Privacy Act of 1974; Report of a Modified or Altered System of Records, 36000-36005 [E7-12679]

Agencies

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

[Federal Register Volume 72, Number 126 (Monday, July 2, 2007)]
[Notices]
[Pages 36000-36005]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: E7-12679]


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

[[Page 36001]]


ACTION: Notice of a Modified or Altered System of Records (SOR).

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SUMMARY: In accordance with the Privacy Act of 1974, we are proposing 
to modify or alter an existing SOR, ``Supplemental Medical Insurance 
(SMI) and Hospital Insurance (HI) Premium Accounting Collection and 
Enrollment (SPACE) System,'' System No. 09-70-0505, last published at 
67 Federal Register 40933 (June 14, 2002). The third party premium 
collection system bills and collects Part A and/or Part B Medicare 
premiums paid by third party payers on behalf of beneficiaries 
represented by that entity. In September, 2003, the third party premium 
collection system known as ``SPACE'' was replaced by a redesigned 
system referred to as the ``Third Party System (TPS).'' The new system 
was designed to: (1) Integrate beneficiary third party data onto the 
EDB with Direct Billing and Enrollment/Entitlement data; (2) eliminate 
redundant and discrepant data; (3) reduce the number of exception cases 
requiring processing; (4) provide daily update of third party data at 
CMS and Social Security Administration; (5) implement several 
legislative provisions affecting premium collection; and (6) provide 
integrated online access to Medicare enrollment data. To more 
accurately reflect the changes proposed for this system, we will modify 
the name of this system to read: ``Third Party System (TPS).'' TPS will 
retain its current system identification number: CMS No. 09-70-0505.
    We propose to modify existing routine use number 3 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 5 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 will broaden the scope of published routine 
uses number 7 and 8, authorizing disclosures to combat fraud and abuse 
in the Medicare and Medicaid programs to include combating ``waste'' 
which refers to specific beneficiary/recipient practices that result in 
unnecessary cost to all federally-funded health benefit programs.
    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) 
(Public Law 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 process 
beneficiary premium billing accretions and deletions to third party 
premium payer accounts (state Medicaid agencies, Office of Personnel 
Management (OPM), and formal third party groups and surcharge only 
group payers (latter as defined in 42 Code of Federal Regulations (CFR) 
408.80 through 408.92 and 408.200 through 408.210)) for the payment of 
Part B (SMI) and/or Part A (HI) premiums on behalf of Medicare 
beneficiaries, the payment of the surcharge portion of the Part B 
premium on behalf of Medicare beneficiaries by a State or local 
government entity, and for enrolling individuals for Part A or Part B 
coverage under state buy-in agreements. 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 a CMS grantee; (2) assist 
another Federal or State agency, agency of a State government, an 
agency established by State law, or its fiscal agent; (3) support 
formal third party groups and surcharge only group payers pursuant to 
an agreement with CMS; (4) assist an individual or research 
organization to support research evaluation of epidemiological 
projects; (5) support litigation involving the agency; and (6) combat 
fraud, waste, and abuse in certain Federally-funded health care 
programs. We have provided background information about the modified 
system in the SUPPLEMENTARY INFORMATION section below. Although the 
Privacy Act requires only that CMS provide an opportunity for 
interested persons to comment on the modified or altered routine uses, 
CMS invites comments on all portions of this notice. See ``Effective 
Dates'' section for comment period.

DATES: Effective Dates: CMS filed a modified or altered system 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 June 25, 
2007. To ensure that all parties have adequate time in which to 
comment, the modified system, including routine uses, will become 
effective 30 days from the publication of the notice, or 40 days from 
the date it was submitted to OMB and Congress, whichever is later, 
unless CMS receives comments that require alterations to this notice.

ADDRESSES: The public should address comments to: CMS Privacy Officer, 
Division of Privacy Compliance, Enterprise Architecture and Strategy 
Group, Office of Information Services, CMS, Room 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: Frances Ferrante, Division of Premium 
Billing and Collections, Accounting Management Group, Office of 
Financial Management, CMS, Mail Stop N3-21-06, 7500 Security Boulevard, 
Baltimore, Maryland 21244-1850. She can also be reached by telephone at 
410-786-6193, or via e-mail at Frances.Ferrante@cms.hhs.gov.

SUPPLEMENTARY INFORMATION:

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. Sec.  
1818, 1818A, (42 United States Code (U.S.C.) 1395i-2 and 2a), 
Sec. Sec.  1818(e) and (g) (42 U.S.C. 1395i-2(e) and (g)), 1839(e) (42 
U.S.C. 1395r), 1840(d) and (e) (42 U.S.C. 1395s(d) and (e)), and 1843 
(42 U.S.C. 1395v) of Title XVIII of the Social Security Act (the Act).

B. Collection and Maintenance of Data in the System

    The system contains information on Medicare beneficiaries whose 
Part A benefit and/or Part B Medicare premiums are paid by a state 
Medicaid agency, OPM, a formal third party group, or a surcharge only 
group payer.

[[Page 36002]]

Information collected includes, but is not limited to, name, social 
security number, health insurance claims number, date of birth, gender, 
amount of premium liability, date agency first became liable for Part A 
or Part B premiums or Part B surcharges, last month of agency premium 
liability, agency identification number, and an OPM annuity number.

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 TPS 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 TPS. 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 process beneficiary 
premium billing accretions and deletions to third party premium payer 
accounts (state Medicaid agencies, Office of Personnel Management 
(OPM), and formal third party groups and surcharge only group payers 
(latter as defined in 42 Code of Federal Regulations (CFR) 408.80 
through 408.92 and 408.200 through 408.210)) for the payment of Part B 
(SMI) and/or Part A (HI) premiums on behalf of Medicare beneficiaries, 
the payment of the surcharge portion of the Part B premium on behalf of 
Medicare beneficiaries by a State or local government entity, and for 
enrolling individuals for Part A or Part B coverage under state buy-in 
agreements.
    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 is 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 functions 
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 and/or State agency, agency of a State 
government, an agency established by State law, or its fiscal agent:
    a. Contribute to the accuracy of CMS' 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 TPS information in order to support 
evaluations and monitoring of Medicare premium billing information.
    In addition, state Medicaid agencies may require TPS data, pursuant 
to agreements with HHS, for enrollment of dually eligible beneficiaries 
for medical insurance under Sec.  1843 of the Act.
    The Social Security Administration (SSA) requires TPS data to 
enable them to assist in the implementation and maintenance of the 
Medicare program.
    The Railroad Retirement Board (RRB) requires TPS information to 
enable them to assist in the implementation and maintenance of the 
Medicare program.
    OPM requires TPS information in order to perform monthly premium 
billing functions to identify annuitants for whom premium collections 
must be initiated, and to periodically reconcile third-party master 
records.
    3. To support formal third party groups and surcharge only group 
payers pursuant to agreements with CMS to pay the Medicare premiums or 
surcharge only portion of the Part B premium on behalf of their members 
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 has entered into a contractual or similar 
agreement with a formal third-party group; e.g., private groups, 
retirement funds, religious orders, local government agency, etc., or 
surcharge only group payer; e.g., State or local government entity, 
that can pay Medicare Part A &/or Part B premiums or the surcharge only 
portion of the Part B premium or as necessary to assist in a CMS 
function relating to the payment on behalf of their members.
    4. To assist an individual or organization for research, 
evaluation, or epidemiological projects related to the prevention of 
disease or disability, the restoration or maintenance of health, or 
payment related projects.

[[Page 36003]]

    TPS data will provide for the research, evaluation, and 
epidemiological projects, 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 policy that governs the care.
    5. 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.
    6. To assist a CMS contractor (including, but not 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 has entered into a contract or grant 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 when doing 
so would contribute to effective and efficient operations. CMS must be 
able to give a contractor or consultant whatever information is 
necessary for the contractor or consultant to fulfill its duties. In 
these situations, safeguards are provided in the contract prohibiting 
the contractor or consultant from using or disclosing the information 
for any purpose other than that described in the contract, and requires 
the contractor or consultant to return or destroy all information at 
the completion of the contract.
    7. 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 TPS 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 
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 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.


[[Page 36004]]


    Dated: June 20, 2007.
Charlene Frizzera,
Chief Operating Officer, Centers for Medicare & Medicaid Services.
SYSTEM NO. 09-70-0505

SYSTEM NAME:
    ``Third Party System (TPS),'' HHS/CMS/OFM.

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:
    The system contains information on Medicare beneficiaries whose 
Part A benefit and/or Part B Medicare premiums are paid by a state 
Medicaid agency, OPM, a formal third party group, or a surcharge only 
group payer.

CATEGORIES OF RECORDS IN THE SYSTEM:
    Information collected includes, but is not limited to, name, social 
security number, health insurance claims number, date of birth, gender, 
amount of premium liability, date agency first became liable for Part A 
or Part B premiums or Part B surcharges, last month of agency premium 
liability, agency identification number, and an OPM annuity number.

AUTHORITY FOR MAINTENANCE OF THE SYSTEM:
    Authority for maintenance of the system is given under Sec. Sec.  
1818, 1818A, (42 United States Code (U.S.C.) 1395i-2 and 2a), 1818(e) 
and (g) (42 U.S.C. 1395i-2(e) and (g)), 1839(e) (42 U.S.C. 1395r), 1840 
(d) and (e) (42 U.S.C. 1395s (d) and (e)), and 1843 (42 U.S.C. 1395v) 
of Title XVIII of the Social Security Act (the Act).

PURPOSE(S) OF THE SYSTEM:
    The primary purpose of this modified system is to process 
beneficiary premium billing accretions and deletions to third party 
premium payer accounts (state Medicaid agencies, Office of Personnel 
Management (OPM), and formal third party groups and surcharge only 
group payers (latter as defined in 42 Code of Federal Regulations (CFR) 
408.80 through 408.92 and 408.200 through 408.210)) for the payment of 
Part B (SMI) and/or Part A (HI) premiums on behalf of Medicare 
beneficiaries, the payment of the surcharge portion of the Part B 
premium on behalf of Medicare beneficiaries by a State or local 
government entity, and for enrolling individuals for Part A or Part B 
coverage under state buy-in agreements. 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 a CMS grantee; (2) assist 
another Federal or State agency, agency of a State government, an 
agency established by State law, or its fiscal agent; (3) support 
formal third party groups and surcharge only group payers pursuant to 
an agreement with CMS; (4) assist an individual or research 
organization to support research, evaluation of epidemiological 
projects; (5) support litigation involving the agency; and (6) combat 
fraud, waste, and abuse in certain Federally-funded health care 
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 and/or State agency, agency of a State 
government, an agency established by State law, or its fiscal agent:
    a. Contribute to the accuracy of CMS' 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 formal third party groups and surcharge only group 
payers pursuant to agreements with CMS to pay the Medicare premiums or 
surcharge only portion of the Part B premium on behalf of their members 
and who need to have access to the records in order to perform the 
activity.
    4. To assist an individual or organization for research, 
evaluation, or epidemiological projects related to the prevention of 
disease or disability, the restoration or maintenance of health, or 
payment related projects.
    5. 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.
    6. To assist a CMS contractor (including, but not 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.
    7. 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

[[Page 36005]]

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 direct access storage devices and other 
electronically retrievable media.

RETRIEVABILITY:
    Information can be retrieved by name, HICN, and assigned agency 
identification number.

SAFEGUARDS:
    CMS has safeguards in place for authorized users and monitors such 
users to ensure against 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:
    Records are maintained in a secure storage area with identifiers 
for 6 years 3 months after final action of the case is completed. 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:
    Director, Division of Premium Billing and Collections, Accounting 
Management Group, Office of Financial Management, CMS, Mail Stop N3-21-
06, 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.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:
    Information contained in this system is obtained from third party 
agencies, Social Security Administration's Master Beneficiary Record, 
and CMS' Enrollment Database.

SYSTEMS EXEMPTED FROM CERTAIN PROVISIONS OF THE ACT:
    None.

 [FR Doc. E7-12679 Filed 6-29-07; 8:45 am]
BILLING CODE 4120-03-P