55896 Federal Register / Vol. 70, No. 184 / Friday, September 23, 2005 / Notices 

to acknowledge or respond to them 

individually. We will consider all 

comments we receive by the date and 

time specified in the Comment Period 

section of this preamble, and, if we 

proceed with a subsequent document, 

we will respond to the comments in the 

preamble of that document. 

Authority: Sections 1816(f), 1834(a)(12), 

and 1842(b) of the Social Security Act (42 

U.S.C. 1395h(f), 1395m(a)(12), and 1395u(b)) 

(Catalog of Federal Domestic Assistance 

Program No. 93.774, Medicare—

Supplementary Medical Insurance Program) 

Dated: May 19, 2005. 

Mark B. McClellan, 

Administrator, Centers for Medicare & 

Medicaid Services. 

[FR Doc. 05–18923 Filed 9–22–05; 8:45 am] 

BILLING CODE 4120–01–U 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[CMS–8025–N] 

RIN 0938–AO01 

Medicare Program; Part A Premium for 

Calendar Year 2006 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) 2006. This premium 

is to be paid by enrollees age 65 and 

over who are not otherwise eligible 

(hereafter known as the ‘‘uninsured 

aged’’) and for certain disabled 

individuals who have exhausted other 

entitlement. The monthly Part A 

premium for the 12 months beginning 

January 1, 2006 for these individuals 

will be $393. The reduced premium for 

certain other individuals as described in 

this notice will be $216. Section 1818(d) 

of the Social Security Act specifies the 

method to be used to determine these 

amounts. 

EFFECTIVE DATE: This notice is effective 

on January 1, 2006. 

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. (Persons 

insured under the OASDI program or 

the Railroad Retirement Act and certain 

others do not have to pay premiums for 

hospital insurance.) 

Section 1818A of the Act provides for 

voluntary enrollment in Medicare Part 

A, subject to payment of a monthly 

premium, of certain disabled 

individuals who have exhausted other 

entitlement. These are individuals who 

are not currently entitled to Part A 

coverage, but who were entitled to 

coverage due to a disabling impairment 

under section 226(b) of the Act, and 

who would still be entitled to Part A 

coverage if their earnings had not 

exceeded 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 following 

calendar year (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, during 

September of each year, 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). 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 2006 will be 

equal to the premium for uninsured 

aged enrollees reduced by 45 percent. 

II. Monthly Premium Amount for CY 

2006 

The monthly premium for the 

uninsured aged and certain disabled 

individuals who have exhausted other 

entitlement for the 12 months beginning 

January 1, 2006, is $393. 

The monthly premium for those 

individuals subject to the 45 percent 

reduction in the monthly premium is 

$216. 

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 2006 

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. 

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 2006 

on: (a) current historical data, and (b) 

projection assumptions derived from 

current law and the Mid-Session Review 

of the President’s Fiscal Year 2006 

Budget. 

We estimate that in CY 2006, 35.205 

million people aged 65 years and over 

will be entitled to benefits (without 

premium payment) and that they will 

incur $166.121 billion of benefits and 

related administrative costs. Thus, the 

estimated monthly average per capita 

amount is $393.23 and the monthly 

Federal Register / Vol. 70, No. 184 / Friday, September 23, 2005 / Notices 55897 

premium is $393. The full monthly 

premium reduced by 45 percent is $216. 

IV. Costs to Beneficiaries 

The CY 2006 premium of $393 is 

about 5 percent higher than the CY 2005 

premium of $375. 

We estimate that approximately 

523,000 enrollees will voluntarily enroll 

in Medicare Part A by paying the full 

premium. We estimate an additional 

1,000 enrollees will pay the reduced 

premium. We estimate that the aggregate 

cost to enrollees paying these premiums 

will be about $113 million in CY 2006 

over the amount that they paid in CY 

2005. 

V. Waiver of Proposed Notice and 

Comment Period 

We are not using notice and comment 

rulemaking in this notification of Part A 

premiums for CY 2006, 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 

Administrative Procedure Act (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. Regulatory Impact Statement 

We have examined the impacts of this 

notice as required by Executive Order 

12866 (September 1993, Regulatory 

Planning and Review), the Regulatory 

Flexibility Act (RFA) (September 19, 

1980, Pub. L. 96–354), section 1102(b) of 

the Act, the Unfunded Mandates Reform 

Act of 1995 (Pub. L. 104–4), and 

Executive Order 13132. 

Executive Order 12866 directs 

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). 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 cost to voluntary 

enrollees (section 1818 and section 

1818A of the Act) of about $113 million. 

Therefore, this notice is a major rule as 

defined in Title 5, United States Code, 

section 804(2) and is an economically 

significant rule 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 

government agencies. Most hospitals 

and most other providers and suppliers 

are small entities, either by nonprofit 

status or by having revenues of $6 

million to $29 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 for the RFA. 

In addition, section 1102(b) of the 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 (MSA) 

and has fewer than 100 beds. 

We have determined that this notice 

will not have a significant effect on the 

operations of a substantial number of 

small rural hospitals. Therefore, we are 

not preparing an analysis for 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 that may result in expenditure in 

any 1 year by State, local, or tribal 

governments, in the aggregate, or by the 

private sector, of $110 million. This 

notice has no consequential effect on 

State, local, or tribal governments or on 

the private sector. 

Executive Order 13132 establishes 

certain requirements that an agency 

must meet when it publishes 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 regulation 

was reviewed by the Office of 

Management and Budget. 

Authority: Sections 1818(d)(2) and 

1818A(d)(2) of the Social Security Act (42 

U.S.C. 1395i-2(d)(2) and 1395i-2a(d)(2)). 

(Catalog of Federal Domestic Assistance 

Program No. 93.773, Medicare—Hospital 

Insurance) 

Dated: September 12, 2005. 

Mark B. McClellan, 

Administrator, Centers for Medicare & 

Medicaid Services. 

Dated: September 15, 2005. 

Michael O. Leavitt, 

Secretary. 

[FR Doc. 05–18839 Filed 9–16–05; 4:00 pm] 

BILLING CODE 4120–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[CMS–8027–N] 

RIN 0938–AO02 

Medicare Program; Medicare Part B 

Monthly Actuarial Rates, Premium 

Rate, and Annual Deductible for 

Calendar Year 2006 

AGENCY: Centers for Medicare & 

Medicaid Services (CMS), HHS. 

ACTION: Notice. 

SUMMARY: This notice announces the 

monthly actuarial rates for aged (age 65 

and over) and disabled (under age 65) 

beneficiaries enrolled in Part B of the 

Medicare Supplementary Medical 

Insurance (SMI) program beginning 

January 1, 2006. In addition, this notice 

announces the monthly premium for 

aged and disabled beneficiaries and the 

annual deductible to be paid during 

2006. The monthly actuarial rates for 

2006 are $176.90 for aged enrollees and 

$203.70 for disabled enrollees. The 

monthly Part B premium rate for 2006 

is $88.50 which is equal to 50 percent 

of the monthly actuarial rate for aged 

enrollees or about 25 percent of Part B 

costs for aged enrollees. (The 2005 

premium rate was $78.20.) The Part B 

deductible for 2006 is $124.00. 

EFFECTIVE DATE: January 1, 2006. 

FOR FURTHER INFORMATION CONTACT: M. 

Kent Clemens, (410) 786–6391. 

SUPPLEMENTARY INFORMATION: 

I. Background 

Part B is the voluntary portion of the 

Medicare program that pays all or part 

of the costs for physicians’ services, 

outpatient hospital services, certain 

home health services, services furnished 

by rural health clinics, ambulatory 

surgical centers, comprehensive 

outpatient rehabilitation facilities, and 

certain other medical and health 

services not covered by Medicare Part 

A, Hospital Insurance. Medicare Part B 

is available to individuals who are 

entitled to Medicare Part A, as well as