Privacy Act of 1974; Report of a Modified or Altered System, 69691-69696 [E7-23877]

Agencies

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

[Federal Register Volume 72, Number 236 (Monday, December 10, 2007)]
[Notices]
[Pages 69691-69696]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: E7-23877]


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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

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

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

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SUMMARY: In accordance with the requirements of the Privacy Act of 
1974, we are proposing to modify or alter an existing SOR, ``Intern and 
Resident Information System (IRIS), System No. 09-70-0524, last 
published at 67 Federal Register 48189 (July 23, 2002). We propose to 
modify existing routine use number 1 that permits disclosure to agency 
contractors and consultants to include disclosure to CMS grantees who

[[Page 69692]]

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 remain 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 
increasingly more to specific beneficiary or recipient practices that 
result in unnecessary cost to Federally-funded health benefit programs.
    We will delete the section titled ``Additional Circumstances 
Affecting Routine Use Disclosures,'' that addresses ``Protected Health 
Information (PHI)'' and ``small cell size.'' The requirement for 
compliance with HHS regulation ``Standards for Privacy of Individually 
Identifiable Health Information'' does not apply because this system 
does not collect or maintain PHI. In addition, our policy to prohibit 
release if there is a possibility that an individual can be identified 
through ``small cell size'' is not applicable to the data maintained in 
this system.
    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' 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 by Medicare Prescription Drug, 
Improvement, and Modernization Act of 2003 (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 the SOR is to ensure that no interns and 
residents (IRs) are counted by the Medicare program as more than one 
full-time equivalent (FTE) employee in the calculation of payments for 
the costs of direct graduate medical education (GME) and indirect 
medical education (IME). Information retrieved from this SOR will also 
be disclosed to: (1) Support regulatory, reimbursement, and policy 
functions performed within the Agency or by a contractor or consultant, 
(2) assist another Federal and/or state agency, agency of a state 
government, an agency established by state law, or its fiscal agent, 
(3) support providers and suppliers of services, (4) assist third-party 
contacts where necessary to establish or verify information, (5) 
support litigation involving the Agency, and (6) combat fraud, waste, 
and abuse in certain health benefits programs. We have provided 
background information about the modified system in the ``Supplementary 
Information'' section below. Although the Privacy Act requires only 
that CMS provide an opportunity for interested persons to comment on 
the 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 and 
Governmental Affairs, and the Administrator, Office of Information and 
Regulatory Affairs, Office of Management and Budget (OMB) on December 
4, 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 Zone.

FOR FURTHER INFORMATION CONTACT: Milton Jacobson, Division of Provider 
Audit Operations, Financial Services Group, Office of Financial 
Management, CMS, Room C3-14-00, 7500 Security Boulevard, Baltimore, 
Maryland 21244-1850. Mr. Jacobson can be reached by telephone at 410-
786-7553 or via e-mail at Milton.Jacobson@cms.hhs.gov.

SUPPLEMENTARY INFORMATION:

I. Description of the Modified or Altered System of Records

A. Statutory and Regulatory Basis for System

    Authority for maintenance of the system is given under the 
provisions of Sec. Sec.  1886(d)(5)(B) and 1886(h) of the Social 
Security Act (Title 42 United States Code (U.S.C.) 1395ww(d)(5)(B) and 
1395ww(h)).

B. Collection and Maintenance of Data in the System

    The system collects and maintains information interns and residents 
in programs approved under 42 CFR 413.75, working in all areas of the 
hospital complex, or other freestanding providers, as well as non-
hospital or non-provider settings on or after July 1, 1985. The system 
includes the following information for each IR: name, social security 
number; name of medical, osteopathic, dental, or podiatric school 
graduated from and date of graduation, type of residency program for 
the medical specialty, number of years completed in all types of 
residency programs, foreign medical school graduation date and 
certification date, name of employer (e.g., hospital, university, 
corporation) paying the salary, the percentage of time spent working in 
either the inpatient areas of the hospital subject to the Prospective 
Payment System or in the outpatient areas of the hospital or in a non-
hospital setting under agreement with the hospital for IME, the 
percentage of time spent working in any area of the hospital complex or 
in a non-provider setting under agreement with the hospital for GME, 
the start and end dates assigned to the hospital and any hospital-based 
providers (assignment periods) during the hospital's cost reporting 
period, the start and end dates assigned to any non-hospital or non-
provider setting in connection with approved residency programs 
(assignment periods) during the hospital's cost reporting period, and 
the full-time or part-time percentage during each assignment period.

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

    A. The Privacy Act permits us to disclose information without an 
individual's consent if the information is to be used for a purpose 
that is compatible with the purpose(s) for which the information was 
collected. Any such disclosure of data is known as a ``routine use.'' 
The government will only release IRIS information that can be 
associated with an individual as provided for under ``Section III.

[[Page 69693]]

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 IRIS. 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 ensure that no 
interns and residents (IR) are counted by the Medicare program as more 
than one full-time equivalent (FTE) employee in the calculation of 
payments for the costs of GME and IME.
    2. Determines:
    a. That the purpose for which the disclosure is to be made can only 
be accomplished if the record is provided in individually identifiable 
form;
    b. That the purpose for which the disclosure is to be made is of 
sufficient importance to warrant the potential effect and/or risk on 
the privacy of the individual that additional exposure of the record 
might bring; and
    c. That 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; and
    b. Remove or destroy at the earliest time all patient-identifiable 
information.
    4. Determines that the data are valid and reliable.

III. Proposed Routine Use Disclosures of Data in the System

A. Entities Who May Receive Disclosures Under Routine Use

    These routine uses specify circumstances, in addition to those 
provided by statute in the Privacy Act of 1974, under which CMS may 
release information from the IRIS without the consent of the individual 
to whom such information pertains. Each proposed disclosure of 
information under these routine uses will be evaluated to ensure that 
the disclosure is legally permissible, including but not limited to 
ensuring that the purpose of the disclosure is compatible with the 
purpose for which the information was collected. We are proposing to 
establish or modify 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 another Federal or state agency, agency of a state 
government, an agency established by state law, or its fiscal agent:
    a. To contribute to the accuracy of CMS' 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.
    Other Federal or state agencies in their administration of a 
Federal health program may require IRIS information in order to support 
evaluations and monitoring of reimbursement for services provided.
    SSA may require IRIS data to enable it to assist in the 
implementation and maintenance of the Medicare program.
    State licensing boards may require IRIS data to enable them to 
assist in the review of activities related to IRs in their state.
    The Medicare Payment Advisory Commission and Congressional Budget 
Office may require IRIS data to assist in certain budgetary and 
planning activities related to IR status.
    3. To providers and suppliers of services (and their authorized 
billing agents) directly or dealing through fiscal intermediaries or 
carriers, for administration of provisions of Title XVIII of the Social 
Security Act.
    We contemplate disclosing information under this routine use only 
in situations in which CMS may enter into a contractual agreement with 
providers and suppliers of services to assist in accomplishing CMS 
functions relating to purposes for this SOR.
    4. To third-party contacts where necessary to establish or verify 
information provided on or by IR.
    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 of records.
    5. To the Department of Justice (DOJ), court or adjudicatory body 
when:
    a. The agency or any component thereof, or
    b. Any employee of the agency in his or her official capacity, or
    c. Any employee of the agency in his or her individual capacity 
where the DOJ has agreed to represent the employee, or
    d. The United States Government

Is a party to litigation or has an interest in such litigation, and by 
careful review, CMS determines that the records are both relevant and 
necessary to the litigation and that the use of such records by the 
DOJ, court or adjudicatory body is compatible with the purpose for 
which the agency collected the records.
    Whenever CMS is involved in litigation, or 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 a CMS contractor (including, but not limited to FIs 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, or abuse in such program.
    We contemplate disclosing information under this routine use only 
in situations in which CMS may enter 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

[[Page 69694]]

would contribute to effective and efficient operations. CMS must be 
able to give a contractor or grantee whatever information is necessary 
for the contractor or grantee to fulfill its duties. In these 
situations, safeguards are provided in the contract prohibiting the 
contractor or grantee from using or disclosing the information for any 
purpose other than that described in the contract and requiring the 
contractor or grantee to return or destroy all information.
    7. To another Federal agency or to an instrumentality of any 
governmental jurisdiction within or under the control of the United 
States (including any state or local governmental agency), that 
administers, or that has the authority to investigate potential fraud 
or abuse in a health benefits program funded in whole or in part by 
Federal funds, when disclosure is deemed reasonably necessary by CMS to 
prevent, deter, discover, detect, investigate, examine, prosecute, sue 
with respect to, defend against, correct, remedy, or otherwise combat 
fraud, waste, or abuse in such programs.
    Other agencies may require IRIS information for the purpose of 
combating fraud, waste, and abuse in such Federally funded programs.

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 or Altered 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 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: November 28, 2007.
Charlene Frizzera,
Chief Operating Officer, Centers for Medicare & Medicaid Services.
SYSTEM NO. 09-70-0524

SYSTEM NAME:
    ``Intern and Resident Information System (IRIS), 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 South Building, Baltimore, Maryland 21244-1850.

CATEGORIES OF INDIVIDUALS COVERED BY THE SYSTEM:
    Interns and residents (IR) in medical residency programs approved 
under 42 CFR Sec.  413.75, working in all areas of the hospital 
complex, or other freestanding providers, as well as non-hospital or 
non-provider settings on or after July 1, 1985.

CATEGORIES OF RECORDS IN THE SYSTEM:
    The system includes the following information for each IR: name, 
social security number; name of medical, osteopathic, dental, or 
podiatric school graduated from and date of graduation, type of 
residency program for the medical specialty, number of years completed 
in all types of residency programs, foreign medical school graduation 
date and certification date, name of employer (e.g., hospital, 
university, corporation) paying the salary, the percentage of time 
spent working in either the inpatient areas of the hospital subject to 
the Prospective Payment System or in the outpatient areas of the 
hospital or in a non-hospital setting under agreement with the hospital 
for indirect medical education (IME), the percentage of time spent 
working in any area of the hospital complex or in a non-provider 
setting under agreement with the hospital for graduate medical 
education (GME), the start and end dates assigned to the hospital and 
any hospital-based providers (assignment periods) during the hospital's 
cost reporting period, the start and end dates assigned to any non-
hospital or non-provider setting in connection with approved residency 
programs (assignment periods) during the hospital's cost reporting 
period, and the full-time or part-time percentage during each 
assignment period.

AUTHORITY FOR MAINTENANCE OF THE SYSTEM:
    Authority for maintenance of the system is given under the 
provisions of Sec. Sec.  1886(d)(5)(B) and 1886(h) of the Social 
Security Act (Title 42 United States Code (U.S.C.) Sec. Sec.  
1395ww(d)(5)(B) and 1395ww (h)).

PURPOSE(S) OF THE SYSTEM:
    The primary purpose of the SOR is to ensure that no interns and 
residents (IRs) are counted by the Medicare program as more than one 
full-time equivalent (FTE) employee in the calculation of payments for 
the costs of direct graduate medical education (GME) and indirect 
medical education (IME). Information retrieved from this SOR will also 
be disclosed to: (1) Support regulatory, reimbursement, and policy 
functions performed within the Agency or by a contractor or consultant, 
(2) assist another Federal and/or state agency, agency of a state 
government, an agency established by state law, or its fiscal agent, 
(3) support providers and suppliers of services, (4) assist third-party 
contacts where necessary to establish or verify information, (5)

[[Page 69695]]

support litigation involving the Agency, and (6) combat fraud, waste, 
and abuse in certain health benefits programs.

ROUTINE USES OF RECORDS MAINTAINED IN THE SYSTEM, INCLUDING CATEGORIES 
OR USERS AND THE PURPOSES OF SUCH USES:
    A. Entities Who May Receive Disclosures Under Routine Use
    These routine uses specify circumstances, in addition to those 
provided by statute in the Privacy Act of 1974, under which CMS may 
release information from the IRIS without the consent of the individual 
to whom such information pertains. Each proposed disclosure of 
information under these routine uses will be evaluated to ensure that 
the disclosure is legally permissible, including but not limited to 
ensuring that the purpose of the disclosure is compatible with the 
purpose for which the information was collected. We are proposing to 
establish or modify 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 another Federal or state agency, agency of a state 
government, an agency established by state law, or its fiscal agent:
    a. To contribute to the accuracy of CMS' 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.
    3. To providers and suppliers of services (and their authorized 
billing agents) directly or dealing through fiscal intermediaries or 
carriers, for administration of provisions of Title XVIII of the Social 
Security Act.
    4. To third-party contacts where necessary to establish or verify 
information provided on or by IR.
    5. To the Department of Justice (DOJ), court or adjudicatory body 
when:
    a. The agency or any component thereof, or
    b. Any employee of the agency in his or her official capacity, or
    c. Any employee of the agency in his or her individual capacity 
where the DOJ has agreed to represent the employee, or
    d. The United States Government

    Is a party to litigation or has an interest in such litigation, and 
by careful review, CMS determines that the records are both relevant 
and necessary to the litigation and that the use of such records by the 
DOJ, court or adjudicatory body is compatible with the purpose for 
which the agency collected the records.
    6. To a CMS contractor (including, but not limited to FIs 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, or abuse in such program.
    7. To another Federal agency or to an instrumentality of any 
governmental jurisdiction within or under the control of the United 
States (including any state or local governmental agency), that 
administers, or that has the authority to investigate potential fraud 
or abuse in a health benefits program funded in whole or in part by 
Federal funds, when disclosure is deemed reasonably necessary by CMS to 
prevent, deter, discover, detect, investigate, examine, prosecute, sue 
with respect to, defend against, correct, remedy, or otherwise combat 
fraud, waste, or abuse in such programs.

POLICIES AND PRACTICES FOR STORING, RETRIEVING, ACCESSING, RETAINING, 
AND DISPOSING OF RECORDS IN THE SYSTEM:
STORAGE:
    All records are stored on paper and magnetic disk.

RETRIEVABILITY:
    Magnetic media records are retrieved by the name of the employees 
or other authorized individual and/or card key number. Paper records 
are retrieved alphabetically by name.

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:
    Records are maintained in a secure storage area with identifiers. 
Disposal occurs three years from the last action on the hospital's cost 
report, and should be coordinated with disposal of the reports.

SYSTEM MANAGER AND ADDRESS:
    Director, Division of Provider Audit Operations, Financial Services 
Group, Office of Financial Management, CMS, 7500 Security Boulevard, 
C3-14-00, Baltimore, Maryland 21244-1850.

NOTIFICATION PROCEDURE:
    For purpose of access, the subject individual should write to the 
systems manager who will require the system name, SSN, address, date of 
birth, sex, and for verification purposes, the subject individual's 
name (woman's maiden name, if applicable). Furnishing the SSN is 
voluntary, but it may make searching for a record easier and prevent 
delay.

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

CONTESTING RECORD PROCEDURES:
    The subject individual should contact the system manager named 
above, and reasonably identify the record and specify the information 
to be contested.

[[Page 69696]]

State the corrective action sought and the reasons for the correction 
with supporting justification. (These procedures are in accordance with 
Department regulation 45 CFR 5b.7.)

RECORD SOURCE CATEGORIES:
    Data for this system is collected from IRIS diskettes/CDs as 
transmitted by the hospitals.

SYSTEMS EXEMPTED FROM CERTAIN PROVISIONS OF THE ACT:
    None.

 [FR Doc. E7-23877 Filed 12-7-07; 8:45 am]
BILLING CODE 4120-03-P