[Code of Federal Regulations]

[Title 42, Volume 2]

[Revised as of October 1, 2005]

From the U.S. Government Printing Office via GPO Access

[CITE: 42CFR408.21]



[Page 277-278]

 

                         TITLE 42--PUBLIC HEALTH

 

                    CHAPTER IV--CENTERS FOR MEDICARE

                          & MEDICAID SERVICES,

                        DEPARTMENT OF HEALTH AND

                             HUMAN SERVICES

 

PART 408_PREMIUMS FOR SUPPLEMENTARY MEDICAL INSURANCE--Table of Contents

 

                  Subpart B_Amount of Monthly Premiums

 

Sec. 408.21  Reduction in Medicare Part B premium as an additional 

benefit under Medicare+Choice plans.



    (a) Basis for reduction in Part B premium. Beginning January 1, 2003 

an M+C organization may elect to receive a reduction in its payments 

under Sec. 422.250(a)(1) of this chapter if--

    (1) 80 percent of the payment reduction is applied to reduce the 

standard Medicare Part B premiums of its Medicare enrollees.

    (2) The Medicare Part B premium is reduced monthly and is offered to 

all Medicare enrollees in a specific plan benefit package.

    (b) Administrative requirements for the Part B premium reduction. 

(1) The Medicare Part B premium reduction cannot be greater than the 

standard premium amount determined for the year, under section 

1839(a)(3) of the Act. However, it may be less.

    (2) The Medicare Part B premium reduction must be a multiple of 10 

cents.

    (3) The Medicare Part B premium reduction is applied regardless of 

who pays or collects the Part B premium on behalf of the beneficiary.

    (4) The Medicare Part B premium can never be less than zero and will 

never result in a payment to a beneficiary for a specific month.

    (c) Beneficiary eligibility. In order for a beneficiary to be 

eligible for the Medicare Part B premium reduction, the beneficiary must 

be enrolled in an M+C plan that offers the Medicare Part B premium 

reduction as an additional benefit.

    (d) Notifications. After determining the Medicare Part B premium 

reduction amount for each eligible beneficiary, CMS will--

    (1) Transmit this information to the Social Security Administration, 

Railroad Retirement Board, or the Office of Personnel Management, as 

appropriate, which will adjust the benefit check amounts as appropriate 

and notify the beneficiaries of their new benefit amount.



[[Page 278]]



    (2) Notify states and formal groups and direct billed beneficiaries 

of their reduced premium amounts in the regular monthly billing process.



[68 FR 66723, Nov. 28, 2003]