[Federal Register Volume 61, Number 150 (Friday, August 2, 1996)]
[Rules and Regulations]
[Pages 40343-40347]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 96-19558]
=======================================================================
-----------------------------------------------------------------------
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Health Care Financing Administration
42 CFR Parts 406, 407, 408, and 416
[BPD-752-FC]
RIN 0938-AH33
Medicare Program: Special Enrollment Periods and Waiting Period
AGENCY: Health Care Financing Administration (HCFA), HHS.
ACTION: Final rules with comment period.
-----------------------------------------------------------------------
SUMMARY: These rules provide an additional way for certain disabled
individuals under age 65 to qualify for special enrollment periods
(SEPs); extend from 1991 through 1998 the period during which certain
disabled individuals under age 65 who are covered under large group
health plans (LGHPs) may qualify for SEPs; and make clear that a second
24-month waiting period is not required for disability-based
reentitlement if the current impairment is the same as, or directly
related to, the impairment on which the previous period of entitlement
was based.
The changes made by these rules conform the HCFA regulations to
certain provisions of the Omnibus Budget Reconciliation Acts of 1987,
1989, 1990, and 1993 (commonly referred to as OBRA '87, OBRA '89, OBRA
'90, and OBRA '93, respectively), and the Social Security Act (SSA)
Amendments of 1994 (Pub. L. 103-432).
In OBRA '93, Congress amended section 1862(b) of the Social
Security Act (the Act), to extend through September 30, 1998 the
Medicare Secondary Payer (MSP) provisions for disabled beneficiaries.
Congress did not make a conforming amendment to section 1837(i) of the
Act, which authorizes SEPs for disabled beneficiaries who stop working.
However, the SSA Amendments of 1994 made the conforming change to
section 1837(i), retroactive to the OBRA '93 effective date.
The purpose of the special enrollment period amendments is to
ensure that a disabled individual under age 65 who meets the conditions
for enrollment in Medicare Part B will be able to enroll as soon as his
or her group health plan coverage based on current employment ends; and
to extend until September 30, 1998 the protection afforded by the
special enrollment periods to disabled individuals covered under LGHPs.
DATES: Effective date: These rules are effective on September 3, 1996.
Comment date: We will consider comments received by October 1,
1996.
ADDRESSES: Please mail original and 3 copies of your comments to the
following address: Health Care Financing Administration, Department of
Health and Human Services, Attention: BPD-752-FC, P.O. Box 26688,
Baltimore, Maryland 21207.
If you prefer, you may deliver original and 3 copies of your
comments to either of the following addresses:
Room 309-G, 200 Independence Avenue, S.W., Washington, DC 20201,
Room C5-09-26, 7500 Security Boulevard, Baltimore, Maryland 21244-1850.
Because of staffing and resource limitations, we cannot accept
comments by facsimile (FAX) transmission. In commenting, please refer
to file code BPD-752-FC. Comments received timely will be available for
public inspection as they are received, generally beginning
approximately 3 weeks after publication of a document, in Room 309-G of
the Department's offices at 200 Independence Avenue, SW., Washington,
DC on Monday through Friday of each week from 8:30 a.m. to 5 p.m.
(Phone: (202) 690-7890).
Although we cannot respond to individual comments, if we revise
these rules as a result of comments, we will discuss all timely
comments in the preamble to the revised rules.
FOR FURTHER INFORMATION CONTACT: Margaret Jefferson, (410) 786-4482.
SUPPLEMENTARY INFORMATION:
I. Background
A. Amendments to the Statute: Special Enrollment Periods and Waiting
Period
1. Section 4033 of OBRA '87 (Pub. L. 100-203) amended section
226(f) of the Act to provide that, effective as of March 1988, a second
24-month waiting period is not required for disability-based
reentitlement if the current impairment is the same as, or directly
related to, the impairment on which the
[[Page 40344]]
previous period of entitlement was based.
2. Section 6202(c) of OBRA '89 (Pub. L. 101-239) amended section
1837(i) of the Act to provide, effective July 1, 1990, an additional
way for certain disabled individuals under age 65 to qualify for a SEP.
Before enactment of this amendment, a disabled ``active individual''
could qualify for a SEP only if he or she was covered (directly or as
part of the family of another covered individual) under a large group
health plan (LGHP). (The statute defined ``active individual'' as ``an
employee (as may be defined in regulations), the employer, self-
employed individual (such as the employer) an individual associated
with the employer in a business relationship, or a member of the family
of any such person''). An LGHP is a plan of an employer of 100 or more
employees or of a group of employers at least one of which has 100 or
more employees. Under the amendment, a disabled individual can also
qualify for a SEP under the rules that previously applied only to an
individual age 65 or over, that is, by having been covered under a
group health plan (GHP) on the basis of his or her own employment or
that of a spouse. This rule applies regardless of the number of
employees an employer has. However, since the SEP qualification
provisions for individuals age 65 or over refer specifically to the
plan of the individual or the individual's spouse, this additional way
of qualifying for a SEP is not available to a child or other family
member who is disabled. Those individuals qualify for SEPs only if
covered under an LGHP.
3. Section 4203(b) of OBRA '90 (Public Law 101-508) and section
13561(b) of OBRA '93 (Public Law 103-66) amended section
1862(b)(1)(B)(iii) of the Act to change, first from December 31, 1991
to September 30, 1995, and then to September 30, 1998, the termination
date of the MSP provisions for the disabled. Moreover, sections
13561(e)(1)(E) and (e)(1)(F) of OBRA '93 amended section
1862(b)(1)(B)(i) of the Act to eliminate the ``active individual''
language. Before this amendment, ``active individual'' identified the
beneficiaries to whom the MSP provisions applied. Because of this
change to the ``current employment'' criterion, Medicare is secondary
payer for a disabled beneficiary who is under age 65 and who is covered
under an LGHP--
Through August 9, 1993, as a disabled ``active
individual''; and
From August 10, 1993 through September 1998, ``by virtue
of the individual's current employment status with an employer''.
Section 1862(b)(1)(B) of the Act establishes October 1, 1998 as the
sunset date of the MSP provisions for disabled individuals. As noted
above, section 1837(i) of the Act, which pertains to SEPs, was amended
by the SSA Amendments of 1994 to conform to section 1862(b(1)(B) of the
Act. Since the availability of SEPs to disabled individuals depends
upon the existence of section 1862(b)(1)(B) of the Act, we have
interpreted that the October 1, 1998 sunset date in that section
applies also to those SEP provisions. (The MSP provisions for the aged,
set forth at section 1862(b)(1)(A) of the Act have no sunset date.)
4. Section 147(f) of the Social Security Amendments of 1994 (Pub.
L. 103-432).
Amended section 1837(i)(3) of the Act so that a SEP may
begin earlier and last longer; and
Amended section 1838(e) of the Act to provide options for
the beginning of Medicare coverage that is based on enrollment during
specified months of a SEP.
Under the section 1837 amendment--
Instead of beginning on the first day of the first month
during which the individual is no longer enrolled in a GHP or LGHP on
the basis of current employment status, the SEP may include each month
during any part of which the individual is so enrolled; and
Instead of ending ``seven months later'', the SEP ends on
the last day of the eighth consecutive month in which the individual is
no longer so enrolled.
Under the section 1838 amendment, with respect to the beginning of
coverage--
For one who enrolls in Medicare in a month during any part
of which he or she is enrolled in a GHP or LGHP on the basis of current
employment status, or the first full month when not so enrolled,
Medicare coverage begins on the first day of the month of enrollment
or, at the option of the individual, on the first day of any of the
following three months.
For one who enrolls in any other month of the SEP, there
is no change: Medicare coverage begins on the first day of the month
following the month of enrollment.
B. Conforming Changes in the Regulations: Special Enrollment Periods
and Waiting Period
1. To reflect the statutory changes discussed above, we have made
the following changes:
Added a new paragraph (b)(3) to Sec. 406.12, to specify
that a second 24-month waiting period is not required for reentitlement
to hospital insurance benefits if the previous period of entitlement
ended on or after March 1, 1988 and the current impairment is the same
as, or directly related to, the impairment on which the previous period
of entitlement was based.
Revised Sec. 407.20(d) to set forth the new rule under
which a disabled individual may qualify for a SEP if he or she had GHP
coverage on the basis of the current employment of the individual or
the individual's spouse, and to restate the rule for those who must
qualify on the basis of LGHP coverage.
Revised Sec. 407.20(f) to specify the beginning date of a
SEP for a disabled individual who had GHP coverage on the basis of
current employment.
Revised Sec. 408.24(a)(8)(i) to change ``January 1992'' to
``October 1998'' and add a new paragraph (a)(9) to specify the months
excluded in computing Medicare Part B premium increases (for late
enrollment or reenrollment) for disabled individuals who had GHP
coverage on the basis of current employment. The revisions to
Sec. 408.24(a)(8)(i) reflect the extension of the MSP provisions for
the disabled. The new paragraph 408.24 (a)(9) is needed because the
OBRA '89 amendment that extended the SEP provisions to disabled
beneficiaries covered under a GHP (as distinguished from an LGHP) was
effective July 1990.
C. Technical and Clarifying Changes
1. In Sec. 406.6, we have amended paragraph (b) to clarify that an
individual who is under age 65 and has been entitled, for more than 24
months, to monthly social security or railroad retirement benefits
based on disability is also (in addition to those currently identified
in the paragraph) automatically entitled to Medicare Part A without
filing an application. This provision is part of section 226(b) of the
Act and, through an oversight, this provision had not been reflected in
our regulations.
2. Paragraph (e) of Sec. 406.21, revised to reflect the statutory
changes that affect SEPs, is redesignated as a new Sec. 406.24.
3. In Sec. 407.20(a), we have made the following changes:
Removed the definitions and replaced them with reference
to the definitions in Part 411 of the HCFA rules.
Used the initials ``GHP'' and ``LGHP'' wherever
appropriate.
Explained, under paragraph (a)(1) why the ``former
employee'' language of the Sec. 411.101 definitions of GHP and LGHP
does not apply with respect to SEPs.
[[Page 40345]]
4. In Sec. 407.25, we have revised paragraph (c) to remove the
current outdated content on beginning of entitlement and referenced new
Sec. 406.24. This new section incorporates the statutory changes that
pertain to SEPs and apply to Medicare Part B as well as Medicare Part
A.
5. In Sec. 408.24(a), we have--
Corrected the cross-reference to Sec. 405.340, which has
been redesignated as Sec. 411.170.
Used the initials ``GHP'' and ``LGHP'' wherever
appropriate.
Referenced the definitions in Secs. 411.101, 411.104, and
411.201 of the HCFA regulations, which incorporate the Internal Revenue
Code language.
Removed references to Public Laws because reference to the
implementing rules provides more precise guidance and is sufficient.
6. We have also taken advantage of this opportunity to make minor
technical and editorial changes that we overlooked when Sec. 416.35,
which pertains to ambulatory surgical centers, was amended.
II. Waiver of Proposed Rulemaking
We ordinarily publish a notice of proposed rulemaking in the
Federal Register and invite public comment. The Notice describes the
terms and substance of the proposed rules and references the legal
authority under which they are proposed. However, this procedure may be
waived if the agency finds that notice and public comment rulemaking is
impracticable, unnecessary, or contrary to the public interest.
These rules conform HCFA regulations to statutory amendments that
are already in effect. Publication of these conforming amendments will
ensure better understanding of beneficiary rights, but will have no
fiscal or program impact. The technical and clarifying amendments make
no substantive changes in the rules. For these reasons, we find that
notice and opportunity for comment are unnecessary and that there is
good cause to waive notice of proposed rulemaking procedures.
However, as indicated above under DATES, we will consider timely
comments from anyone who believes that the conforming changes go beyond
what the statute requires or permits, or that any of the technical
amendments affect the substance of the rules.
III. Regulatory Impact Statement
Consistent with the Regulatory Flexibility Act (RFA) (5 U.S.C. 601
through 612), we prepare a regulatory flexibility analysis for each
rule unless the Secretary certifies that it will not have a significant
economic impact on a substantial number of small entities. States and
individuals are not included in the definition of small entities.
In addition, section 1102(b) of the Act requires the Secretary to
prepare a regulatory impact analysis if a rule may have a significant
impact on the operations of a substantial number of small rural
hospitals. This analysis must conform to the provisions of section 604
of the RFA. For purposes of section 1102(b) of the Act, we define a
small rural hospital as a hospital that is located outside of a
Metropolitan Statistical Area and has fewer than 50 beds.
These rules conform the HCFA regulations to certain provisions of
OBRA '87, OBRA '89, OBRA '90, OBRA '93, and the Social Security Act
Amendments of 1994. The statutory effective dates of these provisions
have already passed and the changes are already in effect.
These amendments to the regulations will have no fiscal or program
impact. We are not preparing analyses for either the RFA or section
1102(b) of the Act because we have determined, and the Secretary
certifies, that these rules will not have a significant economic impact
on a substantial number of small entities or a significant impact on
the operation of a substantial number of small rural hospitals.
We have reviewed these rules and determined that, under the
provisions of Public Law 104-121, they are not major rules.
In accordance with the provisions of Executive Order 12866, these
final rules with comment period were not reviewed by the Office of
Management and Budget.
IV. Paperwork Reduction Act
These rules contain no information collection requirements subject
to review by the Office of Management and Budget under the Paperwork
Reduction Act.
List of Subjects
42 CFR Part 406
Health Facilities, Kidney diseases, Medicare.
42 CFR Part 407
Medicare.
42 CFR Part 408
Medicare.
42 CFR Part 416
Health facilities, Kidney diseases, Medicare, Reporting and
recordkeeping requirements.
42 CFR Chapter IV is amended as follows:
A. Part 406 is amended as set forth below:
PART 406--HOSPITAL INSURANCE ELIGIBILITY AND ENTITLEMENT
1. The authority citation for Part 406 continues to read as
follows:
Authority: Secs. 1102 and 1871 of the Social Security Act (42
U.S.C. 1302 and 1395hh), unless otherwise noted.
2. Section 406.6 is amended to revise paragraph (b) to read as
follows:
Sec. 406.6 Application or enrollment for hospital insurance.
* * * * *
(b) Individuals who need not file an application for hospital
insurance. An individual who meets any of the following conditions need
not file an application for hospital insurance:
(1) Is under age 65 and has been entitled, for more than 24 months,
to monthly social security or railroad retirement benefits based on
disability.
(2) At the time of attainment of age 65, is entitled to monthly
social security or railroad retirement benefits.
(3) Establishes entitlement to monthly social security or railroad
retirement benefits at any time after attaining age 65.
3. Section 406.12(b) is amended to remove footnote ``1'', revise
the introductory text, remove the semicolon and the word ``or'' from
the end of paragraph (b)(1) and insert a period in its place, and add a
new paragraph (b)(3), to read as follows:
Sec. 406.12 Individual under age 65 who is entitled to social security
or railroad retirement disability benefits.
* * * * *
(b) Previous periods of disability benefits entitlement. Months of
a previous period of entitlement or deemed entitlement to disability
benefits count toward the 25-month requirement if any of the following
conditions is met:
* * * * *
(3) The previous period ended on or after March 1, 1988 and the
current impairment is the same as, or directly related to, the
impairment on which the previous period of entitlement was based.
* * * * *
4. In Sec. 406.21, paragraph (e) is removed and reserved.
5. A new Sec. 406.24 is added, to read as follows:
[[Page 40346]]
Sec. 406.24 Special enrollment period.1
---------------------------------------------------------------------------
\1\ Before August 1986, SEPs were available only for enrollment
in supplementary medical insurance, not for enrollment in premium
hospital insurance.
---------------------------------------------------------------------------
(a) Terminology. As used in this subpart, the following terms have
the indicated meanings.
(1) Current employment status has the meaning given this term in
Sec. 411.104 of this chapter.
(2) Family member has the meaning given this term in Sec. 411.201
of this chapter.
(3) Group health plan (GHP) and large group health plan (LGHP) have
the meanings given those terms in Sec. 411.101 of this chapter, except
that the ``former employee'' language of those definitions does not
apply with respect to SEPs because--
(i) Section 1837(i)(1)(A) of the Act explicitly requires that GHP
coverage of an individual age 65 or older, be by reason of the
individual's (or the individual's spouse's) current employment status;
and
(ii) The sentence following section 1837(i)(1)(B), of the Act
refers to ``large group health plan''. Under section 1862(b)(1)(B)(i),
as amended by OBRA '93, LGHP coverage of a disabled individual must be
``by virtue of the individual's or a family member's current employment
status with an employer''.
(4) Special enrollment period (SEP) is a period provided by statute
to enable certain individuals to enroll in Medicare without having to
wait for the general enrollment period.
(b) Duration of SEP.2 (1) The SEP includes any month during
any part of which--
---------------------------------------------------------------------------
\2\ Before March 1995, SEPs began on the first day of the first
month the individual was no longer covered under a GHP or LGHP by
reason of current employment status.
---------------------------------------------------------------------------
(i) An individual over age 65 is enrolled in a GHP by reason of the
current employment status of the individual or the individual's spouse;
or
(ii) An individual under age 65 and disabled--
(A) Is enrolled in a GHP by reason of the current employment status
of the individual or the individual's spouse; or
(B) Is enrolled in an LGHP by reason of the current employment
status of the individual or a member of the individual's family.
(2) The SEP ends on the last day of the eighth consecutive month
during which the individual is at no time enrolled in a GHP or an LGHP
by reason of current employment status.
(c) Conditions for use of a SEP.3 In order to use a SEP, the
individual must meet the following conditions:
---------------------------------------------------------------------------
\3\ Before August 10, 1993, an individual under age 65 could
qualify for a SEP only if he or she had LGHP coverage as an ``active
individual'', which the statute defined as ``an employee, employer,
self-employed individual (such as the employer), individual
associated with the employer in a business relationship, or as a
member of the family of any of those persons''.
---------------------------------------------------------------------------
(1) When first eligible to enroll for premium hospital insurance
under Sec. 406.20(b) or (c), the individual was--
(i) Age 65 or over and covered under a GHP by reason of the current
employment status of the individual or the individual's spouse;
(ii) Under age 65 and covered under an LGHP by reason of the
current employment status of the individual or a member of the
individual's family ; or
(iii) Under age 65 and covered under a GHP by reason of the current
employment status of the individual or the individual's spouse.
(2) For all the months thereafter, the individual has maintained
coverage either under hospital insurance or a GHP or LGHP.
(d) Special rule: Additional SEPs. (1) Generally, if an individual
fails to enroll during any available SEP, he or she is not entitled to
any additional SEPs.
(2) However, if an individual fails to enroll during a SEP, because
coverage under the same or a different GHP or LGHP was restored before
the end of that particular SEP, that failure to enroll does not
preclude additional SEPs.
(e) Effective date of coverage. (1) If the individual enrolls in a
month during any part of which he or she is covered under a GHP or LGHP
on the basis of current employment status, or in the first full month
when no longer so covered, coverage begins on the first day of the
month of enrollment or, at the individual's option, on the first day of
any of the three following months.
(2) If the individual enrolls in any month of the SEP other than
the months specified in paragraph (e)(1) of this section, coverage
begins on the first day of the month following the month of enrollment.
B. Part 407 is amended as set forth below.
PART 407--SUPPLEMENTARY MEDICAL INSURANCE (SMI) ENROLLMENT AND
ENTITLEMENT
1. The authority citation for part 407 continues to read as
follows:
Authority: Secs. 1102 and 1871 of the Social Security Act (42
U.S.C. 1302 and 1395hh).
2. Section 407.20 is revised to read as follows:
Sec. 407.20 Special enrollment period related to coverage under group
health plans.
(a) Terminology--(1) Group health plan (GHP) and large group health
plan (LGHP). These terms have the meanings given them in Sec. 411.101
of this chapter except that the ``former employee'' language of those
definitions does not apply with respect to SEPs for the reasons
specified in Sec. 406.24(a)(3) of this chapter.
(2) Special enrollment period (SEP). This term has the meaning set
forth in Sec. 406.24(a)(4) of this chapter. In order to use a SEP, an
individual must meet the conditions of paragraph (b) and of paragraph
(c) or (d) of this section, as appropriate.
(b) General rule. All individuals must meet the following
conditions:
(1) They are eligible to enroll for SMI on the basis of age or
disability, but not on the basis of end-stage renal disease.
(2) When first eligible for SMI coverage (4th month of their
initial enrollment period), they were covered under a GHP or LGHP on
the basis of current employment status or, if not so covered, they
enrolled in SMI during their initial enrollment period; and
(3) For all months thereafter, they maintained coverage under
either SMI or a GHP or LGHP. (Generally, if an individual fails to
enroll in SMI during any available SEP, he or she is not entitled to
any additional SEPs. However, if an individual fails to enroll during a
SEP because coverage under the same or a different GHP or LGHP was
restored before the end of that particular SEP, that failure to enroll
does not preclude additional SEPs.)
(c) Special rule: Individual age 65 or over. For an individual who
is or was covered under a GHP, coverage must be by reason of the
current employment status of the individual or the individual's spouse.
(d) Special rules: Disabled individual.4 Individuals entitled
on the basis of disability (but not on the basis of end-stage renal
disease) must meet conditions that vary depending on whether they were
covered under a GHP or an LGHP.
---------------------------------------------------------------------------
\4\ Under the current statute, the SEP provision applicable to
disabled individuals covered under an LGHP expires on September
1998. Unless Congress changes that date, the last SEP available
under those provisions will begin with June 1998.
---------------------------------------------------------------------------
(1) For a disabled individual who is or was covered under a GHP,
coverage must be on the basis of the current employment status of the
individual or the individual's spouse.
(2) For a disabled individual who is or was covered under an LGHP,
coverage must be as follows:
(i) Before August 10, 1993, as an ``active individual'', that is,
as an employee, employer, self-employed individual (such as the
employer), individual associated with the employer
[[Page 40347]]
in a business relationship, or as a member of the family of any of
those persons.
(ii) On or after August 10, 1993, by reason of current employment
status of the individual or a member of the individual's family.
(e) Effective date of coverage. The rule set forth in
Sec. 406.24(d) for Medicare Part A applies equally to Medicare Part B.
3. In Sec. 407.25, paragraph (c) is revised to read as follows:
Sec. 407.25 Beginning of entitlement: Individual enrollment.
* * * * *
(c) Enrollment or reenrollment during a SEP. The rules set forth in
Sec. 406.24(d) of this chapter apply.
C. Part 408 is amended as set forth below:
PART 408--SUPPLEMENTARY MEDICAL INSURANCE PREMIUMS
1. The authority citation for Part 408 continues to read as
follows:
Authority: Secs. 1102 and 1871 of the Social Security Act (42
U.S.C. 1302 and 1395hh).
2. Section 408.24 is amended to republish the introductory text of
paragraph (a), to revise paragraphs (a)(6), (a)(7), and (a)(8), to add
a new paragraph (a)(9), and to revise paragraph (b)(2)(i), to read as
follows:
Sec. 408.24 Individuals who enrolled or reenrolled before April 1,
1981 or after September 30, 1981.
(a) Enrollment. For an individual who first enrolled before April
1, 1981 or after September 30, 1981, the period includes the number of
months elapsed between the close of the individual's initial enrollment
period and the close of the enrollment period in which he or she first
enrolled, and excludes the following:
* * * * *
(6) For premiums due for months beginning with September 1984 and
ending with May 1986, the following:
(i) Any months after December 1982 during which the individual
was--
(A) Age 65 to 69;
(B) Entitled to hospital insurance (Medicare Part A); and
(C) Covered under a group health plan (GHP) by reason of current
employment status.
(ii) Any months of SMI coverage for which the individual enrolled
during a special enrollment period as provided in Sec. 407.20 of this
chapter.
(7) For premiums due for months beginning with June 1986, the
following:
(i) Any months after December 1982 during which the individual was:
(A) Age 65 or over; and
(B) Covered under a GHP by reason of current employment status.
(ii) Any months of SMI coverage for which the individual enrolled
during a special enrollment period as provided in Sec. 407.20 of this
chapter.
(8) For premiums due for months beginning with January 1987, the
following:
(i) Any months after December 1986 and before October 1998 during
which the individual was:
(A) A disabled Medicare beneficiary under age 65;
(B) Not eligible for Medicare on the basis of end stage renal
disease, under Sec. 406.13 of this chapter; and
(C) Covered under an LGHP as described in Sec. 407.20 of this
chapter.
(ii) Any months of SMI coverage for which the individual enrolled
during a special enrollment period as provided in Sec. 407.20 of this
chapter.
(9) For premiums due for months beginning with July 1990, the
following:
(i) Any months after December 1986 during which the individual met
the conditions of paragraphs (a)(8)(i)(A) and (a)(8)(i)(B) of this
section, and was covered under a GHP by reason of the current
employment status of the individual or the individual's spouse.
(ii) Any months of SMI coverage for which the individual enrolled
during a special enrollment period as provided in Sec. 407.20 of this
chapter.
(b) * * *
(2) * * *
(i) The periods specified in paragraphs (a)(1) through (a)(9) of
this section; and
* * * * *
D. Part 416 is amended as set forth below.
PART 416--AMBULATORY SURGICAL SERVICES
1. The authority citation for part 416 continues to read as
follows:
Authority: Secs. 1102 and 1871 of the Social Security Act (42
U.S.C. 1302 and 1395hh).
Sec. 416.35 [Amended]
2. In Sec. 416.35, the following changes are made:
a. In paragraph (b)(1)(i), ``Sec. 416.39'' is revised to read
``Sec. 416.26''.
b. In the introductory text of paragraph (d), ``shall be given'' is
revised to read ``is given''.
(Catalog of Federal Domestic Assistance Program No. 93.773,
Medicare--Hospital Insurance and No. 93.774, Medicare--Supplementary
Medical Insurance)
Dated: July 26, 1996.
Bruce C. Vladeck,
Administrator, Health Care Financing Administration.
[FR Doc. 96-19558 Filed 8-1-96; 8:45 am]
BILLING CODE 4120-01-P