Federal Register - August 10, 2021
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Source: Federal Register
43622
Federal Register / Vol. 86, No. 151 / Tuesday, August 10, 2021 / Proposed Rules
TABLE 1ACCOUNTING STATEMENT: ESTIMATED IMPACTS FROM CY 2021 TO CY 2028 AS A RESULT OF PROVISIONS OF
THIS PROPOSED RULE BASED ON THE OACT ESTIMATEContinued Units Category
Estimates Year dollar
Annualized Monetized $million/year
From Whom to Whom
11,502.5
11,906.3
4,087.2
4,228.3
7
3
January 2021December 2027.
January 2021December 2027.
2018
2018
7
3
January 2021December 2027.
January 2021December 2027.
Beneficiaries to hospitals/physicians and MA plans.
Annualized Monetized $million/year
From Whom to Whom
2018
2018
Period covered
Federal Government to hospitals/physicians and MA plans.
Annualized Monetized $million/year
From Whom to Whom
Discount rate %
577.5
596.5
2018
2018
7
3
January 2021December 2027.
January 2021December 2027.
States to hospitals/physicians and MA plans.
TABLE 2ACCOUNTING STATEMENT: ESTIMATED IMPACTS FROM CY 2021 TO CY 2028 AS A RESULT OF THE PROVISIONS
OF THIS PROPOSED RULE BASED ON THE ASPE ESTIMATE
Units Category
Estimates Year dollar
Costs:
Annualized Monetized $million/year
To Whom
29.4
27.1
Transfers:
Annualized Monetized $million/year
jbell on DSKJLSW7X2PROD with PROPOSALS
D. Regulatory Flexibility Act RFA
The RFA requires agencies to analyze options for regulatory relief of small entities. For purposes of the RFA, small entities include small businesses, nonprofit organizations, and small governmental jurisdictions. Most hospitals and most other providers and suppliers are small entities, either by nonprofit status or by having revenues of less than $8 million to $41.5 million in any 1 year. Individuals and states are not included in the definition of a small entity. For details, see the Small Business Administrations Table of Small Business Size Standards at
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7
3
January 2021December 2028.
January 2021December 2028.
0.4
0.4
2018
2018
7
3
January 2021December 2027.
January 2021December 2027.
7,058.3
7,276.5
2018
2018
7
3
January 2021December 2027.
January 2021December 2027.
4,504.9
4,638.6
2018
2018
7
3
January 2021December 2027.
January 2021December 2027.
Beneficiaries to hospitals/physicians and MA plans
Annualized Monetized $million/year
From Whom to Whom
2018
2018
Federal Government to hospitals/physicians and MA plans
Annualized Monetized $million/year
From Whom to Whom
Period covered
Hospital/physicians
Annualized Monetized $million/year
From Whom to Whom
Discount rate %
342.4
351.6
2018
2018
7
3
January 2021December 2027.
January 2021December 2027.
States to hospitals/physicians and MA plans
https www.sba.gov/document/support-table-size-standards. The rule of thumb used by HHS for determining whether an impact is significant is an adverse effect equal to 3 percent or more of total annual revenues.
This proposed rule, if finalized, would impact the vast majority of Medicare-participating providers and suppliers that submit claims for separately payable Medicare Part B
drugs by preventing the impacts described in the November 2020 interim final rule 85 FR 76246 from being realized. There are over 20,000 small entities that would be included or
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affected by the MFN Model if the model was implemented. We refer readers to Table 3 and Table 8 in the November 2020 interim final rule 85 FR 76195
and 76219, respectively to see the number of entities, as well as the types of providers and suppliers, that would be most likely impacted by the MFN
Model. This proposed rule proposes to withdraw the MFN Model, and therefore would likely impact these same entities.
Accordingly, we have determined that a Regulatory Flexibility Analysis RFA is required. As its measure of significant economic impact on a substantial number of small entities, HHS uses a
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