustment Amount), we will 

apply that income-related monthly 

adjustment amount determination under 

this subpart to determine your Part D 

income-related monthly adjustment 

amount for the same effective year. 

Therefore, if you obtain Medicare 

prescription drug coverage in the 

effective year after we make an incomerelated monthly adjustment amount 

determination about your Medicare Part 

B, the income-related monthly 

adjustment amount determination we 

made for your Medicare Part B will also 

apply to your Medicare prescription 

drug coverage. Any change in your net 

benefit due will be accompanied by a 

letter explaining the change in your net 

benefit and your right to appeal the 

change. 

§ 418.2325 When may you request a 

reconsideration? 

We will follow the rules in 

§ 418.1325, except that any references in 

that section to regulations in subpart B 

of this part shall be treated as references 

to the corresponding regulation in this 

subpart. 

§ 418.2330 Can you request a 

reconsideration when you believe that the 

IRS information we used is incorrect? 

If you request a reconsideration solely 

because you believe that the information 

that the IRS gave us is incorrect, we will 

dismiss your request for a 

reconsideration and notify you to obtain 

proof of a correction from the IRS and 

request a new initial determination 

(§ 418.2335). Our dismissal of your 

request for reconsideration is not an 

initial determination subject to further 

administrative or judicial review. 

§ 418.2332 Can you request a 

reconsideration when you believe that the 

CMS information we used is incorrect? 

If you request a reconsideration solely 

because you believe that the information 

that CMS gave us about your 

participation in a Medicare prescription 

drug coverage plan is incorrect, we will 

dismiss your request for a 

reconsideration and notify you that you 

must contact CMS to get your records 

corrected. Our dismissal of your request 

for reconsideration is not an initial 

determination subject to further 

administrative or judicial review. 

§ 418.2335 What should you do if we base 

our initial determination on modified 

adjusted gross income information you 

believe to be incorrect? 

We will follow the rules in 

§ 418.1335, except that any references in 

that section to regulations in subpart B 

of this part shall be treated as references 

to the corresponding regulation in this 

subpart. 

§ 418.2340 What are the rules for our 

administrative review process? 

We will follow the rules in 

§ 418.1340, except that any references in 

that section to regulations in subpart B 

of this part shall be treated as references 

to the corresponding regulation in this 

subpart. 

§ 418.2345 Is reopening of an initial or 

reconsidered determination made by us 

ever appropriate? 

We will follow the rules in 

§ 418.1345, except that any references in 

that section to regulations in subpart B 

of this part shall be treated as references 

to the corresponding regulation in this 

subpart. 

§ 418.2350 What are the rules for review of 

a reconsidered determination or an ALJ 

decision? 

You may request a hearing before an 

OMHA administrative law judge 

consistent with HHS’ regulations at 42 

CFR part 423. You may seek further 

review of the administrative law judge’s 

decision by requesting MAC review and 

judicial review in accordance with HHS’ 

regulations. 

§ 418.2355 What are the rules for 

reopening a decision by an ALJ of the 

Office of Medicare Hearings and Appeals 

(OMHA) or by the Medicare Appeals Council 

(MAC)? 

The rules in 42 CFR 423.1980 through 

423.1986 govern reopenings of decisions 

by an administrative law judge of the 

OMHA and decisions by the MAC. A 

decision by an administrative law judge 

of the OMHA may be reopened by the 

administrative law judge or the MAC. A 

decision by the MAC may be reopened 

only by the MAC. 

[FR Doc. 2010–30276 Filed 12–6–10; 8:45 am] 

BILLING CODE 4191–02–P 

DEPARTMENT OF THE TREASURY 

Internal Revenue Service 

26 CFR 1 

[TD 9504] 

RIN 1545–BI66 

Basis Reporting by Securities Brokers 

and Basis Determination for Stock 

Correction 

In rule document 2010–25504 

beginning on page 64072 in the issue of 

Monday, October 18, 2010, make the 

following corrections: 

§ 1.6054–1 [Corrected] 

1. On page 64093, in the third 

column, in § 1.6045–1(d)(6)(i), in the 

first line ‘‘(i)’’ should read ‘‘(i)’’. 

2. On the same page, in the same 

column, in § 1.604–1(d)(6)(ii)(A), in the 

first line ‘‘(A)’’ should read ‘‘(A)’’. 

3. On page 64094, in the first column, 

in § 1.604–1(d)(6)(ii)(B)(2), in the first 

line ‘‘(2)’’; should read ‘‘(2)’’. 

4. On the same page, in the same 

column, in § 1.604–1(d)(6)(iii)(A), in the 

first line ‘‘(A)’’ should read ‘‘(A)’’. 

[FR Doc. C1–2010–25504 Filed 12–6–10; 8:45 am] 

BILLING CODE 1505–01–D 


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