Department of Health and Human Services, Centers for Medicare and Medicaid Services: Medicare Program; Monthly Actuarial Rates and Monthly Supplementary Medical Insurance Premium Beginning January 1, 2004, GAO-04-236R, December 4, 2003

 
 
 
B-293119
 
 
December 4, 2003
 
The Honorable Charles E. Grassley
Chairman
The Honorable Max Baucus
Ranking Minority Member
Committee on Finance
United States Senate


The Honorable W.J. “Billy” Tauzin
Chairman
The Honorable John D. Dingell
Ranking Minority Member
House Committee on Energy and Commerce
House of Representatives
 
The Honorable William M. Thomas
Chairman
The Honorable Charles B. Rangel
Ranking Minority Member
Committee on Ways and Means
House of Representatives


Subject: Department of Health and Human Services, Centers for Medicare and Medicaid Services: Medicare Program; Monthly Actuarial Rates and Monthly Supplementary Medical Insurance Premium Beginning January 1, 2004
 
Pursuant to section 801(a)(2)(A) of title 5, United States Code, this is our report on a major rule promulgated by the Department of Health and Human Services, Centers for Medicare and Medicaid Services (CMS), entitled “Medicare Program; Monthly Actuarial Rates and Monthly Supplementary Medical Insurance Premium Beginning January 1, 2004” (RIN: 0938-AM91). We received the rule on November 20, 2003. It was published in the Federal Register as a notice on October 24, 2003. 68 Fed. Reg. 60997.
 
The notice announces the monthly actuarial rates for aged (age 65 or over) and disabled (under age 65) enrollees in the Medicare Supplementary Medical Insurance (SMI) program for 2004.  It also announces the monthly SMI premium rate to be paid by all enrollees during 2004.  The monthly actuarial rates for 2004 are $133.20 for aged enrollees and $175.50 for disabled enrollees.  The monthly SMI premium rate is $66.60.
 
Enclosed is our assessment of the CMS’s compliance with the procedural steps required by section 801(a)(1)(B)(i) through (iv) of title 5 with respect to the rule.  Our review indicates that the CMS complied with the applicable requirements.
 
If you have any questions about this report, please contact James W. Vickers, Assistant General Counsel, at (202) 512-8210.  The official responsible for GAO evaluation work relating to the subject matter of the rule is William Scanlon, Managing Director, Health Care.  Mr. Scanlon can be reached at (202) 512-7114.
 
 
            signed
 
Kathleen E. Wannisky
Managing Associate General Counsel
 
Enclosure
 
cc: Ann Stallion
Regulations Coordinator
Department of Health and
  Human Services
 
  ENCLOSURE
 
ANALYSIS UNDER 5 U.S.C. § 801(a)(1)(B)(i)-(iv) OF A MAJOR RULE
ISSUED BY THE
DEPARTMENT OF HEALTH AND HUMAN SERVICES,
CENTERS FOR MEDICARE AND MEDICAID SERVICES
ENTITLED
"MEDICARE PROGRAM; MONTHLY ACTUARIAL RATES AND
MONTHLY SUPPLEMENTARY MEDICAL INSURANCE PREMIUM
BEGINNING JANUARY 1, 2004"
(RIN: 0938-AM91)


 
(i) Cost-benefit analysis
 
While a cost-benefit analysis was not conducted because the increases were statutorily directed, the cost to the beneficiaries is discussed in the notice.  It is estimated that the cost of the increase in the premium to the approximately 39 million SMI enrollees will be about $3.7 billion for 2004.
 
(ii) Agency actions relevant to the Regulatory Flexibility Act, 5 U.S.C. §§ 603-605, 607, and 609
 
CMS has reviewed the notice and has found that no analyses under the Act are required.  Since states and individuals are not considered small entities, there will be no significant impact on a substantial number of small entities.
 
(iii) Agency actions relevant to sections 202-205 of the Unfunded Mandates Reform Act of 1995, 2 U.S.C. §§ 1532-1535
 
The notice will not impose either an intergovernmental or private sector mandate, as defined in title II, of more than $100 million in any one year.
 
(iv) Other relevant information or requirements under acts and executive orders
 
Administrative Procedure Act, 5 U.S.C. §§ 551 et seq.
 
In accordance with CMS’s past practice regarding publication of the monthly actuarial rates and the Part B premium amount under Medicare where such amounts are determined according to statute, general notice rather than notice and comment rulemaking procedures contained in section 553 of the Administrative Procedure Act are used.
 
Paperwork Reduction Act, 44 U.S.C. §§ 3501-3520
 
The notice does not contain any information collections that are subject to review by the Office of Management and Budget (OMB) under the Paperwork Reduction Act.
 
Statutory authorization for the rule
 
The notice is issued pursuant to the authority contained in section 1839 of the Social Security Act (42 U.S.C. 1395r).
 
Executive Order No. 12866
 
The notice was reviewed by OMB and found to be an “economically significant” regulatory action under the order.