Medicare program; special enrollment period and Medicare premium changes. Final rule

This final rule provides a special enrollment period (SEP) for Medicare Part B and premium Part A for certain individuals who are sponsored by prescribed organizations as volunteers outside of the United States and who have health insurance that covers them while outside the United States. Under the SEP provision, qualifying volunteers can delay enrollment in Part B and premium Part A, or terminate such coverage, for the period of service outside of the United States and reenroll without incurring a premium surcharge for late enrollment or reenrollment. This final rule also codifies provisions that require certain beneficiaries to pay an income-related monthly adjustment amount (IRMAA) in addition to the standard Medicare Part B premium, plus any applicable increase for late enrollment or reenrollment. The income-related monthly adjustment amount is to be paid by beneficiaries who have a modified adjusted gross income that exceeds certain threshold amounts. It also represents the amount of decreases in the Medicare Part B premium subsidy, that is, the amount of the Federal government's contribution to the Federal Supplementary Medicare Insurance (SMI) Trust Fund.     

Medicare program; supplementary medical insurance premium surcharge agreements. Final rule

This final rule implements legislation contained in section 1839(e) of the Social Security Act (the Act). That statute authorizes a Medicare premium payment arrangement whereby State and local government agencies can enter into an agreement with the Secretary to make periodic lump sum payments for the Supplementary Medical Insurance (SMI) late enrollment premium surcharge amounts due for a designated group of eligible enrollees. Under this rule, we define and set out the basic rules for the new SMI premium surcharge billing agreement. In order to give States additional time for implementation of the provisions of this final rule, we are delaying the rule's effective date to six months from the date of its publication in the Federal Register.     

The recidivist premium

Joel Feinberg, Offense to Others New York: Oxford University Press, 1985, xix + 328 pp.     

Medicare program; monthly supplementary medical insurance premium beginning January 1, 1990--HCFA. Notice

This notice announces the monthly premium rate, as changed by the Omnibus Budget Reconciliation Act of 1989 and the Medicare Catastrophic Coverage Repeal Act of 1989, for aged (age 65 or over) and disabled (under age 65) enrollees in the Medicare Supplementary Medical Insurance (SMI) program for calendar year 1990. The 1990 SMI premium will be $28.60. This notice also announces the repeal of the monthly catastrophic coverage premium for aged and disabled enrollees.     

Financial consequences of joining a Medicare HMO: an application of the illness episode approach to estimating out-of-pocket costs

To reduce Medicare costs, Medicare beneficiaries are being encouraged to enroll in "risk contract" HMOs. This paper explores the financial consequences to the elderly of joining a Medicare risk HMO. Using a new method for estimating consumer financial vulnerability called the illness episode approach, we modeled the out-of-pocket costs associated with thirteen illnesses of varying severity for beneficiaries with traditional Medicare coverage only and for beneficiaries who join one of two Los Angeles HMOs which charge no additional premium. The typical total charges for a year's treatment of these thirteen illnesses in Los Angeles in 1986 ranged from a low of $856 for moderate hypertension to a high of $28,411 for care of a severe stroke. For beneficiaries with traditional Medicare whose providers did not accept assignment, out-of-pocket costs ranged from $539 to $14,676 and from a low of 7.7 percent to a high of 84.1 percent of total charges. Out-of-pocket costs are considerably reduced in the two Medicare HMOs in this high-cost market; beneficiaries had modeled out-of-pocket costs ranging from $11 to $7,478 and from less than 0.1 percent of total charges to 60 percent of charges. Reductions in financial vulnerability ranged from over 20 percent to 99.3 percent. The relation of these reductions to altered benefit structures and the policy implications of the results are discussed.     

Medicare and Medicaid; eligibility for premium hospital insurance; state buy-in agreements--HCFA. Final rule with comment period

These rules-- 1. Set forth the requirements and procedures for certain individuals under age 65 to enroll and become entitled to Medicare Part A benefits through payment of monthly premiums; 2. Revise the rules on State buy-in for Medicare benefits to provide that-- After 1988, a State may, at any time, request a buy-in agreement or a modification of an existing agreement, including a modification under which the State may enroll a pay Part B premiums on behalf of a new buy-in coverage group--Qualified Medicare Beneficiaries (QMBs); and After 1989, a State may request and obtain a modification of an existing agreement, under which the State may also enroll QMB's in Part A and pay Part A premiums on their behalf. These amendments are necessary to conform HCFA rules to changes made by section 9010 of the Omnibus Budget Reconciliation Act of 1987 (OBRA '87), section 301 of the Medicare Catastrophic Coverage Act of 1988 (MCCA), and sections 6012 and 6013 of the Omnibus Budget Reconciliation Act of 1989 (OBRA '89). The purposes of the amendments are-- 1. To make it possible for certain disabled individuals to become entitled to Medicare Part A benefits that require payment of a monthly premium. The provisions apply to an individual under age 65 who loses entitlement to Medicare Part A without premiums because his or her earnings exceed the limit imposed for entitlement to social security disability benefits, on which Medicare Part A entitlement was based; and 2. To make available to States, for payment of premiums for QMBs, the administrative and cost efficiencies of the State buy-in procedures.     

Reining in agency action: the rejected proposal rule and Section 1011 of the 2003 Medicare Act

Section 1011 of the 2003 Medicare Act authorized the disbursement of over one billion dollars to healthcare providers that provide uncompensated emergency medical care to undocumented immigrants. In 2005, the Centers for Medicare and Medicaid Services (CMS) issued its final interpretation of the statute. Despite previous statementsto the contrary, CMS conditioned eligibilityfor Section 1011 funds on the collection of certain immigration status-related information from patients seeking emergency care. Prior to the issuance of CMS' final guidance, the House defeated House Resolution 3722, which was substantially similar to the CMS final guidance. This Article argues that the House's rejection of H.R. 3722 renders CMS's final guidance invalid under the analysis set forth in Chevron, U.S.A. Inc. v. National Resources Defense Council, Inc.     

Medicare program; monthly actuarial rates and monthly supplementary medical insurance premium rate beginning January 1, 1999--HCFA. Notice

As required by section 1839 of the Social Security Act, this 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 1999. It also announces the monthly SMI premium rate to be paid by all enrollees during 1999. The monthly actuarial rates for 1999 are $92.30 for aged enrollees and $103.00 for disabled enrollees. The monthly SMI premium rate for 1999 is $45.50. (The 1998 premium rate was $43.80). The 1999 Part B premium is not equal to 50 percent of the monthly actuarial rate because of the differential between the amount of home health that is transferred into Part B in 1999 (two-sixths) and the amount in Part B that is included in the premium calculation (two-sevenths).     

The consequences of a pragmatic turn for semiotics

Clara H. Stewardson Professor of Philosophy.     

Medicare program; monthly actuarial rates and monthly supplementary medical insurance premium rate beginning January 1, 1996--HCFA. Notice

As required by section 1839 of the Social Security Act, this 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 1996. It also announces the monthly SMI premium rate to be paid by all enrollees during 1996. The monthly actuarial rates for 1996 are $84.90 for aged enrollees and $105.10 for disabled enrollees. The monthly SMI premium rate for 1996 is $42.50.     

Medicare program; monthly actuarial rates and monthly supplementary medical insurance premium rate beginning January 1, 1997--HCFA. Notice

As required by section 1839 of the social Security Act, this notice announces the monthly actuarial rates for aged (age 65 and over) and disabled (under age 65) enrollees in the Medicare Supplementary Medical Insurance (SMI) program for 1997. It also announces the monthly SMI premium rate to be paid by the enrollees during 1997. The monthly actuarial rates for 1997 are $87.50 for aged enrollees and $110.40 for disabled enrollees. The monthly SMI premium rate for 1997 is $43.80.     

Medicare program; monthly actuarial rates and monthly supplementary medical insurance premium rates beginning January 1, 1995--HCFA. Notice

As required by section 1839 of the Social Security Act, this 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 calendar year 1995. It also announces the monthly SMI premium rate to be paid by all enrollees during calendar year 1995. The monthly actuarial rates for 1995 are $73.10 for aged enrollees and $105.80 for disabled enrollees. The monthly SMI premium rate for 1995 is $46.10.     

Medicare program; monthly actuarial rates and monthly supplementary medical insurance premium rates beginning January 1, 1992--HCFA. Notice

As required by section 1839 of the Social Security Act, this 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 calendar year 1992. It also announces the monthly SMI premium rate to be paid by all enrollees during calendar year 1992. The monthly actuarial rates for 1992 are $60.80 for aged enrollees and $80.80 for disabled enrollees. The monthly SMI premium rate for 1992 is $31.80.     

Medicare program; monthly actuarial rates and monthly supplementary medical insurance premium rates beginning January 1, 1993--HCFA. Notice

As required by section 1839 of the Social Security Act, this 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 calendar year 1993. It also announces the monthly SMI premium rate to be paid by all enrollees during calendar year 1993. The monthly actuarial rates for 1993 are $70.50 for aged enrollees and $82.90 for disabled enrollees. The monthly SMI premium rate for 1993 is $36.60.     

Medicare program; monthly actuarial rates and monthly supplementary medical insurance premium rate beginning January 1, 1998--HCFA. Notice

As required by section 1839 of the Social Security Act, this 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 1998. It also announces the monthly SMI premium rate to be paid by all enrollees during 1998. The monthly actuarial rates for 1998 are $87.90 for aged enrollees and $97.10 for disabled enrollees. The monthly SMI premium rate for 1998 is $3.80.     

Medicare program; monthly actuarial rates and monthly supplementary medical insurance premium rates beginning January 1, 1994--HCFA. Notice

As required by section 1839 of the Social Security Act, this 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 calendar year 1994. It also announces the monthly SMI premium rate to be paid by all enrollees during calendar year 1994. The monthly actuarial rates for 1994 are $61.80 for aged enrollees and $76.10 for disabled enrollees. The monthly SMI premium rate for 1994 is $41.10.     

Medicare program; monthly actuarial rates and monthly supplementary medical insurance premium rates beginning January 1, 1991--HCFA. Notice

As required by section 1839 of the Social Security Act, this 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 calendar year 1991. It also announces the monthly SMI premium rate to be paid by all enrollees during calendar year 1991. The monthly actuarial rates for 1991 are $62.60 for aged enrollees and $56.00 for disabled enrollees. The monthly SMI premium rate for 1991 is $29.90.     

The shortage of transplantable organs: an analysis and a proposal

During the last decade there have been enormous advances in the transplantation of vital organs - in particular, the kidney, lung, heart, liver and pancreas. Unfortunately, efforts to provide the benefits of these operations to patients have been severely hindered by limitations in the supply of organs -limitations which, in the view of the author, are a consequence of regulation prohibiting the use of market incentives to increase the supply. We conclude that the law should be changed to allow the use of incentives to induce the donation of both present and future interests in cadaver organs.