Medicare Part B Income-Related Premium -- Life-Changing Event

ICR 201006-0960-013

OMB: 0960-0735

Federal Form Document

Forms and Documents
ICR Details
0960-0735 201006-0960-013
Historical Active 200906-0960-001
SSA
Medicare Part B Income-Related Premium -- Life-Changing Event
Revision of a currently approved collection   No
Emergency 07/06/2010
Approved without change 07/07/2010
Retrieve Notice of Action (NOA) 06/29/2010
  Inventory as of this Action Requested Previously Approved
01/31/2011 6 Months From Approved 11/30/2012
176,000 0 160,000
97,250 0 88,000
0 0 0

SSA uses the information collected by form SSA-44 to determine if the initial IRS tax data used for the beneficiary is up-to-date. If the agency determines the LCE has significantly reduced the beneficiary’s income, it will use the information to update its original determinations or to make new initial determinations. The respondents are Medicare part B enrollees with modified adjusted gross income over an established high-income “threshold.” In this emergency ICR, we are requesting minor changes to the form to conform with soon-to-be-published regulations.
In several weeks, SSA plans to publish regulations at RIN 0960-AH06 (docket no. SSA-2009-0078). These rules will expand the definition of property loss and will add a new life-changing event: receipt of a one-time employer’s settlement payment. We will revise form SSA-44 to include the expanded and new LCEs. The attached Supporting Statement and Addendum to the Supporting Statement outline the specific changes we are making. Because these new rules will be effective on publication, we must have the revised form in place by the time they publish. We are therefore requesting emergency clearance one week from today, Tuesday, July 6, 2010. See attached Emergency Request Letter for further details. A copy of the soon-to-be-published rules is also attached.

US Code: 42 USC 1395r Name of Law: Social Security Act
  
PL: Pub.L. 108 - 173 811 Name of Law: Medicare Modernization Act of 2003

Not associated with rulemaking

  75 FR 37518 06/29/2010
No

  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 176,000 160,000 16,000 0 0 0
Annual Time Burden (Hours) 97,250 88,000 9,250 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No
SSA anticipates an increase in burden hours due to a slight increase of the number of requests we will received based on the revised regulation.

$8,419,173
No
No
No
Uncollected
No
Uncollected
Faye Lipsky 410 965-8783 faye.lipsky@ssa.gov

  No

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
06/29/2010


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