CMS Announces Medicare Inpatient Hospital Deductible and Other Program Rates for 2013

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CMS recently published two notices setting out certain Medicare deductible and monthly premium amounts for 2013.  The first notice (the Part A Notice) announces the inpatient hospital deductible and the hospital and extended care services coinsurance amounts for Medicare Part A health care services provided in calendar year 2013.  The second notice (the Part B Notice) announces the monthly actuarial rates for certain aged (age 65 and over) and disabled (under age 65) Part B enrollees, as well as the monthly premium for aged and disabled beneficiaries and deductible amounts.   

CMS announced in the Part A Notice that, for 2013, the inpatient hospital deductible will be $1,184.  CMS noted that the 2013 inpatient hospital deductible was calculated using, among other things, a market basket percentage increase of 2.6 percent (from 2012) reduced by 0.1 percentage points, and a multifactor productivity adjustment of 0.7 percent.  In this notice, CMS also announced the following daily coinsurance amounts for 2013: $296 for days 61 through 90 of hospitalization in a benefit period; $592 for lifetime reserve days; and $148 for days 21 through 100 of extended care services in a skilled nursing facility in a benefit period.  CMS estimates that the amounts announced in the Part A Notice will result in about $1.03 billion in increased costs to beneficiaries.

With respect to the Part B Notice, CMS announced that the monthly actuarial rates for 2013 are $209.80 for aged enrollees and $235.50 for disabled enrollees.  CMS also announced that, for all enrollees for 2013, the standard, unadjusted monthly Part B premium rate will be $104.90—up from the 2012 rate of $99.90—and the standard, unadjusted Part B deductible will be $147.00.

CMS published the Part A Notice and the Part B Notice via general notice, rather than using the notice and comment rulemaking procedure.  Both notices were published in the Federal Register on November 21, 2012, and are effective January 1, 2013.

Click here to view the Part A Notice, and here to view the Part B Notice.

Reporter, Greg Sicilian, Atlanta, +1 404 572 2810, gsicilian@kslaw.com.


DISCLAIMER: Because of the generality of this update, the information provided herein may not be applicable in all situations and should not be acted upon without specific legal advice based on particular situations.

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