Privacy Act of 1974; Report of a New System of Records, 57968-57972 [E6-16107]

Agencies

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

[Federal Register Volume 71, Number 190 (Monday, October 2, 2006)]
[Notices]
[Pages 57968-57972]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: E6-16107]


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

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, ``Rural 
Hospice Demonstration (RHD), System No. 09-70-0563.'' The program is 
mandated by Sec.  409 of the Medicare Prescription Drug Improvement and 
Modernization Act of 2003 (MMA) (Public Law (Pub. L.) 108-173), which 
was enacted into law on December 8, 2003, and amended Title XVIII of 
the Social Security Act (the Act). Section 409 authorizes the Secretary 
of HHS (the Secretary) to conduct a demonstration project for the 
delivery of hospice care to Medicare beneficiaries in rural areas. 
Under the demonstration, Medicare beneficiaries who are unable to 
receive hospice care at home for lack of an appropriate caregiver are 
provided such care in a facility of 20 or fewer beds that offers, 
within its walls, the full range of services provided by hospice 
programs.
    In order for a hospice organization or agency to participate in 
this demonstration, it must be Medicare certified and meet all of the 
Medicare Conditions of Participation as described in subparts C 
(General Provisions), D (Core Services), and E (Other Services) of 42 
CFR 418, except it shall not be required to offer services outside the 
facility or meet the 20 percent inpatient cap requirements of section 
1861(dd)(2) (A) (iii) of the Act.
    The purpose of this system is to collect and maintain a person-
level view of identifiable data of Medicare beneficiaries who 
participate in the rural hospice demonstrations. Information retrieved 
from this system may be disclosed to: (1) Support regulatory, 
reimbursement, and policy functions performed within the agency or by a 
contractor, consultant, or grantee; (2) assist another Federal or State 
agency with information to contribute to the accuracy of CMS's proper 
payment of Medicare benefits, enable such agency to administer a 
Federal health benefits program, or to enable such agency to fulfill a 
requirement of Federal statute or regulation that implements a health 
benefits program funded in whole or in part with Federal funds; (3) 
support an individual or organization for a research project or in 
support of an evaluation project related to the prevention of disease 
or disability, the restoration or maintenance of health, or payment 
related projects; (4) support litigation involving the agency; and (5) 
combat fraud, waste, and abuse in certain Federally-funded health 
benefits programs. We have provided background information about this 
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 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, Office of 
Management and Budget (OMB) on September 26, 2006 . To ensure that all 
parties have adequate time in which to comment, the new system will 
become effective 30 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 comment to the CMS Privacy 
Officer, Division of Privacy Compliance, Enterprise Architecture and 
Strategy Group, Office of Information Services, 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 time.

FOR FURTHER INFORMATION CONTACT: Cindy Massuda, Project Officer, 
Division of Deliver System Demonstration, Office of Research 
Development & Information, Mail Stop C4-18-03, Centers for Medicare & 
Medicaid Services, 7500 Security Boulevard, Baltimore, MD 21244-1849. 
She can be reached by telephone at 410-786-0652 or e-mail 
Cindy.Massuda@cms.hhs.gov.

[[Page 57969]]


SUPPLEMENTARY INFORMATION: The demonstration will be offered to up to 
three hospice programs and will not exceed a period of 5 years. The 
demonstration will test whether provisions of hospice services provided 
by a demonstration hospice program to Medicare beneficiaries who lack 
an appropriate caregiver and who reside in rural areas results in wider 
access, improved hospice services, benefits to the community, and a 
sustainable pattern of care. Hospice provides palliative care to 
individuals who have a terminal illness with a prognosis of 6 months or 
less. The care is provided typically in the individual's home or place 
of residence with family members present.
    Individuals who lack family or someone to serve as the primary 
caregiver need proportionately more support from hospice staff. Due to 
long distances and difficult terrain, it can be particularly difficult 
to provide the Medicare hospice benefit efficiently in rural areas. 
There may be situations where the hospice benefit could be provided to 
beneficiaries who would not otherwise be able to receive these services 
if the location of hospice care is altered.
    This demonstration will allow a hospice with up to 20 beds to 
provide all levels of hospice services within its walls to individuals 
who reside in rural areas and lack an appropriate caregiver, while not 
having to provide services outside of the hospice facility or comply 
with the 20-percent cap on inpatient care days.
    While the demonstration provider will not have to meet the limit on 
inpatient care days or provide care outside of the facility, it will 
not alter the level of care requirements for general inpatient care. In 
order to provide general inpatient care to hospice patients, a hospice 
participating in the demonstration must assure that the need for 
general inpatient care is met according to Medicare guidelines. The 
demonstration will test whether hospice services provided by a facility 
that does not meet the limit on inpatient care days or provide services 
outside of the facility for hospice individuals residing in rural areas 
who lack an appropriate caregiver results in wider access, improved 
hospice services, benefits to the rural community, and a sustainable 
pattern of care.
    The demonstration is designed for a demonstration hospice to 
provide the full range of services within its facility to Medicare 
beneficiaries who reside in rural areas and lack an appropriate 
caregiver. If a demonstration hospice provides care to any patient who 
either lives outside a rural area or has an appropriate caregiver, then 
the hospice must comply with all of Medicare hospice requirements at 
Sec.  1861(dd) of the SSA for these patients since they are not 
considered part of the demonstration.

I. Description of the Proposed System of Records

A. Statutory and Regulatory Basis for SOR

    The statutory authority for this system is given under the 
provisions of Sec.  409 of the Medicare Prescription Drug Improvement, 
and Modernization Act of 2003 and Sec.  1861(dd) of the Social Security 
Act. This program is codified at Title 42 United States Code 1395x 
(dd).

B. Collection and Maintenance of Data in the System

    This system will collect and maintain individually identifiable and 
other data collected on Medicare beneficiaries and their providers who 
provide service to such beneficiaries who participate in this 
demonstration. Data will be collected from Medicare administrative and 
claims records, patient medical charts, physician records, and via 
survey instruments administered to beneficiaries and providers. The 
collected information will include, but is not limited to Medicare 
claims and eligibility data, name, address, telephone number, health 
insurance claims number, race/ethnicity, gender, date of birth, 
provider name, unique provider identification number, medical record 
number, as well as clinical, demographic, health/well-being, family 
and/or caregiver contact information, and background information 
relating to Medicare issues.

II. Agency Policies, Procedures, and Restrictions on the Routine Use

    A. 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 RHD 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 RHD.
    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 
a person-level view of identifiable data of Medicare beneficiaries who 
participate in the rural hospice demonstrations.
    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 support agency contractors, consultants or grantees, who have 
been engaged by the agency to assist in the performance of a service 
related to this collection and who need to have access to the records 
in order to perform the activity.
    We contemplate disclosing information under this routine use only

[[Page 57970]]

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.
    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, consultant or grantee 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, consultant or grantee from using or disclosing the 
information for any purpose other than that described in the contract 
and requires the contractor, consultant or grantee to return or destroy 
all information at the completion of the contract.
    2. To assist another Federal or State agency to:
    a. Contribute to the accuracy of CMS's proper payment of Medicare 
benefits;
    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 programs within the State.
    Other Federal or State agencies, in their administration of a 
Federal health program, may require RHD information in order to support 
evaluations and monitoring of Medicare claims information of 
beneficiaries, including proper reimbursement for services provided.
    3. To assist an individual or organization for a research project 
or in support of an evaluation project related to the prevention of 
disease or disability, the restoration or maintenance of health, or 
payment related projects.
    The RHD data will provide for research or support of evaluation 
projects and a broader, longitudinal, national perspective of the 
status of Medicare beneficiaries. CMS anticipates that many researchers 
will have legitimate requests to use these data in projects that could 
ultimately improve the care provided to Medicare beneficiaries and the 
policies that govern their care.
    4. To support 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 assist 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, waste, and abuse in such 
program.
    We contemplate disclosing information under this routine use only 
in situations in which CMS may enter into a contractual, grantee, 
cooperative agreement or consultant relationship with a third party to 
assist in accomplishing CMS functions relating to the purpose of 
combating fraud, waste, and abuse. CMS occasionally contracts out 
certain of its functions or makes grants or cooperative agreements when 
doing so would contribute to effective and efficient operations. CMS 
must be able to give a contractor, grantee, consultant or other legal 
agent whatever information is necessary for the agent to fulfill its 
duties. In these situations, safeguards are provided in the contract 
prohibiting the agent from using or disclosing the information for any 
purpose other than that described in the contract and requiring the 
agent to return or destroy all information.
    6. To assist 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, 
waste, and 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, waste, and abuse in such programs.
    Other agencies may require RHD information for the purpose of 
combating fraud, waste, 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 
because of the small size, use of this information could allow for the 
deduction of the identity of the beneficiary).

IV. Safeguards

    CMS has safeguards in place for authorized users and monitors of 
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

[[Page 57971]]

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 this 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 information relating to individuals.

    Dated: September 19, 2006.
John R. Dyer,
Chief Operating Officer, Centers for Medicare & Medicaid Services.
SYSTEM NO. 09-70-0563

System Name:
    ``Rural Hospice Demonstration (RHD),'' HHS/CMS/ORDI.

Security Classification:
    Level Three Privacy Act Sensitive Data.

System Location:
    CMS Data Center, 7500 Security Boulevard, North Building, First 
Floor, Baltimore, Maryland 21244-1850, and at various contractor 
locations.

Categories of Individuals Covered by the System:
    This system will collect and maintain individually identifiable and 
other data collected on Medicare beneficiaries and their providers who 
provide service to such beneficiaries who participate in this 
demonstration.

Categories of Records in the System:
    Data will be collected from Medicare administrative and claims 
records, patient medical charts, physician records, and via survey 
instruments administered to beneficiaries and providers. The collected 
information will include, but is not limited to Medicare claims and 
eligibility data, name, address, telephone number, health insurance 
claims number, race/ethnicity, gender, date of birth, provider name, 
unique provider identification number, medical record number, as well 
as clinical, demographic, health/well-being, family and/or caregiver 
contact information, and background information relating to Medicare 
issues.

Authority for Maintenance of the System:
    The statutory authority for this system is given under the 
provisions of Sec.  409 of the Medicare Prescription Drug Improvement, 
and Modernization Act of 2003 and Sec.  1861(dd) of the Social Security 
Act. This program is codified at Title 42 United States Code 1395x 
(dd).

Purpose(s) of the System:
    The purpose of this system is to collect and maintain a person-
level view of identifiable data of Medicare beneficiaries who 
participate in the rural hospice demonstrations. Information retrieved 
from this system may be disclosed to: (1) Support regulatory, 
reimbursement, and policy functions performed within the agency or by a 
contractor, consultant, or grantee; (2) assist another Federal or State 
agency with information to contribute to the accuracy of CMS's proper 
payment of Medicare benefits, enable such agency to administer a 
Federal health benefits program, or to enable such agency to fulfill a 
requirement of Federal statute or regulation that implements a health 
benefits program funded in whole or in part with Federal funds; (3) 
support an individual or organization for a research project or in 
support of an evaluation project related to the prevention of disease 
or disability, the restoration or maintenance of health, or payment 
related projects; (4) support litigation involving the agency; and (5) 
combat fraud, waste, and abuse in certain Federally-funded 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:
    1. To support agency contractors, consultants or grantees, who have 
been engaged by the agency to assist in the performance of a service 
related to this collection and who need to have access to the records 
in order to perform the activity.
    2. To assist another Federal or State agency to:
    a. Contribute to the accuracy of CMS's proper payment of Medicare 
benefits;
    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 programs within the State.
    3. To support an individual or organization for a research project 
or in support of an evaluation project related to the prevention of 
disease, disability, or quality care projects, the restoration or 
maintenance of health, and payment related projects.
    4. To support 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. To assist a CMS contractor (including, but not necessarily 
limited to, fiscal intermediaries and carriers) that assists in the 
administration of a CMS-administered health benefits

[[Page 57972]]

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, waste, and 
abuse in such program.
    6. To assist 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, 
waste, and 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, waste, and 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 
because of the small size, use of this information could allow for the 
deduction of 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 media.

Retrievability:
    The collected data are retrieved by an individual identifier; e.g., 
beneficiary name or HICN, and unique provider identification number.

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 not to exceed 25 
years. 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 Deliver Systems Demonstration, Office of 
Research Development and Information, Mail Stop C4-18-03, Centers for 
Medicare & Medicaid Services, 7500 Security Boulevard, Baltimore, MD 
21244-1849.

Notification Procedure:
    For purpose of access, the subject individual should write to the 
system manager who will require the system name, provider's tax 
identification number, national provider number, and for verification 
purposes, or the subject individual's name (woman's maiden name, if 
applicable), HICN, and/or 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).

Records Source Categories:
    Information maintained in this system will be collected from 
physicians volunteering to participate in the RHD. Additional data will 
be collected from Medicare claims payment records.

Systems Exempted from Certain Provisions of the Act:
    None.

[FR Doc. E6-16107 Filed 9-29-06; 8:45 am]
BILLING CODE 4120-03-P