Privacy Act of 1974; Report of a New System of Records, 28347-28351 [E6-7393]

Agencies

• Centers for Medicare & Medicaid Services
• DEPARTMENT OF HEALTH AND HUMAN SERVICES

[Federal Register Volume 71, Number 94 (Tuesday, May 16, 2006)]
[Notices]
[Pages 28347-28351]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: E6-7393]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services


Privacy Act of 1974; Report of a New System of Records

AGENCY: Centers for Medicare & Medicaid Services (CMS), Department of 
Health and Human Services (HHS).

ACTION: Notice of a New System of Records (SOR).

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SUMMARY: In accordance with the requirements of the Privacy Act of 
1974, we are proposing to establish a new system titled, ``Medicaid 
Program and State Children's Health Insurance Program (SCHIP) Payment 
Error Rate Measurement (PERM), System No. 09-70-0578.'' The Improper 
Payments Information Act (IPIA) of 2002 (Pub. L. 107-300) requires 
heads of Federal agencies to annually estimate and report to the 
Congress national error rates for the programs they oversee. The 
Medicaid and SCHIP programs were identified by the Office of Management 
and Budget (OMB) as programs at risk for significant erroneous 
payments. OMB has directed HHS to report the estimated error rate for 
the Medicaid and SCHIP programs to OMB. Since Medicaid and SCHIP are 
administered by state agencies according to each state's unique program 
characteristics, state assistance in estimating improper payments is 
critical and continues to be necessary and important for the Secretary 
to comply with the requirements of the IPIA. CMS will use a national 
contracting strategy to calculate a state-by-state, comprehensive error 
rate for both the Medicaid and SCHIP programs. Implementing regulations 
set forth state requirements to: (1) Provide claims information to CMS 
for the purposes of estimating improper payment in Medicaid and SCHIP; 
and (2) measure improper payments in the Medicaid and SCHIP based on 
eligibility errors.
    The primary purpose of this system is to collect and maintain 
individually identifiable claims information to calculate payment error 
rates for Medicaid and SCHIP programs. Information in this system will 
also be used to: (1) Support regulatory and policy functions performed 
within the Agency or by a contractor, consultant or grantee; (2) assist 
another Federal or state agency in the proper administration of the 
Medicare program, enable such agency to administer a Federal health 
benefits program, and/or assist Federal/state Medicaid programs within 
the state; (3) support constituent requests made to a Congressional 
representative; (4) to support litigation involving the Agency related 
to this system; and (5) combat fraud and abuse in certain health 
benefits programs. We have provided background information about the 
proposed system in the SUPPLEMENTARY INFORMATION section below. 
Although the Privacy Act requires only that the ``routine use'' portion 
of the system be published for comment, CMS invites comments on all 
portions of this notice. See ``Effective Dates'' section for comment 
period.

EFFECTIVE DATES: 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 Homeland Security & Governmental Affairs, and the 
Administrator, Office of Information and Regulatory Affairs, OMB on May 
9, 2006. To ensure that all parties have adequate time in which to 
comment, the new system will become effective 30

[[Page 28348]]

days from the publication of the notice, or 40 days from the date it 
was submitted to OMB and the Congress, whichever is later. We may defer 
implementation of this system 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 comments to: CMS Privacy Officer, 
Division of Privacy Compliance Data Development, CMS, 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: Catherine Pesto, Division of Analysis 
and Evaluation, Program Integrity Group, Office of Financial 
Management, CMS, Mail Stop C3-02-16, 7500 Security Boulevard, 
Baltimore, Maryland 21244-1850. Her telephone number is 410-786-3492, 
or e-mail at Catherine.Pesto@cms.hhs.gov.

SUPPLEMENTARY INFORMATION: The Improper Payments Information Act of 
2002 (IPIA), Public Law 107-300, enacted on November 26, 2002, requires 
the heads of Federal agencies to review annually programs they oversee 
that are susceptible to significant erroneous payments, to estimate the 
amount of improper payments, to report those estimates to the Congress, 
and to submit a report on actions the agency is taking to reduce 
erroneous expenditures. The IPIA directed OMB to provide subsequent 
guidance. OMB defines significant erroneous payments as annual 
erroneous payments in the program exceeding both 2.5 percent of program 
payments and $10 million (OMB M-03-13, 05/21/03). For those programs 
with significant erroneous payments, Federal agencies must provide the 
estimated amount of improper payments and report on what actions the 
agency is taking to reduce them, including setting targets for future 
erroneous payment levels and a timeline by which the targets will be 
reached.
    In the report to the Congress, Federal agencies must include: (1) 
The estimate of the annual amount of erroneous payments; (2) a 
discussion of the causes of the errors and actions taken to correct 
those causes; (3) a discussion of the amount of actual erroneous 
payments the agency expects to recover; and (4) limitations that 
prevent the agency from reducing the erroneous payment levels, that is, 
resources or legal barriers.
    There currently is no systematic means of measuring payment errors 
at the state and national levels for Medicaid and SCHIP. Through the 
Payment Accuracy Measurement (PAM) and Payment Error Rate Measurement 
(PERM) pilot projects that operated in Fiscal Years (FYs) 2002 through 
2005, we determined that it is feasible to estimate improper payments 
for Medicaid and SCHIP and refined a review methodology. This 
methodology was designed to estimate state-specific payment error rates 
within 3 percent of the true population error rate with 95 
percent confidence. Moreover, through weighted aggregation, the state-
specific estimates can be used to make national level error rate 
estimates for Medicaid and SCHIP that meet OMB's confidence and 
precision requirements.

I. Description of the Proposed System of Records

A. Statutory and Regulatory Basis for the System

    Authority for this system is given under provisions of the Improper 
Payments Information Act of 2002 (Pub. L. 107-300), sections 1102, 
1902(a)(6), 1902(a)(27), and 2107(b)(1) of the Social Security Act.

B. Collection and Maintenance of Data in the System

    Information in this system is collected on eligibility and claims 
information included in the annual random sample to measure Medicaid 
and SCHIP payment error rates. Information collected for this system 
will include, but is not limited to, name, Medicaid and SCHIP 
identification number, Medicaid and SCHIP claims data, provider's 
medical records, claim numbers, managed care capitation payment data, 
and eligibility-related information on the Medicaid and SCHIP 
beneficiaries included in the eligibility sample.

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 PERM 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 PERM. CMS has the following policies and procedures 
concerning disclosures of information that will be maintained in the 
system. Disclosure of information from the system 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 collect and maintain 
individually identifiable claims information to calculate payment error 
rates for Medicaid and SCHIP programs.
    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 to:
    1. Agency contractors, consultants or grantees who have been 
contracted by the Agency to assist in accomplishment of a CMS function 
relating to the purposes for this system and who need

[[Page 28349]]

to have access to the records in order to assist CMS.
    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 functions 
relating to purposes for this system. CMS occasionally contracts out 
certain of its functions when this would contribute to effective and 
efficient operations. CMS must be able to give contractors, consultants 
or grantees whatever information is necessary for the contractors, 
consultants or grantees to fulfill its duties. In these situations, 
safeguards are provided in the contract prohibiting the contractors, 
consultants or grantees from using or disclosing the information for 
any purpose other than that described in the contract and to return or 
destroy all information at the completion of the contract.
    2. Another Federal or state agency to:
    a. Contribute to the accuracy of CMS's proper administration of the 
Medicare program,
    b. 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, and/or
    c. Assist Federal/state Medicaid and/or SCHIP programs within the 
state.
    Other Federal or state agencies in their administration of a 
Federal or state health program may require PERM information in order 
to collect information on Medicaid and SCHIP beneficiaries to ensure 
that claims are processed in an orderly and consistent manner.
    3. 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.
    Individuals sometimes request the help of a Member of Congress in 
resolving some 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. 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, or occasionally when 
another party is involved in litigation and CMS's 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. A determination would be made in each instance that, 
under the circumstances involved, the purposes served by the use of the 
information in the particular litigation is compatible with a purpose 
for which CMS collects the information.
    5. A CMS contractor (including, but not necessarily limited to 
Federal contractors engaged by CMS to develop and calculate Medicaid 
and SCHIP payment and eligibility error rates) that assists in the 
administration of a CMS-administered program to measure payment error 
rates in the Medicaid and SCHIP programs, 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 at the direction of CMS.
    6. 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 PERM information for the purpose of 
combating fraud and abuse in such Federally-funded programs.

B. Additional Provisions Affecting Routine Use Disclosures

    To the extent 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, subparts A and E) 65 FR 82462 (12-28-00). Disclosures of such PHI 
that are otherwise 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.'' (See 45 CFR 
164.512(a)(1)).
    In addition, our policy will be to prohibit release even of data 
not directly identifiable, 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 may apply but are not limited to: The Privacy Act of 1974; 
the Federal Information

[[Page 28350]]

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 National Institute of Standards and 
Technology publications; the HHS Information Systems 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 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 individual privacy as a result 
of the disclosure of information relating to individuals.

    Dated: May 8, 2006.
Charlene Frizzera,
Acting Chief Operating Officer, Centers for Medicare & Medicaid 
Services.
System No.: 09-70-0578.

System Name:
    ``Medicaid Program and State Children's Health Insurance Program 
Payment Error Rate Measurement (PERM)''.

Security Classification:
    Level 3 Privacy Act Sensitive.

System Location:
    Centers for Medicare & Medicaid Services (CMS), 7500 Security 
Boulevard, Baltimore, Maryland 21244-1850; and at various contractor 
location.

Categories of Individuals Covered by the System:
    Information in this system is collected on eligibility and claims 
information included in the annual random sample to measure Medicaid 
and SCHIP payment error rates.

Categories of Records in the System:
    Information collected for this system will include, but is not 
limited to, name, Medicaid and SCHIP identification number, Medicaid 
and SCHIP claims data, provider's medical records, claim numbers, 
managed care capitation payment data, and eligibility-related 
information on the Medicaid and SCHIP beneficiaries included in the 
eligibility sample.

Authority for Maintenance of the System:
    Authority for this system is given under provisions of the Improper 
Payments Information Act of 2002 (Pub. L. 107-300), sections 1102, 
1902(a)(6), 1902(a)(27), and 2107(b)(1) of the Social Security Act.

Purpose(s) of the System:
    The primary purpose of this system is to collect and maintain 
individually identifiable claims information to calculate payment error 
rates for Medicaid and SCHIP programs. Information in this system will 
also be used to: (1) Support regulatory and policy functions performed 
within the Agency or by a contractor, consultant or grantee; (2) assist 
another Federal or state agency in the proper administration of the 
Medicare program, enable such agency to administer a Federal health 
benefits program, and/or assist Federal/state Medicaid programs within 
the state; (3) support constituent requests made to a Congressional 
representative; (4) to support litigation involving the Agency related 
to this system; 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:
    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 to:
    1. Agency contractors, consultants or grantees who have been 
contracted by the Agency to assist in accomplishment of a CMS function 
relating to the purposes for this system and who need to have access to 
the records in order to assist CMS.
    2. Another Federal or state agency to:
    a. Contribute to the accuracy of CMS's proper administration of the 
Medicare program,
    b. 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, and/or
    c. Assist Federal/state Medicaid and/or SCHIP programs within the 
state.
    3. 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. 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.
    5. A CMS contractor (including, but not necessarily limited to 
Federal contractors engaged by CMS to develop and calculate Medicaid 
and SCHIP payment and eligibility error rates) that assists in the 
administration of a CMS-administered program to measure payment error 
rates in the Medicaid and SCHIP programs, 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. 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

[[Page 28351]]

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. To the 
extent 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, subparts A 
and E) 65 FR 82462 (12-28-00). Disclosures of such PHI that are 
otherwise 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.'' (See 45 CFR 164.512(a)(1)).
    In addition, our policy will be to prohibit release even of data 
not directly identifiable, 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).

Policies and Practices for Storing, Retrieving, Accessing, Retaining, 
and Disposing of Records in the System:
Storage:
    All records are stored on electronic and/or hard copy media.

Retrievability:
    Information can be retrieved by provider name, beneficiary name, 
claim number, Medicaid or SCHIP identification number, or other 
identifying variables.

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 may apply 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 National 
Institute of Standards and Technology publications; the HHS Information 
Systems Program Handbook and the CMS Information Security Handbook.

Retention and Disposal:
    CMS will retain information for a total period of 6 years and 3 
months. All claims-related records are encompassed by the document 
preservation order and will be retained until notification is received 
from DOJ.

System Manager and Address:
    Director, Division of Analysis and Evaluation, Program Integrity 
Group, Office of Financial Management, CMS, Mail Stop C3-02-16, 7500 
Security Boulevard, Baltimore, Maryland, 21244-1850.

Notification Procedure:
    For purpose of access, the subject individual should write to the 
system manager who will require the system name, Medicaid 
Identification number, national provider number, and for verification 
purposes, the subject individual's name (woman's maiden name, if 
applicable), and Social Security Number (SSN) (furnishing the SSN is 
voluntary, but it may make searching for a record easier and prevent 
delay).

Record Access Procedure:
    For purpose of access, use the same procedures outlined in 
Notification Procedures above. Requestors should also reasonably 
specify the record contents being sought. (These procedures are in 
accordance with Department regulation 45 CFR 5b.5 (a) (2)).

Contesting Record Procedures:
    The subject individual should contact the system manager named 
above, and reasonably identify the record 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).

Record Source Categories:
    Sources of information contained in this records system include 
data collected from claims submitted by providers participating in the 
Medicaid and SCHIP programs, provider's medical records, and 
information collected on individuals to establish their eligibility for 
these programs.

Systems Exempted from Certain Provisions of the Act:
    None.

 [FR Doc. E6-7393 Filed 5-15-06; 8:45 am]
BILLING CODE 4120-03-P