These final rules describe the standards that you must meet in order for us to use a more recent tax year's modified adjusted gross income to determine whether you must pay an incomerelated monthly adjustment amount and what your incomerelated monthly adjustment amount will be. In these final rules we define qualifying major life changing events and what is a significant reduction in your modified adjusted gross income. We also specify the evidence we will require of major lifechanging events and the resulting reduction in your modified adjusted gross income.

Section 1839(i)(4)(C)(ii)(II) specifies that major lifechanging events include marriage, divorce, and death of a spouse. Under that section, we have discretion to include in regulations additional major lifechanging events
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that would allow us to grant your request that we use information from a more recent tax year to determine your incomerelated monthly adjustment amount. In these rules we establish the following categories of qualifying major lifechanging events:

We have included these additional categories of major lifechanging events because we recognize that these events may cause a significant reduction in your modified adjusted gross income. We will include losses in pension income from an insured pension plan that occur due to events outside of your control, such as underfunding that results in a termination of the plan, but not due to your choices about funding an employeedirected pension plan. The statute authorizes us to define as major lifechanging events circumstances that affect your income, not circumstances that affect only your expenses.

We define a significant reduction in your modified adjusted gross income as any change that results in a reduction or elimination of your incomerelated monthly adjustment amount. Therefore, a significant reduction in your modified adjusted gross income is any change that lowers your income below the threshold amount or lowers the modified adjusted gross income range in which your income falls. Section 1839(i)(4)(C)(ii) provides that we may grant your request to use a more recent tax year's modified adjusted gross income to determine your incomerelated monthly adjustment amount only if you provide us with a copy of a filed Federal income tax return or equivalent document. These final rules define the evidence that we will consider to be equivalent to a copy of a filed Federal income tax return.

When we make an incomerelated monthly adjustment amount determination based on your request due to a qualifying major life changing event, the determination will generally be effective on January 1 of the calendar year for which we make the determination. If you enrolled in Medicare Part B after January 1 of the year for which we make an incomerelated monthly adjustment amount determination based on your request due to a major lifechanging event, the determination will be effective the month of your Medicare Part B enrollment.

When we make an incomerelated monthly adjustment amount determination following a major lifechanging event using your more recent tax year's modified adjusted gross income, we will continue trying to get IRS data for that tax year. When we receive modified adjusted gross income information from IRS for that tax year, we will use the information from IRS to determine the correct incomerelated monthly adjustment amount for the year or years for which we used information that you provided, and we will make retroactive adjustments, if necessary. Retroactive adjustments will apply to all months for which you paid an incorrect incomerelated monthly adjustment amount.
If You Disagree With Our Determination of Your IncomeRelated Monthly Adjustment Amount

We will decide whether you must pay an incomerelated monthly adjustment, and the amount of any adjustment, based on information we receive from IRS or you. We will send you a notice of our initial determination of your incomerelated monthly adjustment amount and the basis for our determination. The notice will explain that, if you disagree with our determination, you may request that we reconsider it within 60 days after the date you receive notice of our initial determination. The notice will also explain that you may request a new initial determination, rather than a reconsideration, if you believe the information we used in our initial determination was correct, but you want us to use different information about your modified adjusted gross income.

For purposes of this subpart, in making initial determinations and reconsiderations, we will use the rules for the administrative review process that we use for determinations of your rights regarding nonmedical issues under title II of the Act. However, in order to expedite the processing of requests for reconsideration under these final rules, we have also provided in these rules that we may accept requests for reconsideration that are filed by electronic or other means that we determine to be appropriate, other than a request in writing, as our title II regulations provide. If you are dissatisfied with our reconsidered determination, you may request further review, including a hearing before an administrative law judge (ALJ) from the Office of Medicare Hearings and Appeals (OMHA) at HHS, review by the Medicare Appeals Council (MAC), and judicial review, consistent with the CMS regulations at 42 CFR part 405. As part of your request for an ALJ hearing or MAC review, you will be required to provide your consent for us to release your relevant tax return information to OMHA or the MAC for the purposes of adjudicating any appeal of the amount of an incomerelated adjustment to the Part B premium subsidy and for any judicial review of that appeal.

We are establishing a new procedure, a request for a new initial determination, that you may use when you do not dispute the accuracy of the determination we made based on the modified adjusted gross income information provided by IRS, but you want us to use different information. You may provide evidence of your modified adjusted gross income for a more recent tax year than the information provided by IRS when you have had a major lifechanging event that significantly reduces your income or when IRS has provided modified adjusted gross income information from 3 years prior to the premium effective year and you supply your retained copy of your Federal income tax return for the tax year 2 years prior. You may also request that we make a new initial determination when you have amended your Federal income tax return or when you can furnish proof that IRS has provided incorrect information about your modified adjusted gross income for the year that we used to determine your incomerelated monthly adjustment amount.

We are establishing this alternative procedure in view of the nature of the information that we are required by the MMA to use in making determinations regarding the incomerelated monthly adjustment amount. We anticipate that the use of this new procedure will allow us to make timely adjustments when you have updated information about your modified adjusted gross income, or when you can prove the IRS information we used is incorrect. This process does not affect your right to appeal an initial determination that we make about your incomerelated monthly adjustment amount, but allows you to choose an alternative of requesting that we use other information to make a new initial determination.
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Explanation of Subpart B

We are adding a new subpart B, Medicare Part B IncomeRelated Monthly Adjustment Amount, to part 418 of chapter III of title 20 of the Code of Federal Regulations. Subpart B contains the rules that we will use to determine when you will be required to pay an income related monthly adjustment amount in addition to your Medicare Part B standard monthly premium plus any applicable premium increase for late enrollment or reenrollment. Following is a description of each section for subpart B.
Introduction, General Provisions, and Definitions

Public Comments

On March 3, 2006, we published proposed rules in the Federal Register at 71 FR 10926 and provided a 60day period for interested persons to comment. We received comments from three organizations and four individuals. We have condensed, summarized or paraphrased the comments in the following discussion to facilitate comprehension of the issues. We have tried to present all views accurately and address carefully all of the issues raised by the commenters that are within the scope of the proposed rules.

In our proposed rules, we invited but received no comments on the issue of individuals for whom the IRS cannot supply income tax return information. The statute requires that we issue regulations that ``provide for the treatment of the premium adjustment with respect to such individual[s]'' when we have information that such individuals have income that exceeds the threshold. Consistent with the requirements of Sec. 1839(i)(4)(B)(iii) of the Act, we have added Sec. 418.1135(f) to these rules to clarify that if, after a premium effective year, we receive information from IRS that such an individual had modified adjusted gross income above the applicable threshold, we will apply the highest incomerelated adjustment percentage to such individual as required by the statute. When we receive such information, we will retroactively correct Medicare premiums for any affected effective year(s), as required by statute.

Introduction, General Provisions and Definitions

Comment: Four commenters expressed concerns over the concept that some higher income Medicare beneficiaries should receive a reduction in the Federal subsidy of their Medicare Part B premiums.

Response: The provision to reduce the amount of the subsidy based on your income levels was specifically legislated by Congress. Our responsibility is to implement section 811 of the MMA through these regulations in a manner consistent with the requirements of this law.

Comment: One commenter found the proposed rules confusing.

Response: We have reorganized the rules and changed some of the captions and wording of the regulation text in order to improve the clarity of the regulation.

We changed the order of Sec. Sec. 418.1110 through 418.1120 by moving the section about the effective date of our initial determination so that it precedes the section that describes how we make our initial determination of your incomerelated monthly adjustment amount. This change provides a more logical progression of concepts related to incomerelated monthly adjustment amount determinations.

We renumbered the sections related to a determination using a more recent tax year's modified adjusted gross income because we created two new sections (Sec. Sec. 418.1215 and 418.1220) to clarify what is a significant reduction in modified adjusted gross income. In the proposed regulation, the definition of a significant reduction in modified adjusted gross income was in Sec. 418.1201(b). We have left that definition intact, but added further clarification in the new sections.

Comment: Several commenters raised concerns about confusion that may arise regarding the administrative review process.

Response: We agree with the comments and have added Sec. Sec. 418.1340 and 418.1345 which clarify that we will apply our rules for administrative review by SSA and reopening of our determinations. Sections 418.1350 and 418.1355 clarify that HHS will apply its rules for administrative review and reopenings by ALJs from OMHA and by the MAC.

Comment: One commenter suggested that we define what we mean by ``significant reduction'' in income resulting from a major life changing event. It was also requested that we add more information to the final rules about what evidence of lifechanging events we will require, and how we will establish a causal link between the major lifechanging event and the significant reduction in income.

Response: We agree with this suggestion and have added new sections to the regulations that explain what does and does not constitute a significant reduction in income resulting from a major lifechanging event. Section 418.1215 defines a significant reduction in modified adjusted gross income, and Sec. 418.1220 explains that we will not consider a reduction in income to be significant if it does not affect the amount of incomerelated monthly adjustment you must pay.

Section 418.1250 states that we will ask for evidence of the major lifechanging event and how that event significantly reduced your modified adjusted gross income. We have also added explanations of what major lifechanging event evidence we will not accept and what modified adjusted gross income information we will not accept. Section 418.1260 describes the types of evidence of major lifechanging events that we will not accept, and Sec. 418.1270 describes the types of modified adjusted gross income evidence we will not accept.

In Sec. 418.1265(b) we expanded our description of the evidence that we will accept of reductions in your modified adjusted gross income. The revision clarifies that we will accept a copy of your filed Federal income tax return for a more recent taxable year. If you have amended your tax return for the more recent taxable year, you should provide a copy of the amended tax return. Finally, if you filed a tax return for the more recent taxable year, but have proof from IRS of a correction of your tax return information, you should provide evidence of the correction.

Comment: One commenter expressed concerns about privacy issues surrounding the modified adjusted gross income data that we will obtain from IRS.

Response: Section 811 of the MMA created a new provision of the Internal Revenue Code that authorizes IRS to disclose modified adjusted gross income information to us for the specific purpose of determining incomerelated monthly adjustments to Medicare Part B premiums. We have worked with the IRS under existing protocols and within the specifications of section 811 and other legislation to limit the information that IRS discloses to us and the information that we will supply to IRS for this purpose. The data exchange will be conducted in accordance with the provisions of section 1106 of the Act (42 U.S.C. 1306), the Privacy Act (5 U.S.C. 552a), and section 6103 of the Internal Revenue Code (26 U.S.C. 6103) to ensure safeguarding of any personally identifiable information that is exchanged. We added a statement in Sec. 418.1350 to clarify that we will not disclose information that we have about your tax information for the purpose of a hearing with an ALJ, MAC review, or judicial review unless you authorize us to do so, and the IRS confirms that the authorization meets all legal requirements.

[[Page 62929]]

Comment: One commenter said that the regulations should address beneficiary education activities to inform the public about their appeal rights and how the different agencies involved will coordinate those activities.

Response: After careful consideration, we decided that including education plans in the final regulations would not be appropriate. We are working on the best methods to provide initial and continuing information to the public that explains their appeal rights and other information that the public may need and are coordinating our efforts with CMS. We will include information in notifications that we will send to affected beneficiaries and through other vehicles, such as Fact Sheets and Web page information published by both agencies.

Comment: One commenter addressed concerns about the timing of notifications to beneficiaries about incomerelated monthly adjustments to Medicare Part B premiums, suggesting that such notices be issued by October 31. The commenter also encouraged us to provide detailed information in those notifications.

Response: As we explained earlier in this preamble, generally we will use 2year old modified adjusted gross income information from IRS to determine whether you are required to pay an incomerelated monthly adjustment amount. Section 811 of the MMA gives IRS until October 15 to provide us with 2year old tax data to use in determining your adjustment amount for the next year. If we do not receive the information by October 15, the law allows us to use 3year old data. Because we must wait until after October 15 to obtain the required information, it is not possible for us to process the data from IRS and issue notices by the suggested date.

We will send notices that will explain the basis of our decision and what you should do if you disagree with our decision or have better information than we do (such as a copy of a filed 2year old tax return when we used 3year old information to set a premium adjustment). The notices will provide information about which year's income tax return information we used to make our determination, and what information IRS gave us about your tax filing status and modified adjusted gross income for that year. The notices will also explain what you may do if there has been a major lifechanging event(s) resulting in a significant reduction in income since the year we used to set your Medicare Part B premium.

Comment: One commenter urged us to publish the annual, updated modified adjusted gross income ranges at the same time as the Medicare Part B premium changes and for CMS to include projected amounts for a 5 to 10year period in its Annual Trustees Report.

Response: We do not determine the annual modified adjusted gross income ranges, nor do we determine the standard Medicare Part B premium. CMS will determine the ranges annually as it does the standard Medicare Part B premium. We will include this information on our Web site http://www.socialsecurity.gov as it becomes available to us. We have shared with CMS the suggestion to include projected modified adjusted gross income ranges in CMS's Annual Trustees Report. Determination of the IncomeRelated Monthly Adjustment Amount

Comment: Two commenters expressed concern about using information from IRS for a past period. One of those comments focused on the use of IRS information from more than 2 years before the year for which the Medicare Part B premiums will be effective. That commenter expressed hope that IRS would be able to provide appropriate electronic information about beneficiaries' modified adjusted gross income from the tax year 2 years before the premium year well in advance of October 15 each year. The other comment expressed a generalized concern about the coordination of data transfers between Federal agencies.

Response: Based on our discussions with IRS, we expect that the overwhelming majority of income tax returns from the tax year 2 years before the premium year will be processed and in electronic format by October 15 of each year. Although many taxpayers request filing extensions, almost all file a tax return by October 15. The language of the statute dictates the October 15 date and provides an exception for the temporary use of 3year old data when 2year old information is not available. We are working with IRS to minimize the temporary use of older data, and to ensure accurate data exchanges.
Determinations Using a More Recent Tax Year's Modified Adjusted Gross Income

Comment: Two commenters addressed the possibility of job loss or retirement affecting income in the past year while we use 2 or 3year old information from IRS.

Response: Reduction of work or work stoppage can be a major life changing event for purposes of determining the incomerelated monthly adjustment amount. If you experience a significant reduction of income because of work reduction or stoppage, the final rules provide that you may request that we use information that you provide about your income for a more recent tax year to determine your incomerelated monthly adjustment amount. If you report a major lifechanging event that significantly reduces your income, we will use that information to determine if an incomerelated monthly adjustment amount is applicable. When we determine that you have paid too much for your Medicare Part B premium, we will follow current processing procedures to refund excess amounts of Medicare Part B premiums that have been paid. If a Medicare beneficiary pays premiums through another Federal agency, we will convey the information that the agency needs to refund excess Medicare Part B premiums that have been paid.

Comment: One commenter thought that the impairmentrelated work expenses deduction from income for the disabled in other Social Security programs should be extended to the incomerelated monthly adjustments to Medicare Part B premiums.

Response: We have not adopted the comment. The statute clearly defines the method for determining whether an incomerelated monthly adjustment is applicable and the amount of such adjustment. The MMA requires us to use only the modified adjusted gross income as defined in section 1839(i)(4) of the Act and does not provide any authority for us to consider an individual's expenses or net income.

Comment: One commenter suggested that the list of significant life changing events should be flexible. Another commenter suggested that the list of significant lifechanging events should be expanded to include decreases in dividend income and requested clarification on whether interest income from financial securities (such as stocks and bonds) is considered the same as dividend income. The latter commenter also expressed concerns about the burden of documenting lifechanging events, such as divorce that occurred several years earlier.

Response: We have given careful consideration to these comments but decided not to expand the list of significant lifechanging events to include decreases in dividend income and loss of income from financial securities. The current list of significant lifechanging events includes major events that have a direct and potentially permanent effect on an individual's income. Reductions in income that are [[Page 62930]]
unrelated to major lifechanging events are not contemplated in the statute. Decreases in dividend income and loss of income from financial securities are not ``events'' but rather fluctuations in the financial markets and should not be considered as part of the list of events with a potentially permanent effect on income. Similarly, making the list more flexible would run counter to the statutory requirement that major lifechanging events be ``specified in regulations.''

When you have experienced a significant lifechanging event, we will provide assistance to you when documentation is needed as we routinely do for Social Security claimants and beneficiaries. To the extent possible, when you need a document such as a divorce decree and do not know how to obtain it, we will provide the appropriate address and associated information so that you can secure it. Further, it is unlikely that a divorce that occurred several years ago will have caused a significant reduction in income in a more recent tax year. Determinations and the Administrative Review Process

Comment: One commenter expressed concern about the process that we will use to make corrections of amounts of Part B premiums charged after we have decided that use of a more recent taxable year is appropriate when there has been a significant reduction in income because of a major lifechanging event.

Response: The commenter asked about the process for making premium adjustments. When a beneficiary reports a major lifechanging event and new information about his income in a more recent tax year that we use to make a new initial determination of the incomerelated monthly adjustment amount, we will follow current processing procedures to refund excess Medicare Part B premiums that have been paid. If a Medicare beneficiary pays premiums through another Federal agency, we will convey the information that agency needs to process an appropriate correction for the beneficiary.

Comment: One commenter asked for clarification of what is not subject to appeal, and when our rules and HHS rules will apply. The commenter also expressed concerns about the complexity of the administrative review process which spans two Federal agencies.

Response: We are responsible for reconsiderations of initial determinations made by us. Reconsiderations are the first step in the appeal process, and our rules are used for reconsiderations. When an individual is dissatisfied with our reconsideration determination, he may request a hearing before an ALJ. Section 931 of the MMA transferred responsibility for the functions of the ALJs responsible for hearing cases under title XVIII of the Act to HHS. HHS established regulations for Medicare appeals in 42 CFR part 405. Hearings related to income related monthly adjustment amounts are hearings under title XVIII and are the responsibility of HHS. We have clarified this information in the regulations. Our regulations also explain what is and is not an initial determination for purposes of administrative review.

We agree with the concern that the commenter expressed about the complexity of the administrative review process for these cases. We have simplified our process for requesting a reconsidered determination of our decision about an incomerelated monthly adjustment amount. If you want us to reconsider our determination about your incomerelated monthly Medicare Part B premium adjustment, you will be able to request a reconsideration without requesting it in writing.

Comment: A commenter suggested that we should give beneficiaries more than 60 days after receipt of the notice of our initial determination to seek a reconsideration or a new determination because of likely confusion in the initial year or two of implementation.

Response: Our experience in administering the title II program has been that a 60day period to file an appeal is reasonable. If you request your reconsideration later, we will follow our current rules in 20 CFR 404.911 to evaluate whether you have a good reason for us to extend the 60day period, such as illness or a death in your immediate family.

A request for a new initial determination is not an appeal and is not tied to the 60day period to file an appeal. A major lifechanging event such as death of a spouse or divorce can happen any time during a year and may result in a significant reduction in income for that year or a subsequent year. If you have experienced a significant reduction in income because of a major lifechanging event, you may request a new determination at any time during the year that the significant reduction in income has occurred. Further, if that reduction follows a major lifechanging event in the last 3 months of the year, you may report the event and request a new initial determination within the first 3 months of the next year and we will determine if premiums should be adjusted for the preceding year.

In the proposed rule, we established a 60day time limit for requesting a new initial determination based on a beneficiary correction of IRS information that we used to make an initial determination about the incomerelated monthly adjustment amount. After considering this comment, we eliminated the requirement that a beneficiary make a request for a new initial determination within 60 days following receipt of our notice of an incomerelated monthly adjustment amount when he believes that the IRS information we used is incorrect. Section 418.1310(a)(3) of the final rule states that an individual who believes that the IRS information we used in making an initial determination of the incomerelated monthly adjustment amount is incorrect may request a new initial determination at any time after he receives a notice from us about the determination.

Other Changes

In response to these comments and our further review of the structure and format of the proposed rule, we have restructured these regulations slightly. In this final rule, we have moved some sections and added new sections. We provide explanations below of the changes that were not explained under the ``Public Comments'' section of the preamble. These changes are consistent with the policies outlined in the proposed regulations and are intended to clarify and further explain the procedures that we will apply to compute the amount of any incomerelated monthly adjustment to the Medicare Part B premium.

In Sec. 418.1010(a), we have added definitions for the Medicare Appeals Council (MAC), the Office of Medicare Hearings and Appeals (OMHA), and the Department of Health and Human Services (HHS). We added a definition of the term ``Tax Year'' to Sec. 418.1010(b). In Sec. 418.1205(c), we clarified that a marriage may end either through divorce or annulment.

We also added sections clarifying that we will apply our rules for the reconsideration of initial determinations that we have made, and HHS rules will apply for administrative review by the OMHA and the MAC. We have added language clarifying the process we will follow when a beneficiary who filed a Federal income tax return as Married Filing Separately informs us that the spouses lived apart throughout the year. In a new paragraph (e) in Sec. 418.1140, we explain that if you request that we review your incomerelated premium
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adjustment for this reason, we will require you to attest that you lived apart from your spouse throughout the tax year we are using to set your premium, and to provide address information for your spouse and yourself for that year.
Regulatory Procedures

Executive Order 12866

We have consulted with the Office of Management and Budget (OMB) and determined that these final rules meet the criteria for an ``economically significant'' regulatory action under Executive Order 12866, as amended by Executive Order 13258. Thus, they were reviewed by OMB. We have also determined that these final rules meet the plain language requirement of Executive Order 12866, as amended by Executive Order 13258. In addition, these are major rules under the Congressional Review Act in 5 U.S.C. 801808.

These final rules provide the implementing rules for the income related premium calculation enacted as part of MMA. The legislative provision is expected to result in an overall savings to the Medicare Part B account in the SMI Trust Fund of roughly $7.7 billion over the period of fiscal years 20072011. The changes in this final rule from the notice of proposed rulemaking (NPRM) are not expected to affect the cost/savings projections for this rule. The following chart shows the estimated total savings in millions for each program year.
Total Fiscal year savings 2007....................................................... $490 2008....................................................... 1,180 2009....................................................... 1,860 2010....................................................... 2,060 2011....................................................... 2,150

Total 20072011........................................ 7,740

In addition, the process of determining the additional premiums will result in an increase in administrative expenses incurred by us in the amount of $200 million over that same 5year period.

Accounting Statement

As required by OMB Circular A4 (available at http://www.whitehouse.gov/omb/circulars/a004/a4.pdf ), in the following table
(Table 1) we have prepared an accounting statement showing the classification of the expenditures associated with the provisions of these final rules. This table provides our best estimate of the increase in premium payments as a result of the changes to the Part B program presented in these final rules. All expenditures are classified as transfers to the SMI Trust Fund.
Table 1.Accounting Statement: Classification of Estimated Savings [In millions]
Category Transfers Annualized Monetized Transfers............ $1,370.
From Whom to Whom?........................ Certain HighIncome Medicare Part B Beneficiaries to the Medicare SMI Trust Fund. Regulatory Flexibility Act

We certify that these final rules will not have a significant economic impact on a substantial number of small entities as they affect individuals only. Therefore, a regulatory flexibility analysis as provided in the Regulatory Flexibility Act, as amended, is not required for these final rules.

Paperwork Reduction Act

These final rules contain information collection requirements that require Office of Management and Budget clearance under the Paperwork Reduction Act of 1995 (PRA). As per PRA stipulations, we have submitted a clearance request to OMB for approval. Upon approval from OMB, we will publish a Federal Register notice indicating the OMB number and expiration date.

We published an NPRM on March 3, 2006 at 71 FR 10926. In the NPRM, we solicited comments under the PRA on the burden estimate; the need for the information; its practical utility; ways to enhance its quality, utility, and clarity; and on ways to minimize the burden on respondents, including the use of automated collection techniques or other forms of information technology.

Of the multiple comments the public submitted on these rules, only one pertained to the issues listed above. Specifically, one commenter expressed concerns about the burden of documenting lifechanging events. However, the MMA states that when beneficiaries request that we use their income information about a more recent tax year, the reduction in modified adjusted gross income must be caused by a verifiable lifechanging event. Therefore, we must ask Medicare beneficiaries to provide proof of the event.

One section containing a public reporting requirement, Sec. 418.1140(e), is included in these final rules but was not included in the NPRM. This section states that spouses who have been living in separate homes for the past year must provide written certification, or attestation, that they have been living separately. This requirement was included here and not in the NPRM because at the time we published the NPRM, we were still investigating ways that we could confirm this living arrangement from agency data. However, this section will not impact the public burden reported in the NPRM, since the only additional requirement for respondents is to certify that their address is separate from their spouse's, and certifications are not generally covered by the PRA as per OMB rules in 5 CFR 1320.3(h)(1).
(Catalog of Federal Domestic Assistance Program Nos. 93.773, MedicareHospital Insurance and 93.774, MedicareSupplementary Medical Insurance Program)

List of Subjects in 20 CFR Part 418

Administrative practice and procedure, Aged, Blind, Disability benefits, Public assistance programs, Reporting and recordkeeping requirements, Supplemental Security Income (SSI), Medicare subsidies.

Dated: October 13, 2006.
Jo Anne B. Barnhart,
Commissioner of Social Security.
For the reasons set out in the preamble, we are adding a new subpart B to part 418 of chapter III of title 20 of the Code of Federal Regulations as follows:
PART 418[AMENDED]
Subpart BMedicare Part B IncomeRelated Monthly Adjustment Amount Introduction, General Provisions, and Definitions
Sec.
418.1001 What is this subpart about?
418.1005 Purpose and administration.
418.1010 Definitions.
Determination of the IncomeRelated Monthly Adjustment Amount 418.1101 What is the incomerelated monthly adjustment amount? 418.1105 What is the threshold?
418.1110 What is the effective date of our initial determination about your incomerelated monthly adjustment amount?
418.1115 What are the modified adjusted gross income ranges? 418.1120 How do we determine your incomerelated monthly adjustment amount?
418.1125 How will the incomerelated monthly adjustment amount affect your total Medicare Part B premium?
418.1130 How will we phase in the incomerelated monthly adjustment amount?
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418.1135 What modified adjusted gross income information will we use to determine your incomerelated monthly adjustment amount?
418.1140 What will happen if the modified adjusted gross income information from IRS is different from the modified adjusted gross income information we used to determine your incomerelated monthly adjustment amount?
418.1145 How do we determine your incomerelated monthly adjustment amount if IRS does not provide information about your modified adjusted gross income?
418.1150 When will we use your amended tax return filed with IRS? Determinations Using a More Recent Tax Year's Modified Adjusted Gross Income
418.1201 When will we determine your incomerelated monthly adjustment amount based on the modified adjusted gross income information that you provide for a more recent tax year?
418.1205 What is a major lifechanging event?
418.1210 What is not a major lifechanging event?
418.1215 What is a significant reduction in your income?
418.1220 What is not a significant reduction in your income? 418.1225 Which more recent tax year will we use?
418.1230 What is the effective date of an incomerelated monthly adjustment amount initial determination that is based on a more recent tax year?
418.1235 When will we stop using your more recent tax year's modified adjusted gross income to determine your incomerelated monthly adjustment amount?
418.1240 Should you notify us if the information you gave us about your modified adjusted gross income for the more recent tax year changes?
418.1245 What will happen if you notify us that your modified adjusted gross income for the more recent tax year changes? 418.1250 What evidence will you need to support your request that we use a more recent tax year?
418.1255 What kind of major lifechanging event evidence will you need to support your request for us to use a more recent tax year? 418.1260 What major lifechanging event evidence will we not accept? 418.1265 What kind of significant modified adjusted gross income reduction evidence will you need to support your request?
418.1270 What modified adjusted gross income evidence will we not accept?
Determinations and the Administrative Review Process
418.1301 What is an initial determination regarding your income related monthly adjustment amount?
418.1305 What is not an initial determination regarding your income related monthly adjustment amount?
418.1310 When may you request that we make a new initial
determination?
418.1315 How will we notify you and what information will we provide about our initial determination?
418.1320 What is the effect of an initial determination?
418.1325 When may you request a reconsideration?
418.1330 Can you request a reconsideration

FOR FURTHER INFORMATION CONTACT

Craig Streett, Team Leader, Office of Income Security Programs, Social Security Administration, 252 Altmeyer Building, 6401 Security Boulevard, Baltimore, MD 212356401, 410965 9793 or TTY 18009665609, for information about this Federal Register document. For information on eligibility or filing for benefits, call our national tollfree number, 18007721213 or TTY 18003250778, or visit our Internet site, Social Security Online, at http://www.socialsecurity.gov .