Federal Register / Vol. 77, No. 225 / Wednesday, November 21, 2012 / Notices 69859 

announcements. In doing so, we note 

that, under the Administrative 

Procedure Act, interpretive rules, 

general statements of policy, and rules 

of agency organization, procedure, or 

practice are excepted from the 

requirements of notice and comment 

rulemaking. 

We considered publishing a proposed 

notice to provide a period for public 

comment. However, we may waive that 

procedure if we find, for good cause, 

that prior notice and comment are 

impracticable, unnecessary, or contrary 

to the public interest. The statute 

establishes the time period for which 

the premium rates will apply, and 

delaying publication of the Part B 

premium rate such that it would not be 

published before that time would be 

contrary to the public interest. 

Moreover, we find that notice and 

comment are unnecessary because the 

formulas used to calculate the Part B 

premiums are statutorily directed. 

Therefore, we find good cause to waive 

publication of a proposed notice and 

solicitation of public comments. 

(Catalog of Federal Domestic Assistance 

Program No. 93.774, Medicare— 

Supplementary Medical Insurance Program) 

Dated: November 15, 2012. 

Marilyn Tavenner, 

Acting Administrator, Centers for Medicare 

& Medicaid Services. 

Approved: November 15, 2012. 

Kathleen Sebelius, 

Secretary. Department of Health and Human 

Services. 

[FR Doc. 2012–28275 Filed 11–16–12; 11:15 am] 

BILLING CODE 4120–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[CMS–8047–N] 

RIN 0938–AR15 

Medicare Program; Part A Premiums 

for CY 2013 for the Uninsured Aged 

and for Certain Disabled Individuals 

Who Have Exhausted Other 

Entitlement 

AGENCY: Centers for Medicare & 

Medicaid Services (CMS), HHS. 

ACTION: Notice. 

SUMMARY: This annual notice announces 

Medicare’s Hospital Insurance (Part A) 

premium for uninsured enrollees in 

calendar year (CY) 2013. This premium 

is paid by enrollees age 65 and over who 

are not otherwise eligible for benefits 

under Medicare Part A (hereafter known 

as the ‘‘uninsured aged’’) and by certain 

disabled individuals who have 

exhausted other entitlement. The 

monthly Part A premium for the 12 

months beginning January 1, 2013, for 

these individuals will be $441. The 

reduced premium for certain other 

individuals as described in this notice 

will be $243. 

DATES: This notice is effective on 

January 1, 2013. 

FOR FURTHER INFORMATION CONTACT: 

Clare McFarland, (410) 786–6390. 

SUPPLEMENTARY INFORMATION: 

I. Background 

Section 1818 of the Social Security 

Act (the Act) provides for voluntary 

enrollment in the Medicare Hospital 

Insurance Program (Medicare Part A), 

subject to payment of a monthly 

premium, of certain persons aged 65 

and older who are uninsured under the 

Old-Age, Survivors, and Disability 

Insurance (OASDI) program or the 

Railroad Retirement Act and do not 

otherwise meet the requirements for 

entitlement to Medicare Part A. These 

‘‘uninsured aged’’ individuals are 

uninsured under the OASDI program or 

the Railroad Retirement Act, because 

they do not have 40 quarters of coverage 

under Title II of the Act (or are/were not 

married to someone who did). (Persons 

insured under the OASDI program or 

the Railroad Retirement Act and certain 

others do not have to pay premiums for 

Medicare Part A.) 

Section 1818A of the Act provides for 

voluntary enrollment in Medicare Part 

A, subject to payment of a monthly 

premium for certain disabled 

individuals who have exhausted other 

entitlement. These are individuals who 

were entitled to coverage due to a 

disabling impairment under section 

226(b) of the Act, but who are no longer 

entitled to disability benefits and free 

Medicare Part A coverage because they 

have gone back to work and their 

earnings exceed the statutorily defined 

‘‘substantial gainful activity’’ amount 

(section 223(d)(4) of the Act). 

Section 1818A(d)(2) of the Act 

specifies that the provisions relating to 

premiums under section 1818(d) 

through section 1818(f) of the Act for 

the aged will also apply to certain 

disabled individuals as described above. 

Section 1818(d) of the Act requires us 

to estimate, on an average per capita 

basis, the amount to be paid from the 

Federal Hospital Insurance Trust Fund 

for services incurred in the impending 

calendar year (CY) (including the 

associated administrative costs) on 

behalf of individuals aged 65 and over 

who will be entitled to benefits under 

Medicare Part A. We must then 

determine the monthly actuarial rate for 

the following year (the per capita 

amount estimated above divided by 12) 

and publish the dollar amount for the 

monthly premium in the succeeding CY. 

If the premium is not a multiple of $1, 

the premium is rounded to the nearest 

multiple of $1 (or, if it is a multiple of 

50 cents but not of $1, it is rounded to 

the next highest $1). 

Section 13508 of the Omnibus Budget 

Reconciliation Act of 1993 (Pub. L. 103– 

66) amended section 1818(d) of the Act 

to provide for a reduction in the 

premium amount for certain voluntary 

enrollees (section 1818 and section 

1818A of the Act). The reduction 

applies to an individual who is eligible 

to buy into the Medicare Part A program 

and who, as of the last day of the 

previous month— 

• Had at least 30 quarters of coverage 

under Title II of the Act; 

• Was married, and had been married 

for the previous 1-year period, to a 

person who had at least 30 quarters of 

coverage; 

• Had been married to a person for at 

least 1 year at the time of the person’s 

death if, at the time of death, the person 

had at least 30 quarters of coverage; or 

• Is divorced from a person and had 

been married to the person for at least 

10 years at the time of the divorce if, at 

the time of the divorce, the person had 

at least 30 quarters of coverage. 

Section 1818(d)(4)(A) of the Act 

specifies that the premium that these 

individuals will pay for CY 2013 will be 

equal to the premium for uninsured 

aged enrollees reduced by 45 percent. 

II. Monthly Premium Amount for CY 

2013 

The monthly premium for the 

uninsured aged and certain disabled 

individuals who have exhausted other 

entitlement for the 12 months beginning 

January 1, 2013, is $441. 

The monthly premium for those 

individuals subject to the 45 percent 

reduction in the monthly premium is 

$243. 

III. Monthly Premium Rate Calculation 

As discussed in section I of this 

notice, the monthly Medicare Part A 

premium is equal to the estimated 

monthly actuarial rate for CY 2013 

rounded to the nearest multiple of $1 

and equals one-twelfth of the average 

per capita amount, which is determined 

by projecting the number of Part A 

enrollees aged 65 years and over as well 

as the benefits and administrative costs 

that will be incurred on their behalf. 


srobinson on DSK4SPTVN1PROD with 
69860 Federal Register / Vol. 77, No. 225 / Wednesday, November 21, 2012 / Notices 

The steps involved in projecting these 

future costs to the Federal Hospital 

Insurance Trust Fund are: 

• Establishing the present cost of 

services furnished to beneficiaries, by 

type of service, to serve as a projection 

base; 

• Projecting increases in payment 

amounts for each of the service types; 

and 

• Projecting increases in 

administrative costs. 

We base our projections for CY 2013 

on—(1) current historical data; and (2) 

projection assumptions derived from 

current law and the Mid-Session Review 

of the President’s Fiscal Year 2013 

Budget. 

We estimate that in CY 2013, 

42,352,324 people aged 65 years and 

over will be entitled to benefits (without 

premium payment) and that they will 

incur about $223.933 billion in benefits 

and related administrative costs. Thus, 

the estimated monthly average per 

capita amount is $440.62 and the 

monthly premium is $441. The full 

monthly premium reduced by 45 

percent is $243. 

IV. Costs to Beneficiaries 

The CY 2013 premium of $441 is 

approximately 2.22 percent lower than 

the CY 2012 premium of $451. We 

estimate that approximately 604,000 

enrollees will voluntarily enroll in 

Medicare Part A by paying the full 

premium. We estimate an additional 

50,000 enrollees will pay the reduced 

premium. We estimate that the aggregate 

savings to enrollees paying these 

premiums in CY 2013, compared to the 

amount that they paid in CY 2012, will 

be about $75 million. 

V. Waiver of Proposed Notice and 

Comment Period 

We use general notices, rather than 

notice and comment rulemaking 

procedures, to make announcements 

such as this premium notice. In doing 

so, we acknowledge that, under the 

Administrative Procedure Act (APA), 

interpretive rules, general statements of 

policy, and rules of agency organization, 

procedure, or practice are excepted from 

the requirements of notice and comment 

rulemaking. The agency may also waive 

notice and comment if there is ‘‘good 

cause,’’ as defined by the statute. We 

considered publishing a proposed 

notice to provide a period for public 

comment. However, under the APA, we 

may waive that procedure if we find 

good cause that prior notice and 

comment are impracticable, 

unnecessary, or contrary to the public 

interest. 

We are not using notice and comment 

rulemaking in this notification of 

Medicare Part A premiums for CY 2013 

as that procedure is unnecessary 

because of the lack of discretion in the 

statutory formula that is used to 

calculate the premium and the solely 

ministerial function that this notice 

serves. The APA permits agencies to 

waive notice and comment rulemaking 

when notice and public comment 

thereon are unnecessary. On this basis, 

we waive publication of a proposed 

notice and a solicitation of public 

comments. 

VI. Collection of Information 

Requirements 

This document does not impose 

information collection and 

recordkeeping requirements. 

Consequently, it need not be reviewed 

by the Office of Management and 

Budget under the authority of the 

Paperwork Reduction Act of 1995 (44 

U.S.C. 35). 

VII. Regulatory Impact Statement 

We have examined the impact of this 

notice as required by Executive Order 

12866 on Regulatory Planning and 

Review (September 30, 1993), Executive 

Order 13563 on Improving Regulation 

and Regulatory Review (January 18, 

2011), the Regulatory Flexibility Act 

(RFA) (September 19, 1980, Pub. L. 96– 

354), section 1102(b) of the Social 

Security Act, section 202 of the 

Unfunded Mandates Reform Act of 1995 

(March 22, 1995; Pub. L. 104–4), 

Executive Order 13132 on Federalism 

(August 4, 1999) and the Congressional 

Review Act (5 U.S.C., Part I, Ch. 8). 

Executive Orders 12866 and 13563 

direct agencies to assess all costs and 

benefits of available regulatory 

alternatives and, if regulation is 

necessary, to select regulatory 

approaches that maximize net benefits 

(including potential economic, 

environmental, public health and safety 

effects, distributive impacts, and 

equity). A regulatory impact analysis 

(RIA) must be prepared for major rules 

with economically significant effects 

($100 million or more in any 1 year). As 

stated in section IV of this notice, we 

estimate that the overall effect of these 

changes in the Part A premium will be 

a savings to voluntary enrollees (section 

1818 and section 1818A of the Act) of 

about $75 million. Therefore, this notice 

is a not a major action as defined in 

Title 5, United States Code, Part I, Ch. 

8 and is not an economically significant 

action under Executive Order 12866. 

The RFA requires agencies to analyze 

options for regulatory relief of small 

entities. For purposes of the RFA, small 

entities include small businesses, 

nonprofit organizations, and small 

governmental jurisdictions. Most 

hospitals and most other providers and 

suppliers are small entities, either by 

nonprofit status or by having revenues 

of $7.0 million to $34.5 million in any 

1 year. Individuals and States are not 

included in the definition of a small 

entity. We have determined that this 

notice will not have a significant 

economic impact on a substantial 

number of small entities. Therefore, we 

are not preparing an analysis under the 

RFA. 

In addition, section 1102(b) of the 

Social Security Act requires us to 

prepare a regulatory impact analysis if 

a rule may have a significant impact on 

the operations of a substantial number 

of small rural hospitals. This analysis 

must conform to the provisions of 

section 604 of the RFA. For purposes of 

section 1102(b) of the Act, we define a 

small rural hospital as a hospital that is 

located outside of a Metropolitan 

Statistical Area for Medicare payment 

regulations and has fewer than 100 

beds. The Secretary has determined that 

this notice will not have a significant 

impact on the operations of a substantial 

number of small rural hospitals. 

Therefore, we are not preparing an 

analysis under section 1102(b) of the 

Act. 

Section 202 of the Unfunded 

Mandates Reform Act of 1995 also 

requires that agencies assess anticipated 

costs and benefits before issuing any 

rule whose mandates require spending 

in any 1 year of $100 million in 1995 

dollars, updated annually for inflation. 

In 2012, that threshold is approximately 

$139 million. This notice will have no 

consequential effect on State, local, or 

tribal governments or on the private 

sector. However, States are required to 

pay the premiums for dually-eligible 

beneficiaries. 

Executive Order 13132 establishes 

certain requirements that an agency 

must meet when it promulgates a 

proposed rule (and subsequent final 

rule) that imposes substantial direct 

requirement costs on State and local 

governments, preempts State law, or 

otherwise has Federalism implications. 

This notice will not have a substantial 

effect on State or local governments. 

In accordance with the provisions of 

Executive Order 12866, this notice was 

reviewed by the Office of Management 

and Budget. 

(Catalog of Federal Domestic Assistance 

Program No. 93.773, Medicare—Hospital 

Insurance) 


srobinson on DSK4SPTVN1PROD with 
Federal Register / Vol. 77, No. 225 / Wednesday, November 21, 2012 / Notices 69861 

Dated: November 6, 2012. 

Marilyn Tavenner, 

Acting Administrator, Centers for Medicare 

& Medicaid Services. 

Dated: November 15, 2012. 

Kathleen Sebelius, 

Secretary. 

[FR Doc. 2012–28274 Filed 11–16–12; 11:15 am] 

BILLING CODE 4120–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Administration for Children and 

Families 

Proposed Information Collection 

Activity; Comment Request 

Title: Parents and Children Together 

(PACT) Evaluation. 

OMB No.: 0970–0403. 

Description: The Office of Planning, 

Research, and Evaluation (OPRE), 

Administration for Children and 

Families (ACF), U.S. Department of 

Health and Human Services (HHS), is 

proposing data collection activity as 

part of the Parents and Children 

Together (PACT) Evaluation. 

The PACT project is a formative 

evaluation whose overall objective is to 

document and provide initial 

assessment of selected Responsible 

Fatherhood and Healthy Marriage grant 

programs that were authorized under 

the 2010 Claims Resolution Act. This 

information will be critical to informing 

decisions related to future investments 

in this kind of programming as well as 

the design and operation of such 

services. 

To meet the objective of the study, 

PACT is utilizing three major, 

interrelated evaluation strategies: 

(a) Impact evaluation; 

(b) Implementation evaluation; and 

(c) Qualitative evaluation. 

Each of these strategies will be 

employed separately with (1) 

Responsible Fatherhood and (2) Healthy 

Marriage grantees. Specifically, we 

anticipate the following studies: 

(a) Impact evaluation: 

(1) Responsible Fatherhood grantee 

evaluation; and (2) Healthy Marriage 

grantee evaluation. 

(b) Implementation evaluation: 

(1) Responsible Fatherhood grantee 

evaluation; 

(1—additional substudy) Responsible 

Fatherhood grantee evaluation with a 

focus on Hispanic populations; and 

(2) Healthy Marriage grantee 

evaluation. 

(c) Qualitative evaluation: 

(1) Responsible Fatherhood grantee 

evaluation. 

The following instruments have been 

approved for this study: Site selection: 

a discussion guide to assist in selecting 

sites was approved by OMB on April 20, 

2012. 

(a) Impact evaluation: 

(1) Responsible Fatherhood grantee 

evaluation: 

• Introductory script, approved 

October 31, 2012. 

• Baseline survey, approved October 

31, 2012. 

(b) Implementation evaluation: 

(1) Responsible Fatherhood grantee 

evaluation: 

• Responsible Fatherhood Study MIS, 

approved October 31, 2012. 

This 60-Day Federal Register Notice 

requests clearance of new instruments: 

(a) Impact evaluation: 

(1) Healthy Marriage grantee 

evaluation: 

• Introductory script, which program 

staff will use to introduce the study to 

participants. 

• Baseline survey, to capture 

participant characteristics and 

experiences prior to randomization. 

(b) Implementation evaluation: 

(1) and (2) Responsible Fatherhood 

and Healthy Marriage grantee 

evaluation: 

• Semi-structured interview topic 

guide, to gather information on program 

implementation from program staff. 

• On-line survey, to capture program 

staff experiences. 

• Telephone interviews (with staff at 

referral organizations), to document 

linkages between the program and 

referral agencies. 

• Working Alliance Inventory, to 

assess the strength of the participantprogram staff working relationship. 

• Focus group guide, to elicit 

participant experiences. 

• Telephone interviews (with 

program dropouts), to determine reasons 

why those eligible for the program 

choose not to participate. 

(1—additional substudy) Responsible 

Fatherhood grantee evaluation with a 

focus on Hispanic populations: 

• Semi-structured interview topic 

guide, to examine how agencies adapt 

programs to address the needs of 

Hispanic populations. 

• Focus group guide, to elicit 

participant experiences. 

• Participant questionnaire, to 

capture participant characteristics and 

experiences. 

(2) Healthy Marriage grantee 

evaluation: 

• Study MIS (for use in HM 

programs), to track participation in the 

program. 

(c) Qualitative evaluation: 

(1) Responsible Fatherhood grantee 

evaluation: 

• Guide for in-person, in-depth 

interviews, to understand the 

experiences, both in and out of the 

program, of a subset of men. 

• Check-in call guide, to follow-up 

from the in-person, in-depth interviews, 

to ascertain new experiences by these 

men since last discussion. 

This 60-Day Federal Register Notice 

also serves as a request for OMB to 

waive subsequent 60-day Federal 

Register notices pertaining to the PACT 

Evaluation. 

Respondents: 

Respondents include program 

applicants, program participants, 

program staff, and staff at referral 

agencies. Specific respondents per 

instrument are noted in the burden 

tables below. 

Annual Burden Estimates 

Some burden has already been 

approved for this study, and the 

following instruments are still in use. 

Approved burden is provided below: 

Instrument respondent 

Annual 

number of 

respondents 

Number of 

responses per 

respondent 

Average 

burden per 

response 

(minutes) 

Total annual 

burden hours 

Site Selection 

Selecting Study Grantees: 

Discussions/grantee and partner organization staff ................................. 50 1 60 50 


srobinson on DSK4SPTVN1PROD with