Privacy Act of 1974; Report of a Modified or Altered System of Records, 60726-60730 [E6-17058]
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60726
Federal Register / Vol. 71, No. 199 / Monday, October 16, 2006 / Notices
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.
SYSTEMS EXEMPTED FROM CERTAIN PROVISIONS
OF THE ACT:
RETENTION AND DISPOSAL:
Centers for Medicare & Medicaid
Services
Records will be maintained for 10
years after the final action of the
research project is complete. All claimsrelated records are encompassed by the
document preservation order and will
be retained until notification is received
from DOJ.
SYSTEM MANAGER(S) AND ADDRESS:
Deputy Director, Office of Research,
Development and Information, CMS,
Mail Stop C3–20–01, 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, HICN, address, date of birth, and
gender, and for verification purposes,
the subject individual’s name (woman’s
maiden name, if applicable), and 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 specify the record contents being
sought. (These procedures are in
accordance with department regulation
45 CFR 5b(a)(2)).
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).
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RECORDS SOURCE CATEGORIES:
Information contained in these
records will be obtained from the
Medicare enrollment records, Medicare
bill records, Medicare provider records,
Medicare beneficiaries and/or their
representatives, and Medicare carriers
and intermediaries.
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None.
[FR Doc. E6–17057 Filed 10–13–06; 8:45 am]
BILLING CODE 4120–03–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Privacy Act of 1974; Report of a
Modified or Altered System of Records
Centers for Medicare &
Medicaid Services (CMS), Department
of Health and Human Services (HHS).
ACTION: Notice of a modified or altered
system of records (SOR).
AGENCY:
SUMMARY: In accordance with the
Privacy Act of 1974, we are proposing
to modify or alter an existing SOR,
‘‘Person-Level Medicaid Data System
(PMDS),’’ System No. 09–70–0033,
established at 49 Federal Register (FR)
47573 (December 5, 1984) and last
modified at 65 FR 37792 (June 16,
2000). We propose to assign a new CMS
identification number to this system to
simplify the obsolete and confusing
numbering system originally designed
to identify the Bureau, Office, or Center
that maintained information in the
Health Care Financing Administration
systems of records. The new assigned
identifying number for this system
should read: System No. 09–70–0507.
We propose to modify existing routine
use number 2 that permits disclosure to
agency contractors and consultants to
include disclosure to CMS grantees who
perform a task for the agency. CMS
grantees, charged with completing
projects or activities that require CMS
data to carry out that activity, are
classified separate from CMS
contractors and/or consultants. The
modified routine use will be
renumbered as routine use number 1.
We will delete routine use number 3
authorizing disclosure to support
constituent requests made to a
congressional representative. If an
authorization for the disclosure has
been obtained from the data subject,
then no routine use is needed. The
Privacy Act allows for disclosures with
the ‘‘prior written consent’’ of the data
subject.
We propose to broaden the scope of
the disclosure provisions of this system
by adding a routine use to permit the
release of information to other Federal
and State agencies to: (1) Contribute to
the accuracy of CMS’ proper payment of
Medicare benefits; and (2) enable such
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agency to administer a Federal health
benefits program, and/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.
We are modifying the language in the
remaining routine uses to provide a
proper explanation as to the need for the
routine use and to provide clarity to
CMS’s intention to disclose individualspecific information contained in this
system. The routine uses will then be
prioritized and reordered according to
their usage. We will also take the
opportunity to update any sections of
the system that were affected by the
recent reorganization or because of the
impact of the Medicare Prescription
Drug, Improvement, and Modernization
Act of 2003 (MMA) (Pub. L 108–173)
provisions and to update language in
the administrative sections to
correspond with language used in other
CMS SORs.
The primary purpose of this modified
system is to collect and maintain
individually-identifiable data to study
Medicaid use and expenditures in order
to increase CMS’ understanding of the
Medicaid and Medicare programs and to
improve CMS’ ability to conduct
program evaluation, strengthen program
management, evaluate policy
alternatives, conduct and evaluate
demonstration projects, and advise
States in the area of Medicaid financing.
The information retrieved from this
system of records will also 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 and/or State
agency; (3) support an individual or
organization for research, evaluation or
epidemiological projects; and (4)
support litigation involving the agency.
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 modified or altered
routine uses, CMS invites comments on
all portions of this notice. See EFFECTIVE
DATE section for comment period.
EFFECTIVE DATE: CMS filed a modified or
altered 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
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Federal Register / Vol. 71, No. 199 / Monday, October 16, 2006 / Notices
October 6, 2006. To ensure that all
parties have adequate time in which to
comment, the modified 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.
The public should address
comments 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 daylight time.
FOR FURTHER INFORMATION CONTACT:
Dave Baugh, Division of State Program
and Research, Research and Evaluation
Group, Office of Research, Development
and Information, CMS, Mail Stop C3–
20–17, 7500 Security Boulevard,
Baltimore, Maryland 21244–1850. He
can also be reached by telephone at
410–786–7716, or via e-mail at
David.Baugh@cms.hhs.gov.
ADDRESSES:
Enacted
under the authority of section 1902(a)(6)
of the Social Security Act (the Act) (42
United States Code (U.S.C.) 1396(a)(6)),
this section provides that a State plan
for medical assistance must provide that
the State agency will make such report,
in such form and containing such
information, as the Secretary may from
time to time require, and comply with
such provisions as the Secretary may
from time to time find necessary to
assure the correctness and verification
of such reports. To this end we have
created a records system using Medicaid
data which has greatly improved CMS’
ability to conduct program evaluation
and has strengthened program
management.
SUPPLEMENTARY INFORMATION:
I. Description of the Modified or
Altered System of Records
A. Statutory and Regulatory Basis for
SOR
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Authority for maintenance of the
system is given under § 1902(a)(6) of the
Act (42 U.S.C. 1396(a)(6)).
B. Collection and Maintenance of Data
in the System
PMDS contains information on
persons enrolled in the Medicaid
program under either Federal or State
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provisions. Information collected
includes but is not limited to data from
5 State Medicaid agencies (California,
Georgia, Michigan, New York, and
Tennessee) showing claims submitted
for covered medical services, provider
characteristics, name, address, phone
number, date of birth, social security
number, health insurance claim
number, gender and ethnicity.
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 PMDS
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 PMDS. CMS has the
following policies and procedures
concerning disclosures of information
that will be maintained in the system.
Disclosure of information from this
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
study Medicaid use and expenditures in
order to increase CMS’ understanding of
the Medicaid and Medicare programs
and to improve CMS’ ability to conduct
program evaluation, strengthen program
management, evaluate policy
alternatives, conduct and evaluate
demonstration projects, and advise
States in the area of Medicaid financing.
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:
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60727
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
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:
a. To contribute to the accuracy of
CMS’s proper payment of Medicare
benefits,
b. To 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
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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 PMDS information
in order to support evaluations and
monitoring of reimbursement for
services provided.
3. To assist an individual or
organization for research, evaluation or
epidemiological projects related to the
prevention of disease or disability, or
the restoration or maintenance of health,
and for payment related projects.
The collected data will provide the
research, evaluation and
epidemiological projects a broader,
longitudinal, national perspective of the
data. CMS anticipates that many
researchers will have legitimate requests
to use these data in projects that could
ultimately improve the care provided to
Medicare patients and the policy that
governs the care. CMS understands the
concerns about the privacy and
confidentiality of the release of data for
a research use. Disclosure of data for
research and evaluation purposes may
involve aggregate data rather than
individual-specific data.
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.
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
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(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 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
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 National
Institute of Standards and Technology
publications; the HHS Information
Systems Program Handbook and the
CMS Information Security Handbook.
V. Effects of the Modified System of
Records on Individual Rights
CMS proposes to modify this system
in accordance with the principles and
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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
individual privacy as a result of
information relating to individuals.
Dated: October 4, 2006.
Charlene Frizzera,
Acting Chief Operating Officer, Centers for
Medicare & Medicaid Services.
SYSTEM NO. 09–70–0507
SYSTEM NAME:
‘‘Person-Level Medicaid Data System
(PMDS),’’ HHS/CMS/ORDI.
SECURITY CLASSIFICATION:
Level Three Privacy Act Sensitive
Data.
SYSTEM LOCATION:
The Centers for Medicare & Medicaid
Services (CMS) Data Center, 7500
Security Boulevard, North Building,
First Floor, Baltimore, Maryland 21244–
1850 and at various contractor sites and
at CMS Regional Offices.
CATEGORIES OF INDIVIDUALS COVERED BY THE
SYSTEM:
PMDS contains information on
persons enrolled in the Medicaid
program under either Federal or State
provisions, as well as health care
providers.
CATEGORIES OF RECORDS IN THE SYSTEM:
Information collected includes but is
not limited to data from 5 State
Medicaid agencies (California, Georgia,
Michigan, New York, and Tennessee)
showing claims submitted for covered
medical services, provider
characteristics, name, address, phone
number, date of birth, social security
number (SSN), health insurance claim
number (HICN), unique provider
identification number, gender and
ethnicity.
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AUTHORITY FOR MAINTENANCE OF THE SYSTEM:
Authority for maintenance of the
system is given under section 1902(a)(6)
of the Social Security Act (42 United
States Code 1396(a)(6)).
PURPOSE(S) OF THE SYSTEM:
The primary purpose of this modified
system is to collect and maintain
individually-identifiable data to study
Medicaid use and expenditures in order
to increase CMS’ understanding of the
Medicaid and Medicare programs and to
improve CMS’ ability to conduct
program evaluation, strengthen program
management, evaluate policy
alternatives, conduct and evaluate
demonstration projects, and advise
States in the area of Medicaid financing.
The information retrieved from this
system of records will also 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 and/or State
agency; (3) support an individual or
organization for research, evaluation or
epidemiological projects; and (4)
support litigation involving the agency.
jlentini on PROD1PC65 with NOTICES
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:
5. 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.
6. To assist another Federal or State
agency:
a. To contribute to the accuracy of
CMS’s proper payment of Medicare
benefits,
b. To 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.
7. To assist an individual or
organization for research, evaluation or
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epidemiological projects related to the
prevention of disease or disability, or
the restoration or maintenance of health,
and for payment related projects.
8. 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.
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 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 magnetic
tape and computer disk.
RETRIEVABILITY:
Enrollment records are retrieved by
Medicaid and Medicare identification
numbers. Provider records are retrieved
by Medicaid and Medicare provider
identification numbers. Claims records
contain both enrollee and provider
identification numbers.
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60729
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 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 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(S) AND ADDRESS:
Deputy Director, Office of Research,
Development and Information, CMS,
Mail Stop C3–20–11, 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, HICN, address, date of birth, and
gender, and for verification purposes,
the subject individual’s name (woman’s
maiden name, if applicable), and SSN.
Furnishing the SSN is voluntary, but it
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Federal Register / Vol. 71, No. 199 / Monday, October 16, 2006 / Notices
may make searching for a record easier
and prevent delay.
SYSTEMS EXEMPTED FROM CERTAIN PROVISIONS
OF THE ACT:
None.
RECORD ACCESS PROCEDURE:
[FR Doc. E6–17058 Filed 10–13–06; 8:45 am]
For purpose of access, use the same
procedures outlined in Notification
Procedures above. Requestors should
also specify the record contents being
sought. (These procedures are in
accordance with department regulation
45 CFR 5b.5(a)(2)).
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:
Medicaid and Medicare enrollment,
claims, and provider records.
BILLING CODE 4120–03–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Administration for Children and
Families
Proposed Information Collection
Activity; Comment Request
Proposed Projects
Title: Child Care and Development
Fund Plan for States/Territories for FY
2008–2009.
OMB No.: 0970–0114.
Description: The Child Care and
Development Fund (CCDF) Plan (the
Plan) for States and Territories is
required from each CCDF Lead Agency
in accordance with Section 658E of the
Child Care and Development Block
Grant Act of 1990, as amended (Pub. L.
101–508, Pub. L. 104–193, and 42 U.S.C.
9858). The implementing regulations for
the statutorily required Plan are set forth
at 45 CFR 98.10 through 98.18. The
Plan, submitted on the ACF–118, is
required biennially, and remains in
effect for two years. The Plan provides
ACF and the public with a description
of, and assurance about, the State’s or
the Territory’s child care program. The
ACF–118 is currently approved through
June 30, 2008, making it available to
States and Territories needing to submit
Plan Amendments through the end of
the FY 2007 Plan Period. However, in
July 2007, States and Territories will be
required to submit their FY 2008–2009
Plans. Consistent with the statute and
regulations, ACF requests extension of
the ACF–118 with minor corrections
and modifications. The Tribal Plan
(ACF–118A) is not affected by this
notice.
Respondents: State and Territorial
CCDF Lead Agencies.
Annual Burden Estimates:
Number of
respondents
Number of
responses per
respondent
Average
burden
hours per
response
Total burden
hours
ACF–118 ..........................................................................................................
jlentini on PROD1PC65 with NOTICES
Instrument
56
.5
162.57
4,552
Estimated Total Annual Burden
Hours: 4,552.
In compliance with the requirements
of Section 3506(c)(2)(A) of the
Paperwork Reduction Act of 1995, the
Administration for Children and
Families is soliciting public comment
on the specific aspects of the
information collection described above.
Copies of the proposed collection of
information can be obtained and
comments may be forwarded by writing
to the Administration for Children and
Families, Office of Administration,
Office of Information Services, 370
L’Enfant Promenade, SW., Washington,
DC 20447, Attn: ACF Reports Clearance
Officer. E-Mail address:
infocollection@acf.hhs.gov. All requests
should be identified by the title of the
information collection.
The Department specifically requests
comments on: (a) Whether the proposed
collection of information is necessary
for the proper performance of the
functions of the agency, including
whether the information shall have
practical utility; (b) the accuracy of the
agency’s estimate of the burden of the
proposed collection of information; (c)
VerDate Aug<31>2005
16:16 Oct 13, 2006
Jkt 211001
the quality, utility, and clarity of the
information to be collected; and (d)
ways to minimize the burden of the
collection of information on
respondents, including through the use
of automated collection techniques or
other forms of information technology.
Consideration will be given to
comments and suggestions submitted
within 60 days of this publication.
Dated: October 11, 2006.
Robert Sargis,
Reports Clearance Officer.
[FR Doc. 06–8689 Filed 10–13–06; 8:45 am]
BILLING CODE 4184–01–M
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Administration for Children and
Families
Proposed Information Collection
Activity; Comment Request
Proposed Projects
Title: Child Care and Development
Fund Quarterly Financial Report (ACF–
696).
PO 00000
Frm 00045
Fmt 4703
Sfmt 4703
OMB No.: 0970–0163.
Description: States and Territories use
this form to report expenditures for the
Child Care and Development Fund
(CCDF) on a quarterly basis. The form,
which is also available electronically
through a Web-based application,
provides specific data regarding
expenditures, obligations, and
estimates. It provides States and
Territories with a mechanism to request
grant awards and certify the availability
of State matching funds. Failure to
collect this data could seriously
compromise the ability of the
Administration for Children and
Families (ACF) to monitor expenditures.
This form may also be used to prepare
ACF budget submissions to Congress.
Office of Management and Budget
approval for the current form expires on
March 31, 2007.
Respondents: States and Territories
that are CCDF grantees.
Annual Burden Estimates:
E:\FR\FM\16OCN1.SGM
16OCN1
Agencies
[Federal Register Volume 71, Number 199 (Monday, October 16, 2006)]
[Notices]
[Pages 60726-60730]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: E6-17058]
-----------------------------------------------------------------------
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
Privacy Act of 1974; Report of a Modified or Altered System of
Records
AGENCY: Centers for Medicare & Medicaid Services (CMS), Department of
Health and Human Services (HHS).
ACTION: Notice of a modified or altered system of records (SOR).
-----------------------------------------------------------------------
SUMMARY: In accordance with the Privacy Act of 1974, we are proposing
to modify or alter an existing SOR, ``Person-Level Medicaid Data System
(PMDS),'' System No. 09-70-0033, established at 49 Federal Register
(FR) 47573 (December 5, 1984) and last modified at 65 FR 37792 (June
16, 2000). We propose to assign a new CMS identification number to this
system to simplify the obsolete and confusing numbering system
originally designed to identify the Bureau, Office, or Center that
maintained information in the Health Care Financing Administration
systems of records. The new assigned identifying number for this system
should read: System No. 09-70-0507.
We propose to modify existing routine use number 2 that permits
disclosure to agency contractors and consultants to include disclosure
to CMS grantees who perform a task for the agency. CMS grantees,
charged with completing projects or activities that require CMS data to
carry out that activity, are classified separate from CMS contractors
and/or consultants. The modified routine use will be renumbered as
routine use number 1.
We will delete routine use number 3 authorizing disclosure to
support constituent requests made to a congressional representative. If
an authorization for the disclosure has been obtained from the data
subject, then no routine use is needed. The Privacy Act allows for
disclosures with the ``prior written consent'' of the data subject.
We propose to broaden the scope of the disclosure provisions of
this system by adding a routine use to permit the release of
information to other Federal and State agencies to: (1) Contribute to
the accuracy of CMS' proper payment of Medicare benefits; and (2)
enable such agency to administer a Federal health benefits program,
and/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.
We are modifying the language in the remaining routine uses to
provide a proper explanation as to the need for the routine use and to
provide clarity to CMS's intention to disclose individual-specific
information contained in this system. The routine uses will then be
prioritized and reordered according to their usage. We will also take
the opportunity to update any sections of the system that were affected
by the recent reorganization or because of the impact of the Medicare
Prescription Drug, Improvement, and Modernization Act of 2003 (MMA)
(Pub. L 108-173) provisions and to update language in the
administrative sections to correspond with language used in other CMS
SORs.
The primary purpose of this modified system is to collect and
maintain individually-identifiable data to study Medicaid use and
expenditures in order to increase CMS' understanding of the Medicaid
and Medicare programs and to improve CMS' ability to conduct program
evaluation, strengthen program management, evaluate policy
alternatives, conduct and evaluate demonstration projects, and advise
States in the area of Medicaid financing. The information retrieved
from this system of records will also 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 and/or State agency; (3) support an individual or organization
for research, evaluation or epidemiological projects; and (4) support
litigation involving the agency. 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 modified or
altered routine uses, CMS invites comments on all portions of this
notice. See Effective Date section for comment period.
EFFECTIVE DATE: CMS filed a modified or altered 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
[[Page 60727]]
October 6, 2006. To ensure that all parties have adequate time in which
to comment, the modified 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 comments 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 daylight time.
FOR FURTHER INFORMATION CONTACT: Dave Baugh, Division of State Program
and Research, Research and Evaluation Group, Office of Research,
Development and Information, CMS, Mail Stop C3-20-17, 7500 Security
Boulevard, Baltimore, Maryland 21244-1850. He can also be reached by
telephone at 410-786-7716, or via e-mail at David.Baugh@cms.hhs.gov.
SUPPLEMENTARY INFORMATION: Enacted under the authority of section
1902(a)(6) of the Social Security Act (the Act) (42 United States Code
(U.S.C.) 1396(a)(6)), this section provides that a State plan for
medical assistance must provide that the State agency will make such
report, in such form and containing such information, as the Secretary
may from time to time require, and comply with such provisions as the
Secretary may from time to time find necessary to assure the
correctness and verification of such reports. To this end we have
created a records system using Medicaid data which has greatly improved
CMS' ability to conduct program evaluation and has strengthened program
management.
I. Description of the Modified or Altered System of Records
A. Statutory and Regulatory Basis for SOR
Authority for maintenance of the system is given under Sec.
1902(a)(6) of the Act (42 U.S.C. 1396(a)(6)).
B. Collection and Maintenance of Data in the System
PMDS contains information on persons enrolled in the Medicaid
program under either Federal or State provisions. Information collected
includes but is not limited to data from 5 State Medicaid agencies
(California, Georgia, Michigan, New York, and Tennessee) showing claims
submitted for covered medical services, provider characteristics, name,
address, phone number, date of birth, social security number, health
insurance claim number, gender and ethnicity.
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 PMDS 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 PMDS. CMS has the following policies and procedures
concerning disclosures of information that will be maintained in the
system. Disclosure of information from this 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 study Medicaid use
and expenditures in order to increase CMS' understanding of the
Medicaid and Medicare programs and to improve CMS' ability to conduct
program evaluation, strengthen program management, evaluate policy
alternatives, conduct and evaluate demonstration projects, and advise
States in the area of Medicaid financing.
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
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:
a. To contribute to the accuracy of CMS's proper payment of
Medicare benefits,
b. To 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
[[Page 60728]]
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 PMDS information in order to support
evaluations and monitoring of reimbursement for services provided.
3. To assist an individual or organization for research, evaluation
or epidemiological projects related to the prevention of disease or
disability, or the restoration or maintenance of health, and for
payment related projects.
The collected data will provide the research, evaluation and
epidemiological projects a broader, longitudinal, national perspective
of the data. CMS anticipates that many researchers will have legitimate
requests to use these data in projects that could ultimately improve
the care provided to Medicare patients and the policy that governs the
care. CMS understands the concerns about the privacy and
confidentiality of the release of data for a research use. Disclosure
of data for research and evaluation purposes may involve aggregate data
rather than individual-specific data.
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.
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 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 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 Modified System of Records on Individual Rights
CMS proposes to modify 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 individual privacy as a result of information relating to
individuals.
Dated: October 4, 2006.
Charlene Frizzera,
Acting Chief Operating Officer, Centers for Medicare & Medicaid
Services.
SYSTEM NO. 09-70-0507
SYSTEM NAME:
``Person-Level Medicaid Data System (PMDS),'' HHS/CMS/ORDI.
SECURITY CLASSIFICATION:
Level Three Privacy Act Sensitive Data.
SYSTEM LOCATION:
The Centers for Medicare & Medicaid Services (CMS) Data Center,
7500 Security Boulevard, North Building, First Floor, Baltimore,
Maryland 21244-1850 and at various contractor sites and at CMS Regional
Offices.
CATEGORIES OF INDIVIDUALS COVERED BY THE SYSTEM:
PMDS contains information on persons enrolled in the Medicaid
program under either Federal or State provisions, as well as health
care providers.
CATEGORIES OF RECORDS IN THE SYSTEM:
Information collected includes but is not limited to data from 5
State Medicaid agencies (California, Georgia, Michigan, New York, and
Tennessee) showing claims submitted for covered medical services,
provider characteristics, name, address, phone number, date of birth,
social security number (SSN), health insurance claim number (HICN),
unique provider identification number, gender and ethnicity.
[[Page 60729]]
AUTHORITY FOR MAINTENANCE OF THE SYSTEM:
Authority for maintenance of the system is given under section
1902(a)(6) of the Social Security Act (42 United States Code
1396(a)(6)).
PURPOSE(S) OF THE SYSTEM:
The primary purpose of this modified system is to collect and
maintain individually-identifiable data to study Medicaid use and
expenditures in order to increase CMS' understanding of the Medicaid
and Medicare programs and to improve CMS' ability to conduct program
evaluation, strengthen program management, evaluate policy
alternatives, conduct and evaluate demonstration projects, and advise
States in the area of Medicaid financing. The information retrieved
from this system of records will also 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 and/or State agency; (3) support an individual or organization
for research, evaluation or epidemiological projects; and (4) support
litigation involving the agency.
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:
5. 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.
6. To assist another Federal or State agency:
a. To contribute to the accuracy of CMS's proper payment of
Medicare benefits,
b. To 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.
7. To assist an individual or organization for research, evaluation
or epidemiological projects related to the prevention of disease or
disability, or the restoration or maintenance of health, and for
payment related projects.
8. 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.
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 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 magnetic tape and computer disk.
RETRIEVABILITY:
Enrollment records are retrieved by Medicaid and Medicare
identification numbers. Provider records are retrieved by Medicaid and
Medicare provider identification numbers. Claims records contain both
enrollee and provider identification numbers.
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(S) AND ADDRESS:
Deputy Director, Office of Research, Development and Information,
CMS, Mail Stop C3-20-11, 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, HICN, address, date of
birth, and gender, and for verification purposes, the subject
individual's name (woman's maiden name, if applicable), and SSN.
Furnishing the SSN is voluntary, but it
[[Page 60730]]
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 specify the
record contents being sought. (These procedures are in accordance with
department regulation 45 CFR 5b.5(a)(2)).
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:
Medicaid and Medicare enrollment, claims, and provider records.
SYSTEMS EXEMPTED FROM CERTAIN PROVISIONS OF THE ACT:
None.
[FR Doc. E6-17058 Filed 10-13-06; 8:45 am]
BILLING CODE 4120-03-P