Medicare Program: Special Enrollment Periods and Waiting Period

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.

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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

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\1\ Before August 1986, SEPs were available only for enrollment

in supplementary medical insurance, not for enrollment in premium

hospital insurance.

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(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--

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\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.

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(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:

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\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''.

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(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.

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\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.

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(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