Privacy Act of 1974; Report of a New System of Records, 38944-38948 [05-13188]
Download as PDF
38944
Federal Register / Vol. 70, No. 128 / Wednesday, July 6, 2005 / Notices
budget period. The progress report will
serve as your non-competing
continuation application, and must
contain the following elements:
a. Current Budget Period Activities
Objectives.
b. Current Budget Period Financial
Progress.
c. New Budget Period Program
Proposed Activity Objectives.
d. Budget.
e. Measures of Effectiveness.
f. Additional Requested Information.
2. Annual progress report, due 90
days after the end of the budget period.
3. Financial status report, no more
than 90 days after the end of the budget
period.
4. Final financial and performance
reports, no more than 90 days after the
end of the project period.
VII. Agency Contacts
We encourage inquiries concerning
this announcement. For general
questions, contact: Technical
Information Management Section, CDC
Procurement and Grants Office, 2920
Brandywine Road, Atlanta, GA 30341,
Telephone: 770–488–2700.
For program technical assistance,
contact: Debra Hayes-Hughes, Project
Officer, Centers for Disease Control and
Prevention, 1600 Clifton Road, NE., MS
E–47, Atlanta, GA 30333, Telephone:
404–639–4493, E-mail: DHayesHughes@cdc.gov.
For financial, grants management, or
budget assistance, contact: Kang Lee,
Grants Management Specialist, CDC
Procurement and Grants Office, 2920
Brandywine Road, Atlanta, GA 30341,
Telephone: 404–498–1917, E-mail:
kil8@cdc.gov.
VIII. Other Information
This and other CDC funding
opportunity announcements can be
found at https://www.cdc.gov. Click on
‘‘Funding,’’ then ‘‘Grants and
Cooperative Agreements.’’
Dated: June 28, 2005.
Alan A. Kotch,
Acting Deputy Director, Procurement and
Grants Office, Centers for Disease Control
and Prevention.
[FR Doc. 05–13223 Filed 7–5–05; 8:45 am]
BILLING CODE 4163–18–P
VerDate jul<14>2003
16:35 Jul 05, 2005
Jkt 205001
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Centers for Medicare & Medicaid
Services
Privacy Act of 1974; Report of a New
System of Records
Department of Health and
Human Services (HHS), Centers for
Medicare & Medicaid Services (CMS).
ACTION: Notice of a new System of
Records (SOR).
AGENCY:
SUMMARY: In accordance with the
requirements of the Privacy Act of 1974,
we are proposing to establish a new
system of records titled, ‘‘Health
Insurance Portability and
Accountability Act (HIPAA) Information
Tracking System (HITS), System No.
09–70–0544.’’ The Office of E-Health
Standards and Services (OESS) has been
delegated the responsibility to regulate
and enforce compliance for violations of
Transactions and Code Sets, Security,
and Unique Identifier provisions of
HIPAA. Enforcement of these provisions
is a complaint driven process; seeking
voluntary compliance from all HIPAA
covered entities. OESS has procured the
services of a contractor to provide a
database for complaint intake and
management, to manage and maintain
the overall electronic complaint process.
Due to investigatory activities, CMS is
exempting this system from the
notification, access, correction and
amendment provisions of the Privacy
Act of 1974.
The purpose of this system is to store
the results of all OESS regional
investigations, to determine if there
were violations as charged in the
original complaint, to investigate
complaints that appear to be in violation
of the Transactions and Code Sets,
Security, and Unique Identifier
provisions of HIPAA, to refer violations
to law enforcement activities as
necessary, and to maintain and retrieve
records of the results of the complaint
investigations. Information retrieved
from this SOR will also be disclosed to:
(1) Support regulatory, reimbursement,
and policy functions performed within
the agency, HIPAA entities, or by a
contractor or consultant; (2) assist
another Federal or state agency in the
enforcement of HIPAA regulations
where sharing the information is
necessary to complete the processing of
a complaint, contribute to the accuracy
of CMS’s proper payment of Medicare
benefits, and/or enable such agency to
administer a Federal health benefits
program; (3) support constituent
requests made to a congressional
PO 00000
Frm 00083
Fmt 4703
Sfmt 4703
representative; (4) support litigation
involving the agency; and (5) combat
fraud and abuse in certain health
benefits programs. We have provided
background information about the
modified system in the ‘‘Supplementary
Information’’ section below. Although
the Privacy Act requires only that CMS
provide an opportunity for interested
persons to comment on the proposed
routine uses, CMS invites comments on
all portions of this notice. See ‘‘Effective
Dates’’ section for comment period.
DATES: Effective Date: CMS filed a new
SOR report with the Chair of the house
Committee on Government Reform and
Oversight, the Chair of the Senate
Committee on Governmental Affairs,
and the Administrator, Office of
Information and Regulatory Affairs,
Office of Management and Budget
(OMB) on June 28, 2005. We will not
disclose any information under a
routine use until 30 days after
publication. We may defer
implementation of this SOR or one or
more of the routine use statements listed
below if we receive comments that
persuade us to defer implementation.
ADDRESSES: The public should address
comment to the CMS Privacy Officer,
Mail-stop N2–04–27, 7500 Security
Boulevard, Baltimore, Maryland 21244–
1850. Comments received will be
available for review at this location, by
appointment, during regular business
hours, Monday through Friday from 9
a.m.–3 p.m., eastern daylight time.
FOR FURTHER INFORMATION CONTACT:
Michael Phillips, Health Insurance
Specialist, OESS, CMS, 7500 Security
Boulevard, Mail Stop S2–24–15,
Baltimore, Maryland 21244–1849,
Telephone Number (410) 786–6713,
mphillips@cms.hhs.gov.
SUPPLEMENTARY INFORMATION: HITS is
used by OESS staff and consists of an
electronic repository of information and
documents and supplementary paper
document files. The HITS system allows
OESS to integrate all of OESS’ various
business process including all of its
investigation activities to allow real
time access and results reporting and
other varied information management
needs. HITS provides (1) a single,
central, electronic repository of all OHS
complaint documents and information
including investigative files,
correspondence, and administrative
records; (2) easy, robust capability to
search all of the information in OESS’
repository; (3) better quality control at
the front end with simplified data entry
and stronger data validation; (4) tools to
help staff work on and manage their
casework; and (5) includes
supplementary paper files. The system
E:\FR\FM\06JYN1.SGM
06JYN1
Federal Register / Vol. 70, No. 128 / Wednesday, July 6, 2005 / Notices
has the capacity to generate reports
concerning the status of current and
closed complaints, reviews and
correspondence.
OESS investigative files maintained in
HITS are either received as electronic
documents or paper records that are
compiled for law enforcement purposes.
In the course of investigations, OESS
often has a need to obtain confidential
information involving individuals other
than the complainant. In these cases, it
is necessary for OHS to: (1) Preserve the
confidentiality of this information, (2)
avoid unwarranted invasions of
personal privacy, and (3) assure
recipients of Federal financial assistance
that such information provided to OESS
will be kept confidential. This assurance
facilitates prompt and effective
completion of the investigations.
Unrestricted disclosure of
confidential information in OESS files
can impede ongoing investigations,
invade personal privacy of individuals
and organizations, reveal the identities
of confidential sources, or otherwise
impair the ability of OESS to conduct
investigations. For these reasons, the
CMS is exempting all investigative files
from the notification, access, correction
and amendment provisions under
subsection (k)(2) of the Privacy Act.
I. Description of the Proposed System of
Records
A. Statutory and Regulatory Basis for
SOR
Authority for maintenance of this
system is given under provisions of the
Health Insurance Portability and
Accountability Act of 1996, Public Law
(Pub. L. 104–191), published at 68 FR
60694 (October 23, 2003). These
regulations are codified at 45 Code of
Federal Regulation, parts 160, 162, and
164.
B. Collection and Maintenance of Data
in the System
HITS will maintain a file of complaint
allegations, information gathered during
the complaint investigation, findings,
and results of the investigation, and
correspondence relating to the
investigation. The collected information
will contain name, address, telephone
number, health insurance claim (HIC)
number, geographic location, as well as,
background information relating to
Medicare or Medicaid issues of the
complainant.
VerDate jul<14>2003
16:35 Jul 05, 2005
Jkt 205001
38945
II. Agency Policies, Procedures, and
Restrictions on the Routine Use
4. Determines that the data are valid
and reliable.
A. Agency Policies, Procedures, and
Restrictions on the Routine Use
III. Proposed Routine Use Disclosures
of Data in the System
A. The Privacy Act allows us to
disclose information without an
individual’s consent if the information
is to be used for a purpose that is
compatible with the purpose(s) for
which the information was collected.
Any such compatible use of data is
known as a ‘‘routine use.’’ The proposed
routine uses in this system meet the
compatibility requirement of the Privacy
Act. We are proposing to establish the
following routine use disclosures of
information maintained in the system:
1. To agency contractors or consultant
who have been engaged by the agency
to assist in the performance of a service
related to this system of records and
who need to have access to the records
in order to perform the activity.
We contemplate disclosing
information under this routine use only
in situations in which CMS may enter
into a contractual or similar agreement
with a third party to assist in
accomplishing CMS function relating to
purposes for this system or records.
CMS occasionally contracts out
certain of its functions when doing so
would contribute to effective and
efficient operations. CMS must be able
to give a contractor or consultant
whatever information is necessary for
the contractor or consultant to fulfill its
duties. In these situations, safeguards
are provided in the contract prohibiting
the contractor or consultant from using
or disclosing the information for any
purpose other than that described in the
contract and requires the contractor or
consultant to return or destroy all
information at the completion of the
contract.
2. To another Federal or state agency
to:
a. Assist in the enforcement of HIPAA
regulations for violations of
Transactions and Code Sets, Security,
and Unique Identifiers where sharing
the information is necessary to complete
the processing of a complaint,
b. Contribute to the accuracy of CMS’s
proper payment of Medicare benefits,
and/or
c. Enable such agency to administer a
Federal health benefits program, or as
necessary to enable such agency to
fulfill a requirement of a Federal statute
or regulation that implements a health
benefits program funded in whole or in
part with Federal funds.
Other Federal or state agencies in
their administration of a Federal health
program may require HITS information
in order to investigate complaint
The Privacy Act permits us to disclose
information without an individual’s
consent if the information is to be used
for a purpose that is compatible with the
purpose(s) for which the information
was collected. Any such disclosure of
data is known as a ‘‘routine use.’’ The
government will only release HITS
information that can be associated with
an individual as provided for under
‘‘Section III. Proposed Routine Use
Disclosures of Data in the System.’’ Both
identifiable and non-identifiable data
may be disclosed under a routine use.
We will only collect the minimum
personal data necessary to achieve the
purpose of HITS. CMS has the following
policies and procedures concerning
disclosures of information that will be
maintained in the system. Disclosure of
information from the SOR will be
approved only to the extent necessary to
accomplish the purpose of the
disclosure and only after CMS:
1. Determines that the use or
disclosure is consistent with the reason
that the data is being collected, e.g., to
store the results of all OESS regional
investigations, to determine if there
were violations as charged in the
original complaint, to investigate
complaints that appear to be in violation
of the HIPAA, to refer violations to law
enforcement activities as necessary, and
to maintain and retrieve records of the
results of the complaint investigations.
2. Determines that:
a. The purpose for which the
disclosure is to be made can only be
accomplished if the record is provided
in individually identifiable form;
b. The purpose for which the
disclosure is to be made is of sufficient
importance to warrant the effect and/or
risk on the privacy of the individual that
additional exposure of the record might
bring; and
c. There is a strong probability that
the proposed use of the data would in
fact accomplish the stated purpose(s).
3. Requires the information recipient
to:
a. Establish administrative, technical,
and physical safeguards to prevent
unauthorized use of disclosure of the
record;
b. Remove or destroy at the earliest
time all patient-identifiable information;
and
c. Agree to not use or disclose the
information for any purpose other than
the stated purpose under which the
information was disclosed.
PO 00000
Frm 00084
Fmt 4703
Sfmt 4703
E:\FR\FM\06JYN1.SGM
06JYN1
38946
Federal Register / Vol. 70, No. 128 / Wednesday, July 6, 2005 / Notices
allegations, evaluate information
gathered during the complaint
investigation, review findings and
results of the investigation relating to
the enforcement of HIPAA regulations
for violations of Transactions and Code
Sets, Security, and Unique Identifiers.
3. To a member of Congress or to a
congressional staff member in response
to an inquiry of the congressional office
made at the written request of the
constituent about whom the record is
maintained.
Beneficiaries sometimes request the
help of a member of Congress in
resolving an issue relating to a matter
before CMS. The member of Congress
then writes CMS, and CMS must be able
to give sufficient information to be
responsive to the inquiry.
4. To the Department of Justice (DOJ),
court or adjudicatory body when:
a. The agency or any component
thereof, or
b. Any employee of the agency in his
or her official capacity, or
c. Any employee of the agency in his
or her individual capacity where the
DOJ has agreed to represent the
employee, or
d. The United States Government is a
party to litigation or has an interest in
such litigation, and by careful review,
CMS determines that the records are
both relevant and necessary to the
litigation and that the use of such
records by the DOJ, court or
adjudicatory body is compatible with
the purpose for which the agency
collected the records.
Whenever CMS is involved in
litigation, and occasionally when
another party is involved in litigation
and CMS’ policies or operations could
be affected by the outcome of the
litigation, CMS would be able to
disclose information to the DOJ, court or
adjudicatory body involved.
5. To a CMS contractor (including, but
not necessarily limited to fiscal
intermediaries and carriers) that assists
in the administration of a CMSadministered health benefits program,
or to a grantee of a CMS-administered
grant program, when disclosure is
deemed reasonably necessary by CMS to
prevent, deter, discover, detect,
investigate, examine, prosecute, sue
with respect to, defend against, correct,
remedy, or otherwise combat fraud or
abuse in such program.
We contemplate disclosing
information under this routine use only
in situations in which CMS may enter
into a contractual relationship or grant
with a third party to assist in
accomplishing CMS functions relating
to the purpose of combating fraud and
abuse.
VerDate jul<14>2003
16:35 Jul 05, 2005
Jkt 205001
CMS occasionally contracts out
certain of its functions and makes grants
when doing so would contribute to
effective and efficient operations. CMS
must be able to give a contractor or
grantee whatever information is
necessary for the contractor or grantee to
fulfill its duties. In these situations,
safeguards are provided in the contract
prohibiting the contractor or grantee
from using or disclosing the information
for any purpose other than that
described in the contract and requiring
the contractor or grantee to return or
destroy all information.
6. To another Federal agency or to an
instrumentality of any governmental
jurisdiction within or under the control
of the United States (including any State
or local governmental agency), that
administers, or that has the authority to
investigate potential fraud or abuse in,
a health benefits program funded in
whole or in part by Federal funds, when
disclosure is deemed reasonably
necessary by CMS to prevent, deter,
discover, detect, investigate, examine,
prosecute, sue with respect to, defend
against, correct, remedy, or otherwise
combat fraud or abuse in such programs.
Other agencies may require HITS
information for the purpose of
combating fraud and abuse in such
Federally funded programs.
B. Additional Provisions Affecting
Routine Use Disclosures. This system
contains Protected Health Information
(PHI) as defined by HHS regulation
‘‘Standards for Privacy of Individually
Identifiable Health Information’’ (45
CFR Parts 160 and 164, 65 FR 82462
(12–28–00), Subparts A and E.
Disclosures of PHI authorized by these
routine uses may only be made if, and
as, permitted or required by the
‘‘Standards for Privacy of Individually
Identifiable Health Information.’’
In addition, our policy will be to
prohibit release even of not directly
identifiable information, except
pursuant to one of the routine uses or
if required by law, if we determine there
is a possibility that an individual can be
identified through implicit deduction
based on small cell sizes (instances
where the patient population is so small
that individuals who are familiar with
the enrollees could, because of the small
size, use this information to deduce the
identity of the beneficiary).
IV. Safeguards
CMS has safeguards in place for
authorized users and monitors such
users to ensure against excessive or
unauthorized use. Personnel having
access to the system have been trained
in the Privacy Act and information
security requirements. Employees who
PO 00000
Frm 00085
Fmt 4703
Sfmt 4703
maintain records in this system are
instructed not to release data until the
intended recipient agrees to implement
appropriate management, operational
and technical safeguards sufficient to
protect the confidentiality, integrity and
availability of the information and
information systems and to prevent
unauthorized access.
This system will conform to all
applicable Federal laws and regulations
and Federal, HHS, and CMS policies
and standards as they relate to
information security and data privacy.
These laws and regulations include but
are not limited to: the Privacy Act of
1974; the Federal Information Security
Management Act of 2002; the Computer
Fraud and Abuse Act of 1986; the
Health Insurance Portability and
Accountability Act of 1996; the EGovernment Act of 2002, the ClingerCohen Act of 1996; the Medicare
Modernization Act of 2003, and the
corresponding implementing
regulations. OMB Circular A–130,
Management of Federal Resources,
Appendix III, Security of Federal
Automated Information Resources also
applies. Federal, HHS, and CMS
policies and standards include but are
not limited to: All pertinent NIST
publications; the DHHS Information
Security Program Handbook and the
CMS Information Security Handbook.
V. Effects of the Proposed System of
Records on Individual Rights
CMS proposes to establish this system
in accordance with the principles and
requirements of the Privacy Act and will
collect, use, and disseminate
information only as prescribed therein.
Data in this system will be subject to the
authorized releases in accordance with
the routine uses identified in this
system of records.
CMS will take precautionary
measures (see item IV above) to
minimize the risks of unauthorized
access to the records and the potential
harm to individual privacy or other
personal or property rights of patients
whose data are maintained in the
system. CMS will collect only that
information necessary to perform the
system’s functions. In addition, CMS
will make disclosure from the proposed
system only with consent of the subject
individual, or his/her legal
representative, or in accordance with an
applicable exception provision of the
Privacy Act. CMS, therefore, does not
anticipate an unfavorable effect on
E:\FR\FM\06JYN1.SGM
06JYN1
Federal Register / Vol. 70, No. 128 / Wednesday, July 6, 2005 / Notices
individual privacy as a result of
information relating to individuals.
John R. Dyer,
Chief Operating Officer.
SYSTEM NO. 09–70–0544
SYSTEM NAME:
‘‘Health Insurance Portability and
Accountability Act (HIPAA) Information
Tracking System (HITS), HHS/CMS/
OESS’’.
SECURITY CLASSIFFICATION:
Level Three Privacy Act Sensitive
Data.
SYSTEM LOCATION:
Atlantic Telephone & Telegraph
Company, Ashburn, Virginia facility
under the control of the Center for
Medicare & Medicaid Services.
CATEGORIES OF INDIVIDUALS COVERED BY THE
SYSTEM:
Individuals who have filed
complaints alleging violations of the
Transactions and Code Sets, Security,
and Unique Identifier provisions under
the Health Insurance Portability and
Accountability Act of 1996, Public Law
104–191, 68 FR 60694 (October 23,
2003). These regulations are codified at
45 CFR, parts 160, 162 and 164.
CATEGORIES OF RECORDS IN THE SYSTEM:
HITS will maintain a file of complaint
allegations, information gathered during
the complaint investigation, findings,
and results of the investigation, and
correspondence relating to the
investigation. The collected information
will contain name, address, telephone
number, health insurance claim (HIC)
number, geographic location, as well as,
background information relating to
Medicare or Medicaid issues.
AUTHORITY FOR MAINTENANCE OF THE SYSTEM:
Authority for maintenance of this
system is given under provisions of the
Health Insurance Portability and
Accountability Act of 1996, (Pub. L.
104–191), published at 68 FR 60694
(October 23, 2003). These regulations
are codified at 45 Code of Federal
Regulation, parts 160, 162, and 164.
PURPOSE(S) OF THE SYSTEM:
The purpose of this system is to store
the results of all OESS regional
investigations, to determine if there
were violations as charged in the
original complaint, to investigate
complaints that appear to be in violation
of the Transactions and Code Sets,
Security, and Unique Identifier
provisions of HIPAA, to refer violations
to law enforcement activities as
necessary, and to maintain and retrieve
VerDate jul<14>2003
16:35 Jul 05, 2005
Jkt 205001
records of the results of the complaint
investigations. Information retrieved
from this SOR will also be disclosed to:
(1) Support regulatory, reimbursement,
and policy functions performed within
the agency, HIPAA entities, or by a
contractor or consultant; (2) assist
another Federal or state agency in the
enforcement of HIPAA regulations
where sharing the information is
necessary to complete the processing of
a complaint, contribute to the accuracy
of CMS’s proper payment of Medicare
benefits, and/or enable such agency to
administer a Federal health benefits
program; (3) support constituent
requests made to a congressional
representative; (4) support litigation
involving the agency; and (5) combat
fraud and abuse in certain health
benefits programs.
ROUTINE USES OF RECORDS MAINTAINED IN THE
SYSTEM, INCLUDING CATEGORIES OR USERS AND
THE PURPOSES OF SUCH USES:
The Privacy Act allows us to disclose
information without an individual’s
consent if the information is to be used
for a purpose that is compatible with the
purpose(s) for which the information
was collected. Any such compatible use
of data is known as a ‘‘routine use.’’ We
are proposing to establish the following
routine use disclosures of information
maintained in the system. Information
will be disclosed:
1. To agency contractors or
consultants who have been engaged by
the agency to assist in the performance
of a service related to this system of
records and who need to have access to
the records in order to perform the
activity.
2. To another Federal or state agency
to:
a. Assist in the enforcement of HIPAA
regulations for violations of
Transactions and Code Sets, Security,
and Unique Identifiers where sharing
the information is necessary to complete
the processing of a complaint,
b. Contribute to the accuracy of CMS’s
proper payment of Medicare benefits,
and/or
c. Enable such agency to administer a
Federal health benefits program, or as
necessary to enable such agency to
fulfill a requirement of a Federal statute
or regulation that implements a health
benefits program funded in whole or in
part with Federal funds.
3. To a member of congress or to a
congressional staff member in response
to an inquiry of the congressional office
made at the written request of the
constituent about whom the record is
maintained.
4. To the Department of Justice (DOJ),
court or adjudicatory body when:
PO 00000
Frm 00086
Fmt 4703
Sfmt 4703
38947
a. The agency or any component
thereof, or
b.Any employee of the agency in hisor
h4r official capacity, or
c. Any employee of the agency in his
or her individual capacity where the
DOJ has agreed to The United States
Government is a party to litigation or
has an interest in such litigation, and by
careful review, CMS determines that the
records are both relevant and necessary
to the litigation and that the use of such
records by the DOJ, court or
adjudicatory body is compatible with
the purpose for which the agency
collected the records.
5. To a CMS contractor (including, but
not necessarily limited to fiscal
intermediaries and carriers) that assists
in the administration of a CMSadministered health benefits program,
or to a grantee of a CMS-administered
grant program, when disclosure is
deemed reasonably necessary by CMS to
prevent, deter, discover, detect,
investigate, examine, prosecute, sue
with respect to, defend against, correct,
remedy, or otherwise combat fraud or
abuse in such program.
6. To another Federal agency or to an
instrumentality of any governmental
jurisdiction within or under the control
of the United States (including any State
or local governmental agency), that
administers, or that has the authority to
investigate potential fraud or abuse in,
a health benefits program funded in
whole or in part by Federal funds, when
disclosure is deemed reasonably
necessary by CMS to prevent, deter,
discover, detect, investigate, examine,
prosecute, sue with respect to, defend
against, correct, remedy, or otherwise
combat fraud or abuse in such programs.
B. Additional Provisions Affecting
Routine Use Disclosures This system
contains Protected Health Information
as defines by HHS regulation
‘‘Standards for Privacy of Individually
Identifiable Health Information’’ (45
CFR Parts 160 and 164, 65 FR 82462
(12–28–00), Subparts A and E).
Disclosures of Protected Health
Information authorized by these routine
uses may only be made if, and as,
permitted or required by the ‘‘Standards
for Privacy of Individually Identifiable
Health Information.’’
In addition, our policy will be to
prohibit release even of not directly
identifiable information, except
pursuant to one of the routine uses or
if required by law, if we determine there
is a possibility that an individual can be
identified through implicit deduction
based on small cell sizes (instances
where the complaint population is so
small that individuals who are familiar
with the complainants could, because of
E:\FR\FM\06JYN1.SGM
06JYN1
38948
Federal Register / Vol. 70, No. 128 / Wednesday, July 6, 2005 / Notices
the small size, use this information to
deduce the identity of the complainant).
POLICIES AND PRACTICES FOR STORING,
RETRIEVING, ACCESSING, RETAINING, AND
DISPOSING OF RECORDS IN THE SYSTEM:
STORAGE:
All records are stored electronically.
RETRIEVABILITY:
The complaint data are retrieved by
an individual identifier i.e., name of
complainant.
SAFEGUARDS:
CMS has safeguards in place for
authorized users and monitors such
users to ensure against excessive or
unauthorized use. Personnel having
access to the system have been trained
in the Privacy Act and information
security requirements. Employees who
maintain records in this system are
instructed not to release data until the
intended recipient agrees to implements
appropriate management, operational
and technical safeguards sufficient to
protect the confidentiality, integrity and
availability of the information and
information systems and to prevent
unauthorized access.
This system will conform to all
applicable Federal laws and regulations
and Federal, HHS, and CMS policies
and standards as they relate to
information security and data privacy.
These laws and regulations include but
are not limited to: The Privacy Act of
1974; the Federal Information Security
Management Act of 2002; the Computer
Fraud and Abuse Act of 1986; the
Health Insurance Portability and
Accountability Act of 1996; the EGovernment Act of 2002; the ClingerCohen Act of 1996; the Medicare
Modernization Act of 2003, and the
corresponding implementing
regulations. OMB Circular A–130,
Management of Federal Resources,
Appendix III, Security of Federal
Automated Information Resources also
applies. Federal, HHS, and CMS
policies and standards include but are
not limited to: All pertinent NIST
publications; the DHHS Information
Security Program Handbook and the
CMS Information Security Handbook.
RETENTION AND DISPOSAL:
CMS will retain complaint
information for a total period not to
exceed 25 years.
Director, Office of E-Health Standards
and Services, CMS, Room S2–26–17,
7500 Security Boulevard, Baltimore,
Maryland 21244–1850.
17:28 Jul 05, 2005
Jkt 205001
Exempt. However, portions of this
system notice are non-exempt and
consideration will be given to requests
addressed to the system manager for
those portions. For general inquiries, it
would be helpful if the request included
the system name, address, age, sex, and
for verification purposes, the subject
individual’s name (woman’s maiden
name, if applicable) and complaint
tracking ID number.
RECORD ACCESS PROCEDURE:
Same as notification procedures.
Requestors should also specify the
record contents being sought.
CONTESTING RECORDS PROCEDURES:
The subject individual should contact
the system manager named above and
reasonably identify the records and
specify the information to be contested.
State the corrective action sought and
the reasons for the correction with
supporting justification. (These
Procedures are in accordance with
Department regulation 45 CFR 5b.7).
RECORDS SOURCE CATEGORIES:
OESS investigative files maintained in
HITS are either received as electronic
documents or paper records that are
compiled for law enforcement purposes.
In the course of investigations, OESS
often has a need to obtain confidential
information involving individuals other
than the complainant.
SYSTEMS EXEMPTED FROM CERTAIN PROVISIONS
OF THE ACT:
HHS claims exemption of certain
records (case files on active fraud
investigations) in the system from
notification and access procedures
under 5 U.S.C. 552a(k)(2) inasmuch as
these records are investigatory materials
compiled for program (law) enforcement
in anticipation of a criminal or
administrative proceedings. (See
Department Regulation (45 CFR 5b.11)).
[FR Doc. 05–13188 Filed 7–5–05; 8:45 am]
BILLING CODE 4120–03–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Administration for Children and
Families
Administration on Children, Youth and
Families, Children’s Bureau
SYSTEM MANAGER AND ADDRESS:
VerDate jul<14>2003
NOTIFICATION PROCEDURE:
Funding Opportunity Title:
Developing Adoption Services and
Supports for Youth Who Wish to Retain
Contact with Family Members in Order
to Improve Permanency Outcomes.
Announcement Type: Initial.
PO 00000
Frm 00087
Fmt 4703
Sfmt 4703
Funding Opportunity Number: HHS–
2005–ACF–ACYF–CO–0051.
CFDA Number: 93.652.
Due Date for Applications:
Application is due August 10, 2005.
Category of Funding Activity: Social
Services and Income Security.
Executive Summary
The purposes of funding these
demonstration projects are to: (1)
Demonstrate the effective
implementation of strategies for
introducing the concept of open
adoption to youth and/or sibling groups
who prefer to maintain contact with
birth families and/or siblings; (2)
demonstrate effective implementation
strategies for connecting youth to adults
to promote a range of permanency
options, particularly adoption and open
adoption, and including guardianship
and kinship care; (3) demonstrate the
effective models of youth leadership
and collaboration between youth,
siblings and other family members,
caseworkers and possible adoptive
families in planning for youth
permanency; (4) evaluate the processes
and outcomes of these strategies and
models; and (5) disseminate information
about these strategies and models so
that other States/locales seeking to
implement effective open adoption
programs for youth and sibling groups
have a demonstrated resource for
guidance, insight, and possible
replication.
Priority Area 1
I. Funding Opportunity Description
The purposes of funding these
demonstration projects are to: (1)
Demonstrate the effective
implementation of strategies for
introducing the concept of open
adoption to youth and/or sibling groups
who prefer to maintain contact with
birth families and/or siblings; (2)
demonstrate effective implementation
strategies for connecting youth to adults
to promote a range of permanency
options, particularly adoption and open
adoption, and including guardianship
and kinship care; (3) demonstrate the
effective models of youth leadership
and collaboration between youth,
siblings and other family members,
caseworkers and possible adoptive
families in planning for youth
permanency; (4) evaluate the processes
and outcomes of these strategies and
models; and (5) disseminate information
about these strategies and models so
that other States/locales seeking to
implement effective open adoption
programs for youth and sibling groups
have a demonstrated resource for
E:\FR\FM\06JYN1.SGM
06JYN1
Agencies
[Federal Register Volume 70, Number 128 (Wednesday, July 6, 2005)]
[Notices]
[Pages 38944-38948]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 05-13188]
-----------------------------------------------------------------------
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
Privacy Act of 1974; Report of a New System of Records
AGENCY: Department of Health and Human Services (HHS), Centers for
Medicare & Medicaid Services (CMS).
ACTION: Notice of a new System of Records (SOR).
-----------------------------------------------------------------------
SUMMARY: In accordance with the requirements of the Privacy Act of
1974, we are proposing to establish a new system of records titled,
``Health Insurance Portability and Accountability Act (HIPAA)
Information Tracking System (HITS), System No. 09-70-0544.'' The Office
of E-Health Standards and Services (OESS) has been delegated the
responsibility to regulate and enforce compliance for violations of
Transactions and Code Sets, Security, and Unique Identifier provisions
of HIPAA. Enforcement of these provisions is a complaint driven
process; seeking voluntary compliance from all HIPAA covered entities.
OESS has procured the services of a contractor to provide a database
for complaint intake and management, to manage and maintain the overall
electronic complaint process. Due to investigatory activities, CMS is
exempting this system from the notification, access, correction and
amendment provisions of the Privacy Act of 1974.
The purpose of this system is to store the results of all OESS
regional investigations, to determine if there were violations as
charged in the original complaint, to investigate complaints that
appear to be in violation of the Transactions and Code Sets, Security,
and Unique Identifier provisions of HIPAA, to refer violations to law
enforcement activities as necessary, and to maintain and retrieve
records of the results of the complaint investigations. Information
retrieved from this SOR will also be disclosed to: (1) Support
regulatory, reimbursement, and policy functions performed within the
agency, HIPAA entities, or by a contractor or consultant; (2) assist
another Federal or state agency in the enforcement of HIPAA regulations
where sharing the information is necessary to complete the processing
of a complaint, contribute to the accuracy of CMS's proper payment of
Medicare benefits, and/or enable such agency to administer a Federal
health benefits program; (3) support constituent requests made to a
congressional representative; (4) support litigation involving the
agency; and (5) combat fraud and abuse in certain health benefits
programs. We have provided background information about the modified
system in the ``Supplementary Information'' section below. Although the
Privacy Act requires only that CMS provide an opportunity for
interested persons to comment on the proposed routine uses, CMS invites
comments on all portions of this notice. See ``Effective Dates''
section for comment period.
DATES: Effective Date: CMS filed a new SOR report with the Chair of the
house Committee on Government Reform and Oversight, the Chair of the
Senate Committee on Governmental Affairs, and the Administrator, Office
of Information and Regulatory Affairs, Office of Management and Budget
(OMB) on June 28, 2005. We will not disclose any information under a
routine use until 30 days after publication. We may defer
implementation of this SOR or one or more of the routine use statements
listed below if we receive comments that persuade us to defer
implementation.
ADDRESSES: The public should address comment to the CMS Privacy
Officer, Mail-stop N2-04-27, 7500 Security Boulevard, Baltimore,
Maryland 21244-1850. Comments received will be available for review at
this location, by appointment, during regular business hours, Monday
through Friday from 9 a.m.-3 p.m., eastern daylight time.
FOR FURTHER INFORMATION CONTACT: Michael Phillips, Health Insurance
Specialist, OESS, CMS, 7500 Security Boulevard, Mail Stop S2-24-15,
Baltimore, Maryland 21244-1849, Telephone Number (410) 786-6713,
mphillips@cms.hhs.gov.
SUPPLEMENTARY INFORMATION: HITS is used by OESS staff and consists of
an electronic repository of information and documents and supplementary
paper document files. The HITS system allows OESS to integrate all of
OESS' various business process including all of its investigation
activities to allow real time access and results reporting and other
varied information management needs. HITS provides (1) a single,
central, electronic repository of all OHS complaint documents and
information including investigative files, correspondence, and
administrative records; (2) easy, robust capability to search all of
the information in OESS' repository; (3) better quality control at the
front end with simplified data entry and stronger data validation; (4)
tools to help staff work on and manage their casework; and (5) includes
supplementary paper files. The system
[[Page 38945]]
has the capacity to generate reports concerning the status of current
and closed complaints, reviews and correspondence.
OESS investigative files maintained in HITS are either received as
electronic documents or paper records that are compiled for law
enforcement purposes. In the course of investigations, OESS often has a
need to obtain confidential information involving individuals other
than the complainant. In these cases, it is necessary for OHS to: (1)
Preserve the confidentiality of this information, (2) avoid unwarranted
invasions of personal privacy, and (3) assure recipients of Federal
financial assistance that such information provided to OESS will be
kept confidential. This assurance facilitates prompt and effective
completion of the investigations.
Unrestricted disclosure of confidential information in OESS files
can impede ongoing investigations, invade personal privacy of
individuals and organizations, reveal the identities of confidential
sources, or otherwise impair the ability of OESS to conduct
investigations. For these reasons, the CMS is exempting all
investigative files from the notification, access, correction and
amendment provisions under subsection (k)(2) of the Privacy Act.
I. Description of the Proposed System of Records
A. Statutory and Regulatory Basis for SOR
Authority for maintenance of this system is given under provisions
of the Health Insurance Portability and Accountability Act of 1996,
Public Law (Pub. L. 104-191), published at 68 FR 60694 (October 23,
2003). These regulations are codified at 45 Code of Federal Regulation,
parts 160, 162, and 164.
B. Collection and Maintenance of Data in the System
HITS will maintain a file of complaint allegations, information
gathered during the complaint investigation, findings, and results of
the investigation, and correspondence relating to the investigation.
The collected information will contain name, address, telephone number,
health insurance claim (HIC) number, geographic location, as well as,
background information relating to Medicare or Medicaid issues of the
complainant.
II. Agency Policies, Procedures, and Restrictions on the Routine Use
A. Agency Policies, Procedures, and Restrictions on the Routine Use
The Privacy Act permits us to disclose information without an
individual's consent if the information is to be used for a purpose
that is compatible with the purpose(s) for which the information was
collected. Any such disclosure of data is known as a ``routine use.''
The government will only release HITS information that can be
associated with an individual as provided for under ``Section III.
Proposed Routine Use Disclosures of Data in the System.'' Both
identifiable and non-identifiable data may be disclosed under a routine
use.
We will only collect the minimum personal data necessary to achieve
the purpose of HITS. CMS has the following policies and procedures
concerning disclosures of information that will be maintained in the
system. Disclosure of information from the SOR will be approved only to
the extent necessary to accomplish the purpose of the disclosure and
only after CMS:
1. Determines that the use or disclosure is consistent with the
reason that the data is being collected, e.g., to store the results of
all OESS regional investigations, to determine if there were violations
as charged in the original complaint, to investigate complaints that
appear to be in violation of the HIPAA, to refer violations to law
enforcement activities as necessary, and to maintain and retrieve
records of the results of the complaint investigations.
2. Determines that:
a. The purpose for which the disclosure is to be made can only be
accomplished if the record is provided in individually identifiable
form;
b. The purpose for which the disclosure is to be made is of
sufficient importance to warrant the effect and/or risk on the privacy
of the individual that additional exposure of the record might bring;
and
c. There is a strong probability that the proposed use of the data
would in fact accomplish the stated purpose(s).
3. Requires the information recipient to:
a. Establish administrative, technical, and physical safeguards to
prevent unauthorized use of disclosure of the record;
b. Remove or destroy at the earliest time all patient-identifiable
information; and
c. Agree to not use or disclose the information for any purpose
other than the stated purpose under which the information was
disclosed.
4. Determines that the data are valid and reliable.
III. Proposed Routine Use Disclosures of Data in the System
A. The Privacy Act allows us to disclose information without an
individual's consent if the information is to be used for a purpose
that is compatible with the purpose(s) for which the information was
collected. Any such compatible use of data is known as a ``routine
use.'' The proposed routine uses in this system meet the compatibility
requirement of the Privacy Act. We are proposing to establish the
following routine use disclosures of information maintained in the
system:
1. To agency contractors or consultant who have been engaged by the
agency to assist in the performance of a service related to this system
of records and who need to have access to the records in order to
perform the activity.
We contemplate disclosing information under this routine use only
in situations in which CMS may enter into a contractual or similar
agreement with a third party to assist in accomplishing CMS function
relating to purposes for this system or records.
CMS occasionally contracts out certain of its functions when doing
so would contribute to effective and efficient operations. CMS must be
able to give a contractor or consultant whatever information is
necessary for the contractor or consultant to fulfill its duties. In
these situations, safeguards are provided in the contract prohibiting
the contractor or consultant from using or disclosing the information
for any purpose other than that described in the contract and requires
the contractor or consultant to return or destroy all information at
the completion of the contract.
2. To another Federal or state agency to:
a. Assist in the enforcement of HIPAA regulations for violations of
Transactions and Code Sets, Security, and Unique Identifiers where
sharing the information is necessary to complete the processing of a
complaint,
b. Contribute to the accuracy of CMS's proper payment of Medicare
benefits, and/or
c. Enable such agency to administer a Federal health benefits
program, or as necessary to enable such agency to fulfill a requirement
of a Federal statute or regulation that implements a health benefits
program funded in whole or in part with Federal funds.
Other Federal or state agencies in their administration of a
Federal health program may require HITS information in order to
investigate complaint
[[Page 38946]]
allegations, evaluate information gathered during the complaint
investigation, review findings and results of the investigation
relating to the enforcement of HIPAA regulations for violations of
Transactions and Code Sets, Security, and Unique Identifiers.
3. To a member of Congress or to a congressional staff member in
response to an inquiry of the congressional office made at the written
request of the constituent about whom the record is maintained.
Beneficiaries sometimes request the help of a member of Congress in
resolving an issue relating to a matter before CMS. The member of
Congress then writes CMS, and CMS must be able to give sufficient
information to be responsive to the inquiry.
4. To the Department of Justice (DOJ), court or adjudicatory body
when:
a. The agency or any component thereof, or
b. Any employee of the agency in his or her official capacity, or
c. Any employee of the agency in his or her individual capacity
where the DOJ has agreed to represent the employee, or
d. The United States Government is a party to litigation or has an
interest in such litigation, and by careful review, CMS determines that
the records are both relevant and necessary to the litigation and that
the use of such records by the DOJ, court or adjudicatory body is
compatible with the purpose for which the agency collected the records.
Whenever CMS is involved in litigation, and occasionally when
another party is involved in litigation and CMS' policies or operations
could be affected by the outcome of the litigation, CMS would be able
to disclose information to the DOJ, court or adjudicatory body
involved.
5. To a CMS contractor (including, but not necessarily limited to
fiscal intermediaries and carriers) that assists in the administration
of a CMS-administered health benefits program, or to a grantee of a
CMS-administered grant program, when disclosure is deemed reasonably
necessary by CMS to prevent, deter, discover, detect, investigate,
examine, prosecute, sue with respect to, defend against, correct,
remedy, or otherwise combat fraud or abuse in such program.
We contemplate disclosing information under this routine use only
in situations in which CMS may enter into a contractual relationship or
grant with a third party to assist in accomplishing CMS functions
relating to the purpose of combating fraud and abuse.
CMS occasionally contracts out certain of its functions and makes
grants when doing so would contribute to effective and efficient
operations. CMS must be able to give a contractor or grantee whatever
information is necessary for the contractor or grantee to fulfill its
duties. In these situations, safeguards are provided in the contract
prohibiting the contractor or grantee from using or disclosing the
information for any purpose other than that described in the contract
and requiring the contractor or grantee to return or destroy all
information.
6. To another Federal agency or to an instrumentality of any
governmental jurisdiction within or under the control of the United
States (including any State or local governmental agency), that
administers, or that has the authority to investigate potential fraud
or abuse in, a health benefits program funded in whole or in part by
Federal funds, when disclosure is deemed reasonably necessary by CMS to
prevent, deter, discover, detect, investigate, examine, prosecute, sue
with respect to, defend against, correct, remedy, or otherwise combat
fraud or abuse in such programs.
Other agencies may require HITS information for the purpose of
combating fraud and abuse in such Federally funded programs.
B. Additional Provisions Affecting Routine Use Disclosures. This
system contains Protected Health Information (PHI) as defined by HHS
regulation ``Standards for Privacy of Individually Identifiable Health
Information'' (45 CFR Parts 160 and 164, 65 FR 82462 (12-28-00),
Subparts A and E. Disclosures of PHI authorized by these routine uses
may only be made if, and as, permitted or required by the ``Standards
for Privacy of Individually Identifiable Health Information.''
In addition, our policy will be to prohibit release even of not
directly identifiable information, except pursuant to one of the
routine uses or if required by law, if we determine there is a
possibility that an individual can be identified through implicit
deduction based on small cell sizes (instances where the patient
population is so small that individuals who are familiar with the
enrollees could, because of the small size, use this information to
deduce the identity of the beneficiary).
IV. Safeguards
CMS has safeguards in place for authorized users and monitors such
users to ensure against excessive or unauthorized use. Personnel having
access to the system have been trained in the Privacy Act and
information security requirements. Employees who maintain records in
this system are instructed not to release data until the intended
recipient agrees to implement appropriate management, operational and
technical safeguards sufficient to protect the confidentiality,
integrity and availability of the information and information systems
and to prevent unauthorized access.
This system will conform to all applicable Federal laws and
regulations and Federal, HHS, and CMS policies and standards as they
relate to information security and data privacy. These laws and
regulations include but are not limited to: the Privacy Act of 1974;
the Federal Information Security Management Act of 2002; the Computer
Fraud and Abuse Act of 1986; the Health Insurance Portability and
Accountability Act of 1996; the E-Government Act of 2002, the Clinger-
Cohen Act of 1996; the Medicare Modernization Act of 2003, and the
corresponding implementing regulations. OMB Circular A-130, Management
of Federal Resources, Appendix III, Security of Federal Automated
Information Resources also applies. Federal, HHS, and CMS policies and
standards include but are not limited to: All pertinent NIST
publications; the DHHS Information Security Program Handbook and the
CMS Information Security Handbook.
V. Effects of the Proposed System of Records on Individual Rights
CMS proposes to establish this system in accordance with the
principles and requirements of the Privacy Act and will collect, use,
and disseminate information only as prescribed therein. Data in this
system will be subject to the authorized releases in accordance with
the routine uses identified in this system of records.
CMS will take precautionary measures (see item IV above) to
minimize the risks of unauthorized access to the records and the
potential harm to individual privacy or other personal or property
rights of patients whose data are maintained in the system. CMS will
collect only that information necessary to perform the system's
functions. In addition, CMS will make disclosure from the proposed
system only with consent of the subject individual, or his/her legal
representative, or in accordance with an applicable exception provision
of the Privacy Act. CMS, therefore, does not anticipate an unfavorable
effect on
[[Page 38947]]
individual privacy as a result of information relating to individuals.
John R. Dyer,
Chief Operating Officer.
SYSTEM NO. 09-70-0544
SYSTEM NAME:
``Health Insurance Portability and Accountability Act (HIPAA)
Information Tracking System (HITS), HHS/CMS/OESS''.
Security Classiffication:
Level Three Privacy Act Sensitive Data.
SYSTEM LOCATION:
Atlantic Telephone & Telegraph Company, Ashburn, Virginia facility
under the control of the Center for Medicare & Medicaid Services.
CATEGORIES OF INDIVIDUALS COVERED BY THE SYSTEM:
Individuals who have filed complaints alleging violations of the
Transactions and Code Sets, Security, and Unique Identifier provisions
under the Health Insurance Portability and Accountability Act of 1996,
Public Law 104-191, 68 FR 60694 (October 23, 2003). These regulations
are codified at 45 CFR, parts 160, 162 and 164.
CATEGORIES OF RECORDS IN THE SYSTEM:
HITS will maintain a file of complaint allegations, information
gathered during the complaint investigation, findings, and results of
the investigation, and correspondence relating to the investigation.
The collected information will contain name, address, telephone number,
health insurance claim (HIC) number, geographic location, as well as,
background information relating to Medicare or Medicaid issues.
AUTHORITY FOR MAINTENANCE OF THE SYSTEM:
Authority for maintenance of this system is given under provisions
of the Health Insurance Portability and Accountability Act of 1996,
(Pub. L. 104-191), published at 68 FR 60694 (October 23, 2003). These
regulations are codified at 45 Code of Federal Regulation, parts 160,
162, and 164.
PURPOSE(S) OF THE SYSTEM:
The purpose of this system is to store the results of all OESS
regional investigations, to determine if there were violations as
charged in the original complaint, to investigate complaints that
appear to be in violation of the Transactions and Code Sets, Security,
and Unique Identifier provisions of HIPAA, to refer violations to law
enforcement activities as necessary, and to maintain and retrieve
records of the results of the complaint investigations. Information
retrieved from this SOR will also be disclosed to: (1) Support
regulatory, reimbursement, and policy functions performed within the
agency, HIPAA entities, or by a contractor or consultant; (2) assist
another Federal or state agency in the enforcement of HIPAA regulations
where sharing the information is necessary to complete the processing
of a complaint, contribute to the accuracy of CMS's proper payment of
Medicare benefits, and/or enable such agency to administer a Federal
health benefits program; (3) support constituent requests made to a
congressional representative; (4) support litigation involving the
agency; and (5) combat fraud and abuse in certain health benefits
programs.
ROUTINE USES OF RECORDS MAINTAINED IN THE SYSTEM, INCLUDING CATEGORIES
OR USERS AND THE PURPOSES OF SUCH USES:
The Privacy Act allows us to disclose information without an
individual's consent if the information is to be used for a purpose
that is compatible with the purpose(s) for which the information was
collected. Any such compatible use of data is known as a ``routine
use.'' We are proposing to establish the following routine use
disclosures of information maintained in the system. Information will
be disclosed:
1. To agency contractors or consultants who have been engaged by
the agency to assist in the performance of a service related to this
system of records and who need to have access to the records in order
to perform the activity.
2. To another Federal or state agency to:
a. Assist in the enforcement of HIPAA regulations for violations of
Transactions and Code Sets, Security, and Unique Identifiers where
sharing the information is necessary to complete the processing of a
complaint,
b. Contribute to the accuracy of CMS's proper payment of Medicare
benefits, and/or
c. Enable such agency to administer a Federal health benefits
program, or as necessary to enable such agency to fulfill a requirement
of a Federal statute or regulation that implements a health benefits
program funded in whole or in part with Federal funds.
3. To a member of congress or to a congressional staff member in
response to an inquiry of the congressional office made at the written
request of the constituent about whom the record is maintained.
4. To the Department of Justice (DOJ), court or adjudicatory body
when:
a. The agency or any component thereof, or
b.Any employee of the agency in hisor h4r official capacity, or
c. Any employee of the agency in his or her individual capacity
where the DOJ has agreed to The United States Government is a party to
litigation or has an interest in such litigation, and by careful
review, CMS determines that the records are both relevant and necessary
to the litigation and that the use of such records by the DOJ, court or
adjudicatory body is compatible with the purpose for which the agency
collected the records.
5. To a CMS contractor (including, but not necessarily limited to
fiscal intermediaries and carriers) that assists in the administration
of a CMS-administered health benefits program, or to a grantee of a
CMS-administered grant program, when disclosure is deemed reasonably
necessary by CMS to prevent, deter, discover, detect, investigate,
examine, prosecute, sue with respect to, defend against, correct,
remedy, or otherwise combat fraud or abuse in such program.
6. To another Federal agency or to an instrumentality of any
governmental jurisdiction within or under the control of the United
States (including any State or local governmental agency), that
administers, or that has the authority to investigate potential fraud
or abuse in, a health benefits program funded in whole or in part by
Federal funds, when disclosure is deemed reasonably necessary by CMS to
prevent, deter, discover, detect, investigate, examine, prosecute, sue
with respect to, defend against, correct, remedy, or otherwise combat
fraud or abuse in such programs.
B. Additional Provisions Affecting Routine Use Disclosures This
system contains Protected Health Information as defines by HHS
regulation ``Standards for Privacy of Individually Identifiable Health
Information'' (45 CFR Parts 160 and 164, 65 FR 82462 (12-28-00),
Subparts A and E). Disclosures of Protected Health Information
authorized by these routine uses may only be made if, and as, permitted
or required by the ``Standards for Privacy of Individually Identifiable
Health Information.''
In addition, our policy will be to prohibit release even of not
directly identifiable information, except pursuant to one of the
routine uses or if required by law, if we determine there is a
possibility that an individual can be identified through implicit
deduction based on small cell sizes (instances where the complaint
population is so small that individuals who are familiar with the
complainants could, because of
[[Page 38948]]
the small size, use this information to deduce the identity of the
complainant).
POLICIES AND PRACTICES FOR STORING, RETRIEVING, ACCESSING, RETAINING,
AND DISPOSING OF RECORDS IN THE SYSTEM:
STORAGE:
All records are stored electronically.
RETRIEVABILITY:
The complaint data are retrieved by an individual identifier i.e.,
name of complainant.
SAFEGUARDS:
CMS has safeguards in place for authorized users and monitors such
users to ensure against excessive or unauthorized use. Personnel having
access to the system have been trained in the Privacy Act and
information security requirements. Employees who maintain records in
this system are instructed not to release data until the intended
recipient agrees to implements appropriate management, operational and
technical safeguards sufficient to protect the confidentiality,
integrity and availability of the information and information systems
and to prevent unauthorized access.
This system will conform to all applicable Federal laws and
regulations and Federal, HHS, and CMS policies and standards as they
relate to information security and data privacy. These laws and
regulations include but are not limited to: The Privacy Act of 1974;
the Federal Information Security Management Act of 2002; the Computer
Fraud and Abuse Act of 1986; the Health Insurance Portability and
Accountability Act of 1996; the E-Government Act of 2002; the Clinger-
Cohen Act of 1996; the Medicare Modernization Act of 2003, and the
corresponding implementing regulations. OMB Circular A-130, Management
of Federal Resources, Appendix III, Security of Federal Automated
Information Resources also applies. Federal, HHS, and CMS policies and
standards include but are not limited to: All pertinent NIST
publications; the DHHS Information Security Program Handbook and the
CMS Information Security Handbook.
RETENTION AND DISPOSAL:
CMS will retain complaint information for a total period not to
exceed 25 years.
SYSTEM MANAGER AND ADDRESS:
Director, Office of E-Health Standards and Services, CMS, Room S2-
26-17, 7500 Security Boulevard, Baltimore, Maryland 21244-1850.
NOTIFICATION PROCEDURE:
Exempt. However, portions of this system notice are non-exempt and
consideration will be given to requests addressed to the system manager
for those portions. For general inquiries, it would be helpful if the
request included the system name, address, age, sex, and for
verification purposes, the subject individual's name (woman's maiden
name, if applicable) and complaint tracking ID number.
RECORD ACCESS PROCEDURE:
Same as notification procedures. Requestors should also specify the
record contents being sought.
CONTESTING RECORDS PROCEDURES:
The subject individual should contact the system manager named
above and reasonably identify the records and specify the information
to be contested. State the corrective action sought and the reasons for
the correction with supporting justification. (These Procedures are in
accordance with Department regulation 45 CFR 5b.7).
RECORDS SOURCE CATEGORIES:
OESS investigative files maintained in HITS are either received as
electronic documents or paper records that are compiled for law
enforcement purposes. In the course of investigations, OESS often has a
need to obtain confidential information involving individuals other
than the complainant.
SYSTEMS EXEMPTED FROM CERTAIN PROVISIONS OF THE ACT:
HHS claims exemption of certain records (case files on active fraud
investigations) in the system from notification and access procedures
under 5 U.S.C. 552a(k)(2) inasmuch as these records are investigatory
materials compiled for program (law) enforcement in anticipation of a
criminal or administrative proceedings. (See Department Regulation (45
CFR 5b.11)).
[FR Doc. 05-13188 Filed 7-5-05; 8:45 am]
BILLING CODE 4120-03-P