TN 1 (11-09)
HI 01130.015 How to Process T2 IRMAA Annual Verification Exceptions when Equitable Relief is Involved
42 CFR 407.32
A. Policy: General
For beneficiaries subject to income-related monthly adjustment amounts (IRMAA), where there is a retroactive change in the amount of the IRMAA, equitable relief is based on the amount of retroactive premiums due, not the number of months for which a premium is due. Equitable relief will automatically be extended if the retroactive IRMAA exceeds the limits in HI 01101.033B.
All notices of IRMAA arrearages exceeding these amounts must include equitable relief language.
Beneficiaries who owe these amounts and who would have difficulty paying the premiums in a lump sum may request refund arrangements, e.g., installment payments. Beneficiaries also have the right to request waiver (extreme financial hardship). Current instructions concerning waiver of premiums will apply; see HI 00805.180 and HI 00805.220H and HI 00805.220I.
B. Policy: Equitable Relief for Individuals Subject to IRMAA-B
For IRMAA-B equitable relief rules, see SM 00850.240B.
C. Policy: Equitable Relief for Individuals Subject to IRMAA-D
For IRMAA-D equitable relief rules, see SM 00850.250B.
D. Process: T2R System
When the T2R system determines that equitable relief applies to an IRMAA Annual Verification determination, T2 establishes an occurrence of Premium Relief. If T2 generates a Batch exception, the technician will establish Premium Relief via MACADE per SM 00850.240E.2. for IRMAA-B and SM 00850.250E.4. for IRMAA-D.
E. Related references