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 § 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.
(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.
(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]