Medicare program; Part A premium for 1998 for the uninsured aged and for certain disabled individuals who have exhausted other entitlement--HCFA. Notice

This notice announces the hospital insurance premium for calendar year 1998 under Medicare's hospital insurance program (Part A) for the uninsured aged and for certain disabled individuals who have exhausted other entitlement. The monthly Medicare Part A premium for the 12 months beginning January 1, 1998 for these individuals is $309. The reduced premium for certain other individuals as described in this notice is $170. Section 1818(d) of the Social Security Act specifies the method to be used to determine these amounts.     

Medicare program; Part A premium for 1994 for the uninsured aged and for certain disabled individuals who have exhausted other entitlement--HCFA. Notice

This notice announces the hospital insurance premium for calendar year 1994 under Medicare's hospital insurance program (Part A) for the uninsured aged and for certain disabled individuals who have exhausted other entitlement. The monthly Medicare Part A premium for the 12 months beginning January 1, 1994 for these individuals is $245. The reduced premium for certain other individuals as described in this notice is $184. Section 1818(d) of the Social Security Act specifies the method to be used to determine these amounts.     

Medicare program; Part A premium for 1996 for the uninsured aged and for certain disabled individuals who have exhausted other entitlement--HCFA. Notice

This notice announces the hospital insurance premium for calendar year 1996 under Medicare's hospital insurance program (Part A) for the uninsured aged and for certain disabled individuals who have exhausted other entitlement. The monthly Medicare Part A premium for the 12 months beginning January 1, 1996 for these individuals is $289. The reduced premium for certain other individuals as described in this notice is $188. Section 1818(d) of the Social Security Act specifies the method to be used to determine these amounts.     

Medicare program; Part A premium for 1997 for the uninsured aged and for certain disabled individuals who have exhausted other entitlement--HCFA. Notice

This notice announces the hospital insurance premium for calendar year 1997 under Medicare's hospital insurance program (Part A) for the uninsured aged and for certain disabled individuals who have exhausted other entitlement. The monthly Medicare Part A premium for the 12 months beginning January 1, 1997 for these individuals is $311. The reduced premium for certain other individuals as described in this notice is $187. Section 1818(d) of the Social Security Act specifies the method to be used to determine these amounts.     

Medicare program; Part A premium for 1995 for the uninsured aged and for certain disabled individuals who have exhausted other entitlement--HCFA. Notice

This notice announces the hospital insurance premium for calendar year 1995 under Medicare's hospital insurance program (Part A) for the uninsured aged and for certain disabled individuals who have exhausted other entitlement. The monthly Medicare Part A premium for the 12 months beginning January 1, 1995 for these individuals is $261. The reduced premium for certain other individuals as described in this notice is $183. Section 1818[d] of the Social Security Act specifies the method to be used to determine these amounts.     

Medicare program; Part A premium for 1993 for the uninsured aged and for certain disabled individuals who have exhausted other entitlement--HCFA. Notice

This notice announces the hospital insurance premium for calendar year 1993 under Medicare's hospital insurance program (Part A) for the uninsured aged and for certain disabled individuals who have exhausted other entitlement. The monthly Medicare Part A premium for the 12 months beginning January 1, 1993 for these individuals is $221. Section 1818(d) of the Social Security Act specifies the method to be used to determine this amount.     

Medicare program; Part A premium for 1992 for the uninsured aged and for certain disabled individuals who have exhausted other entitlement--HCFA. Notice

This notice announces the hospital insurance premium for calendar year 1992 under Medicare's hospital insurance program (Part A) for the uninsured aged and for certain disabled individuals who have exhausted other entitlement. The monthly Medicare Part A premium for the 12 months beginning January 1, 1992 for individuals who are not insured under the Social Security or Railroad Retirement Acts and do not otherwise meet the requirements for entitlement to Medicare Part A is $192. Section 1818(d) of the Social Security Act specifies the method to be used to determine this amount.     

Medicare program; Part A. Premium for the uninsured aged for 1991--HCFA. Notice

This notice announces the hospital insurance premium for the uninsured aged for calendar year 1991 under Medicare's hospital insurance program (Part A). The monthly Medicare Part A premium for the 12 months beginning January 1, 1991 for individuals who are not insured under the Social Security or Railroad Retirement Acts and do not otherwise meet the requirements for entitlement to Part A is $177. Section 1818(d) of the Social Security Act specifies the method to be used to determine this amount.     

Medicare program; inpatient hospital deductible and hospital and extended care services coinsurance amounts for 1999--HCFA. Notice

This notice announces the inpatient hospital deductible and the hospital and extended care services coinsurance amounts for services furnished in calendar year 1999 under Medicare's hospital insurance program (Medicare Part A). The Medicare statute specifies the formulae used to determine these amounts. The inpatient hospital deductible will be $768. The daily coinsurance amounts will be: (a) $192 for the 61st through 90th day of hospitalization in a benefit period; (b) $384 for lifetime reserve days; and (c) $96 for the 21st through 100th day of extended care services in a skilled nursing facility in a benefit period.     

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).     

Medicare program; inpatient hospital deductible and hospital and skilled nursing facility coinsurance amounts for 1992--HCFA. Notice

This notice announces the inpatient hospital deductible and the hospital and skilled nursing facility coinsurance amounts for services furnished in calendar year 1992 under Medicare's hospital insurance program (Medicare Part A). The Medicare statute specifies the formulae to be used to determine these amounts. The inpatient hospital deductible will be $652. The daily coinsurance amounts will be: (a) $163 for the 61st through 90th days of hospitalization in a benefit period; (b) $326 for lifetime reserve days; and (c) $81.50 for the 21st through 100th days of extended care services in a skilled nursing facility in a benefit period.     

Medicare program; inpatient hospital deductible and hospital and extended care services coinsurance amounts for 1996--HCFA. Notice

This notice announces the inpatient hospital deductible and the hospital and extended care services coinsurance amounts for services furnished in calendar year 1996 under Medicare's hospital insurance program (Medicare Part A). The Medicare statute specifies the formulae to be used to determine these amounts. The inpatient hospital deductible will be $736. The daily coinsurance amounts will be: (a) $184 for the 61st through 90th days of hospitalization in a benefit period; (b) $368 for lifetime reserve days; and (c) $92 for the 21st through 100th days of extended care services in a skilled nursing facility in a benefit period.     

Medicare program; inpatient hospital deductible and hospital and extended care services coinsurance amounts for 1994--HCFA. Notice

This notice announces the inpatient hospital deductible and the hospital and extended care services coinsurance amounts for services furnished in calendar year 1994 under Medicare's hospital insurance program (Medicare Part A). The Medicare statute specifies the formulae to be used to determine these amounts. The inpatient hospital deductible will be $696. The daily coinsurance amounts will be: (a) $174 for the 61st through 90th days of hospitalization in a benefit period; (b) $348 for lifetime reserve days; and (c) $87 for the 21st through 100th days of extended care services in a skilled nursing facility in a benefit period.     

Medicare program; inpatient hospital deductible and hospital and extended care services coinsurance amounts for 1995--HCFA. Notice

This notice announces the inpatient hospital deductible and the hospital and extended care services coinsurance amounts for services furnished in calendar year 1995 under Medicare's hospital insurance program (Medicare Part A). The Medicare statute specifies the formulae to be used to determine these amounts. The inpatient hospital deductible will be $716. The daily coinsurance amounts will be: (a) $179 for the 61st through 90th days of hospitalization in a benefit period; (b) $358 for lifetime reserve days; and (c) $89.50 for the 21st through 100th days of extended care services in a skilled nursing facility in a benefit period.     

Medicare program; inpatient hospital deductible and hospital and extended care services coinsurance amounts for 1993--HCFA. Notice

This notice announces the inpatient hospital deductible and the hospital and extended care services coinsurance amounts for services furnished in calendar year 1993 under Medicare's hospital insurance program (Medicare Part A). The Medicare statute specifies the formulae to be used to determine these amounts. The inpatient hospital deductible will be $676. The daily coinsurance amounts will be: (a) $169 for the 61st through 90th days of hospitalization in a benefit period; (b) $338 for lifetime reserve days; and (c) $84.50 for the 21st through 100th days of extended care services in a skilled nursing facility in a benefit period.     

Medicare program; inpatient hospital deductible and hospital and extended care services coinsurance amounts for 1997--HCFA. Notice

This notice announces the inpatient hospital deductible and the hospital and extended care services coinsurance amounts for services furnished in calendar year 1997 under Medicare's hospital insurance program (Medicare Part A). The Medicare statute specifies the formulae to be used to determine these amounts. The inpatient hospital deductible will be $760. The daily coinsurance amounts will be: (1) $190 for the 61st through 90th days of hospitalization in a benefit period; (b) $380 for lifetime reserve days; and (c) $95 for the 21st through 100th days of extended care services in a skilled nursing facility in a benefit period.     

Medicare program; inpatient hospital deductible and hospital and extended care services coinsurance amounts for 1998--HCFA. Notice

This notice announces the inpatient hospital deductible and the hospital and extended care services coinsurance amounts for services furnished in calendar year 1998 under Medicare's hospital insurance program (Medicare Part A). The Medicare statute specifies the formulae to be used to determine these amounts. The inpatient hospital deductible will be $764. The daily coinsurance amounts will be: (a) $191 for the 61st through 90th days of hospitalization in a benefit period; (b) $382 for lifetime reserve days; and (c) $95.50 for the 21st through 100th days of extended care services in a skilled nursing facility in a benefit period.     

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; inpatient hospital deductible and hospital and skilled nursing facility coinsurance amounts for 1991--HCFA. Notice

This notice announces the inpatient hospital deductible and the hospital and skilled nursing facility coinsurance amounts for services furnished in calendar year 1991 under Medicare's hospital insurance program (part A). The Medicare statute specifies the formulae to be used to determine these amounts. The inpatient hospital deductible will be $628. The daily coinsurance amounts will be: (a) $157 for the 61st through 90th days of hospitalization in a benefit period; (b) $314 for lifetime reserve days; and (c) $78.50 for the 21st through 100th days of extended care services in a skilled nursing facility in a benefit period.     

Medicare program; prospective payment system for hospital outpatient services--HCFA. Proposed rule

As required by sections 4521, 4522, and 4523 of the Balanced Budget Act of 1997, this proposed rule would eliminate the formula-driven overpayment for certain outpatient hospital services, extend reductions in payment for costs of hospital outpatient services, and establish in regulations a prospective payment system for hospital outpatient services (and for Medicare Part B services furnished to inpatients who have no Part A coverage). The prospective payment system would simplify our current payment system and apply to all hospitals, including those that are excluded from the inpatient prospective payment system. The Balanced Budget Act provides for implementation of the prospective payment system effective January 1, 1999, but delays application of the system to cancer hospitals until January 1, 2000. The hospital outpatient prospective payment system would also apply to partial hospitalization services furnished by community mental health centers. Although the statutory effective date for the outpatient prospective payment system is January 1, 1999, implementation of the new system will have to be delayed because of year 2000 systems concerns. The demands on intermediary bill processing systems and HCFA internal systems to become compliant for the year 2000 preclude making the major systems changes that are required to implement the prospective payment system. The outpatient prospective payment system will be implemented for all hospitals and community mental health centers as soon as possible after January 1, 2000, and a notice of the anticipated implementation date will be published in the Federal Register at least 90 days in advance. This document also proposes new requirements for provider departments and provider-based entities. These proposed changes, as revised based on our consideration of public comments, will be effective 30 days after publication of a final rule. This proposed rule would also implement section 9343(c) of the Omnibus Budget Reconciliation Act of 1986, which prohibits Medicare payment for nonphysician services furnished to a hospital outpatient by a provider or supplier other than a hospital, unless the services are furnished under an arrangement with the hospital. This section also authorizes the Department of Health and Human Services' Office of Inspector General to impose a civil money penalty, not to exceed $10,000, against any individual or entity who knowingly and willfully presents a bill for nonphysician or other bundled services not provided directly or under such an arrangement. This proposed rule also addresses the requirements for designating certain entities as provider-based or as a department of a hospital.