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Medicare program; grace period and termination for nonpayment of Supplementary Medical Insurance (Part B) premiums for insured and uninsured persons--HCFA. Final rule.

This final rule changes the termination date for Supplementary Medical Insurance (SMI) (Part B) enrollees who fail to pay their Medicare Part B premiums. Presently, there is a 90 day grace period for the enrollee during which he or she may pay all overdue premiums and continue Part B coverage uninterrupted. The grace period begins at different times depending on whether the individual is or is not eligible for monthly social security, railroad retirement or civil service retirement benefits. This final rule establishes a uniform timeframe for determining the 90 day grace period which precedes the termination of SMI enrollees who fail to pay their Medicare Part B premiums.

Centers for Medicare and Medicaid Services, U.S.↗

[Social, hygienic, and economic mechanisms of managing work conditions of insured workers in the system of mandatory social insurance].

The author considers methodic approaches to calculation of insurance rates, discounts and additions, taking into account potential risk of health disorders during work activity, based on hygienic classification of work conditions by jeopardy and hazards of occupational environment with cumulative biologic action, by work intensity and hardness.

Algorithms↗

Actuarial status of the OASI (old age survivors insurance) and DI (disability insurance) Trust Funds.

This article summarizes the current financial condition and actuarial status of the Old-Age, Survivors, and Disability Insurance (OASDI) program, as shown in the 1987 Annual Report of the Board of Trustees. The Trustees note that the assets of the OASI and DI Trust Funds, on a combined basis, will be sufficient to permit the timely payment of OASDI benefits for many years into the future, on the basis of all four sets of assumptions shown in the report. For the next 75 years, the estimates show that the OASDI program, overall, is in close actuarial balance, based on the two intermediate sets of assumptions. The DI program by itself, however, is not in close actuarial balance for the next 75 years. The actuarial deficit for the DI program could be remedied by a small reallocation of the contribution rate from OASI to DI, in such a way that the OASI program would remain in close actuarial balance and OASDI benefits would not be affected. Although the Trustees are not recommending such a reallocation, they note that the financial condition of the DI program will need to be carefully monitored.

Financing, Organized↗

Actuarial status of the Old-Age and Survivors Insurance and Disability Insurance Trust Funds.

This article summarizes the current financial and actuarial status of the Old-Age, Survivors, and Disability Insurance (OASDI) program. The data presented are from the 1983 Trustees Report for the program following enactment of the Social Security Amendments of 1983. The actuarial estimates show that benefits can be paid on time throughout the 1980's and for many years thereafter. However, trust fund levels are projected to be relatively low through 1987, and the program could again experience financial difficulties in the near future if economic conditions become worse than anticipated under the pessimistic Alternative III assumptions. After 1987, the program's ability to withstand economic downturns is projected to improve. On the basis of intermediate assumptions, the OASDI program is now in long-range actuarial balance. This actuarial balance reflects substantial year-by-year surpluses during the first half of the 75-year projection period that slightly outweigh substantial deficits later on.

Costs and Cost Analysis↗

[Diabetic night clinic. Advantages for insured patients and insurance carriers].

The night clinic for diabetics is a new, partially inpatient supplement of the present medical treatment. It represents a modern cooperative model which provides treatment in the time period that is not taken care of by either out-patient or normal in-patient service. The effectivity in the education and metabolic adjustment of the patients is as good as in a normal clinic. The night clinic permits the insured patient to have equal opportunities at work and a better quality of life. It thus fulfills the social and medical demands in the St.-Vincent declaration. The diabetic can no longer be discriminated against due to missing work in order to be instructed. By remaining employed the patients can be more realistically adapted through cooperation with the company doctor. The social and medical subsequent costs can thus be clearly reduced for the payer. By this cost reduction and by lower operating costs while simultaneously being a more efficient way of treatment, the night clinic conception fulfills modern medical, economic and legal standards.

Absenteeism↗