Privacy Act of 1974; Report of a Modified or Altered System of Records, 30411-30415 [2010-12996]

Download as PDF Federal Register / Vol. 75, No. 104 / Tuesday, June 1, 2010 / Notices DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services Privacy Act of 1974; Report of a Modified or Altered System of Records erowe on DSK5CLS3C1PROD with NOTICES 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). SUMMARY: In accordance with the requirements of the Privacy Act of 1974, CMS is proposing to modify or alter existing system of records titled ‘‘National Provider System,’’ System No. 09–70–0008. Under the authority of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) Public Law (Pub. L.) 104–191, this system was established and published in the Federal Register (FR) at 63 FR 40297 (July 28, 1998). The system name ‘‘National Provider System’’ describes the original system designed to enumerate individual health care providers and maintain the information submitted in their application, the National Provider Identifier (NPI) Application/Update Form (Form CMS– 10114). Expectation of the adoption of a standard unique health identifier for health plans would broaden the function of the system to enable it to assign health plan identifiers to health plans; as a result, the name of the system is proposed to read: the ‘‘National Plan and Provider Enumeration System (NPPES).’’ Although the Federal Register Notice (July 28, 1998) stated that both organizational providers and providers who are individuals are included in the NPS database, and the system may be expanded in the future to include enumerated health plans, this system of records will be applicable only to the collection and maintenance of information about enumerated health care providers who are individuals (e.g., physicians and non-physician practitioners), containing the information they submitted on their NPI applications and their assigned NPI. 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. 09–70–0555. We propose to delete published routine use number 1 authorizing VerDate Mar<15>2010 15:41 May 28, 2010 Jkt 220001 disclosure to Federal and Medicaid health plans that are enumerators and their agents. Published routine use number 1 will be deleted because the proposal to have Federal and Medicaid health plans serving as enumerators was not implemented. We propose to delete published routine use number 2 authorizing disclosures to entities implementing or maintaining systems and data files necessary for compliance with Title XI, Part C of the Social Security Act because the information necessary for this use is available in accordance with the NPS Data Dissemination Notice (CMS–6060– N) published in the Federal Register on May 30, 2007. We propose to 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 delete published routine use number 4 authorizing disclosures to another Federal agency for use in processing research and statistical data related to the administration of its programs because the information from NPPES that would be used for this purpose is available in accordance with the Notice published in the Federal Register on May 30, 2007 (CMS–6060–N). We propose to delete published routine use number 6 authorizing disclosures to an individual or organization for a research, demonstration, evaluation, or epidemiological project because the information in NPPES that would be used for this purpose is available in accordance with the Notice published in the Federal Register on May 30, 2007 (CMS–6060–N). We propose to delete published routine use number 7 authorizing disclosures to contractors for the purpose of refining ADP or telecommunication systems or supporting records in the system. Disclosures allowed by published routine use number 7 will be covered by a new routine use for contractors, consultants, or grantees who have been contracted by the Agency to assist with a CMS assigned task and who need access to the records in order to complete that task. The new routine use will be numbered as routine use number 1. We propose to delete routine use number 8 authorizing disclosures to an agency of the State government for PO 00000 Frm 00048 Fmt 4703 Sfmt 4703 30411 purposes of determining effectiveness of health care services provided in the State because the information in NPPES that would be used for this purpose is available in accordance with the Notice published in the Federal Register on May 30, 2007 (CMS–6060–N). We propose to delete in part routine use number 9 authorizing disclosures to another Federal or State agency to fulfill a Federal or State statute or regulation that implements a program funded in whole or in part with Federal funds because the information in NPPES that would be used for this purpose is available in accordance with the Notice published in the Federal Register on May 30, 2007 (CMS–6060–N). We retain routine use number 9 for purposes of identifying health care providers for Debt Collection Information Act of 1996 and the Balanced Budget Act of 1997 and include this as routine use number 2. Routine use number 5 authorizing disclosures to the Department of Justice, to a court or other tribunal, or to another party before such tribunal, is revised for clarity and is renumbered as routine use number 3. We have added two new routine uses for the purposes of combating fraud, waste, and abuse in CMS-administered health benefits programs and to support other Federal agencies, States, and local government agencies in combating fraud, waste, and abuse in programs funded in whole or in part by Federal funds. These two routine uses are routine use numbers 4 and 5. In addition, we propose to add a new routine use to disclose information maintained in this system to respond to a suspected or confirmed breach of the security or confidentiality of information maintained in the system. This new routine use will be numbered as routine use 6. The security classification previously reported as ‘‘None’’ will be modified to reflect that data in this system are considered to be ‘‘Level Three Privacy Act Sensitive.’’ 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. We will also take the opportunity to update any sections of the System of Records Notice that were affected by the reorganization of CMS or to update language in the administrative sections to correspond with language used in other CMS SORs where appropriate. The purpose of the NPPES is to collect and maintain, on behalf of the Secretary, information needed to E:\FR\FM\01JNN1.SGM 01JNN1 30412 Federal Register / Vol. 75, No. 104 / Tuesday, June 1, 2010 / Notices uniquely identify an individual physician or non-physician practitioner, assign a National Provider Identifier (NPI) to that physician or non-physician practitioner, and maintain and update the information in that health care provider’s record in NPPES. Information maintained in this system will also be disclosed to: (1) Support the NPI Enumerator and other agency contractors who need NPPES data to perform their contractual requirements; (2) to assist Federal and State agencies to identify health care providers for debt collection under Federal statutes; (3) to assist the Department of Justice in litigation; (4) to support CMS contractors in combating fraud, waste, and abuse in CMS-administered health benefits programs; (5) to support other Federal agencies or States in combating fraud, waste, and abuse in federallyfunded programs; and (6) to assist Federal agencies in responding to security breaches of information contained in NPPES. We have provided background information about the system in the SUPPLEMENTARY INFORMATION section below. Although the Privacy Act requires only that CMS provide an opportunity for interested persons to comment on the proposed routine uses, CMS invites comments on all portions of this notice. See ‘‘Effective Dates’’ section for comment period. DATES: Effective 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 May 25, 2010. 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. The public should address comments to: CMS Privacy Officer, Division of Information Security and Privacy Management, Enterprise Architecture and Strategy Group, Office of Information Services, CMS, Room N2–24–08, 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. erowe on DSK5CLS3C1PROD with NOTICES ADDRESSES: VerDate Mar<15>2010 15:41 May 28, 2010 Jkt 220001 II. Agency Policies, Procedures, and Restrictions on Routine Use individually-identifiable data may be disclosed under a routine use. We will only disclose the minimum personal data necessary to achieve the purpose of NPPES. CMS has the following policies and procedures concerning disclosures of information that is maintained in the system. Disclosure of information from the system will be approved only to the extent necessary to accomplish the purpose of the disclosure and only after CMS: 1. Determines that the use or disclosure is consistent with the reason that the data is being collected; e.g., maintain information to uniquely identify an individual physician or nonphysician practitioner, assign a National Provider Identifier (NPI) to that physician or non-physician practitioner, and maintain and update information about that physician or non-physician. 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 or disclosure of the record; b. Remove or destroy at the earliest time all individually-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. A. Agency Policies, Procedures, and Restrictions on the Routine Use III. Proposed Routine Use Disclosures of Data in the System 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 NPPES information that can be associated with an individual as provided for under ‘‘Section III. Proposed Routine Use Disclosures of Data in the System.’’ Both individually identifiable and non- 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: FOR FURTHER INFORMATION CONTACT: Patricia Peyton, Office of Financial Management, Program Integrity Staff, Division of Provider/Supplier Enrollment, Centers for Medicare & Medicaid Services, 7500 Security Boulevard, Mail Stop C3–02–16, Baltimore, Maryland 21244–1850. The telephone number is 410–786–1812 or contact Patricia.Peyton@cms.hhs.gov. SUPPLEMENTARY INFORMATION: I. Description of the Modified or Altered System of Records A. Statutory and Regulatory Basis for this SOR Authority for maintenance of this system is given under §§ 1173 and 1175 of the Act; as amended by Public Law 104–191, authorize the assignment of a unique identifier to all health care providers and the maintenance of a data base containing the information they furnished in their application for an NPI. B. Collection and Maintenance of Data in the System For purposes of this SOR, the system contains information related to health care providers who are individuals who have applied for and have been assigned a NPI. The definition of a health care provider is limited to those entities that furnish or bill and are paid for, health care services in the normal course of business. The statutory definition of a health care provider is found at 45 CFR 160.103. The system contains name(s), demographic information, (gender, date of birth), provider taxonomy information, address data, contact information, practice location information, and certain optional information such as social security numbers and provider identifiers assigned to these health care providers by health plans. PO 00000 Frm 00049 Fmt 4703 Sfmt 4703 E:\FR\FM\01JNN1.SGM 01JNN1 erowe on DSK5CLS3C1PROD with NOTICES Federal Register / Vol. 75, No. 104 / Tuesday, June 1, 2010 / Notices 1. To support Agency contractors (such as the NPI Enumerator contractor), consultants, or grantees that have been contracted by the Agency to assist in accomplishment of a CMS function relating to the purposes for this system and who need access to the records in order to assist CMS. We contemplate disclosing information under this routine use only in situations in which CMS may enter into a contractual or similar agreement with a third party to assist in accomplishing a 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, consultant, or grantee 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 or consultant to return or destroy all information at the completion of the contract. 2. To assist another Federal or State agency, agency of a State government, agency established by State law, or its fiscal agent to identify health care providers for debt collection under the provisions of the Debt Collection Information Act of 1996 and the Balanced Budget Act of 1997. 3. Federal or State agencies, agencies of State governments, agencies established by State law, or their fiscal agents may need NPPES data to assist them in collecting debts from health care providers as authorized by the Debt Collection Information Act of 1996 and the Balanced Budget Act of 1997. To assist 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 of 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. VerDate Mar<15>2010 15:41 May 28, 2010 Jkt 220001 Whenever CMS is involved in litigation, or occasionally when another party is involved in litigation and CMS’s policies or operations could be affected by the outcome of the litigation, CMS would be able to disclose information to the DOJ, court, or adjudicatory body involved. 4. To support a CMS contractor that assists in the administration of a CMSadministered 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 programs. 5. 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, or 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 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. 6. To support another Federal agency or 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 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 NPPES information for the purpose of combating fraud, waste, or abuse in such Federally-funded programs. 7. To assist appropriate Federal agencies and Department contractors that have a need to know the information for the purpose of assisting the Department’s efforts to respond to a suspected or confirmed breach of the security or confidentiality of information maintained in this system PO 00000 Frm 00050 Fmt 4703 Sfmt 4703 30413 of records, and the information disclosed is relevant and unnecessary for the assistance. Other Federal agencies and contractors may require NPPES information for the purpose of assisting in a response to a suspected or confirmed breach of the security or confidentiality of information. 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 to maintain the confidentiality of protected information. 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 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 physicians and non-physician practitioners 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 E:\FR\FM\01JNN1.SGM 01JNN1 30414 Federal Register / Vol. 75, No. 104 / Tuesday, June 1, 2010 / Notices PURPOSE(S) OF THE SYSTEM: disclosure from the proposed system only with consent of the subject individual, or his/her legal representative, 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: May 25, 2010. Michelle Snyder, Deputy Chief Operating Officer, Centers for Medicare & Medicaid Services. SYSTEM NUMBER: 09–70–0555 SYSTEM NAME: ‘‘National Plan and Provider Enumeration System’’ (NPPES), 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. CATEGORIES OF INDIVIDUALS COVERED BY THE SYSTEM: For purposes of this SOR, the system contains information related to health care providers who are individuals who have applied for and have been assigned a NPI. The definition of a health care provider is limited to those entities that furnish or bill and are paid for, health care services in the normal course of business. The statutory definition of a health care provider is found at 45 CFR 160.103. CATEGORIES OF RECORDS IN THE SYSTEM: The system contains name(s), demographic information, (gender, date of birth), provider taxonomy information, address data, contact information, practice location information, and certain optional information such as social security numbers and provider identifiers assigned to these health care providers by health plans. erowe on DSK5CLS3C1PROD with NOTICES AUTHORITY FOR MAINTENANCE OF THE SYSTEM: Authority for maintenance of this system is given under §§ 1173 and 1175 of the Act; as amended by Public Law 104–191, authorize the assignment of a unique identifier to all health care providers and the maintenance of a data base on containing the information they furnished in their application for an NPI. VerDate Mar<15>2010 15:41 May 28, 2010 Jkt 220001 The purpose of the NPPES is to collect and maintain, on behalf of the Secretary, information needed to uniquely identify an individual physician or non-physician practitioner, assign a National Provider Identifier (NPI) to that physician or non-physician practitioner, and maintain and update the information in that health care provider’s record in NPPES. Information maintained in this system will also be disclosed to: (1) Support the NPI Enumerator and other agency contractors who need NPPES data to perform their contractual requirements; (2) to assist Federal and State agencies to identify health care providers for debt collection under Federal statutes; (3) to assist the Department of Justice in litigation; (4) to support CMS contractors in combating fraud, waste, and abuse in CMS-administered health benefits programs; (5) to support other Federal agencies or States in combating fraud, waste, and abuse in federallyfunded programs; and (6) to assist Federal agencies in responding to security breaches of information contained in NPPES. 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 (such as the NPI Enumerator contractor), consultants, or grantees that have been contracted by the Agency to assist in accomplishment of a CMS function relating to the purposes for this system and who need access to the records in order to assist CMS. 2. To assist another Federal or State agency, agency of a State government, agency established by State law, or its fiscal agent to identify health care providers for debt collection under the provisions of the Debt Collection Information Act of 1996 and the Balanced Budget Act of 1997. 3. To assist 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 PO 00000 Frm 00051 Fmt 4703 Sfmt 4703 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. 4. To support a CMS contractor that assists in the administration of a CMSadministered 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 programs. 5. To support 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 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. 6. To assist appropriate Federal agencies and Department contractors that have a need to know the information for the purpose of assisting the Department’s efforts to respond to a suspected or confirmed breach of the security or confidentiality of information maintained in this system of records, and the information disclosed is relevant and unnecessary for the assistance. 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 health care provider or the NPI. Paper records are retrieved alphabetically by name of health care provider or the NPI. SAFEGUARDS: CMS has safeguards in place for authorized users and monitors such E:\FR\FM\01JNN1.SGM 01JNN1 Federal Register / Vol. 75, No. 104 / Tuesday, June 1, 2010 / Notices 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 to maintain the confidentiality of protected information. 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: Procedures above are applicable to subject individuals. Other requestors must write to the system manager and specify the record contents being sought. (These procedures are in accordance with Department regulation 45 CFR 5b.5 (a)(2).) CONTESTING RECORD PROCEDURES: The subject individual should contact the system manager named above, and reasonably identify the record and specify the information to be contested. State the corrective action sought and the reasons for the correction with supporting justification. (These procedures are in accordance with Department regulation 45 CFR 5b.7.) RECORD SOURCE CATEGORIES: Information contained in this system is received from the Form(s) CMS– 10114, ‘‘National Provider Identifier Application/Update Form.’’ SYSTEMS EXEMPTED FROM CERTAIN PROVISIONS OF THE ACT: None. [FR Doc. 2010–12996 Filed 5–28–10; 8:45 am] BILLING CODE 4120–03–P DEPARTMENT OF HOMELAND SECURITY Federal Emergency Management Agency CMS will retain identifiable data indefinitely in accordance with 69 FR 3434. [Internal Agency Docket No. FEMA–3310– EM; Docket ID FEMA–2010–0002] SYSTEM MANAGERS AND ADDRESS: Director, Division of Provider/ Supplier Enrollment, Office of Financial Management, CMS, 7500 Security Boulevard, Baltimore, Maryland 21244– 1850. erowe on DSK5CLS3C1PROD with NOTICES NOTIFICATION PROCEDURE: For purpose of access by a subject individual, the subject individual may access to view or update his or her own record in NPPES by using his or her NPPES User ID and password or the subject individual should write to the system manager who will require the system name, the subject individual’s SSN, and, for verification purposes, the subject individual’s name (woman’s maiden name, if applicable). NPPES data that are publicly available may be found in the NPI Registry at https:// nppes.cms.gov/NPPES/ NPIRegistryHome.do and in the downloadable monthly NPPES File at https://nppesdata.cms.gov/ CMS_NPI_files.html. RECORD ACCESS PROCEDURE: For purpose of access, the same procedures outlined in Notification VerDate Mar<15>2010 15:41 May 28, 2010 Jkt 220001 Minnesota; Amendment No. 1 to Notice of an Emergency Declaration AGENCY: Federal Emergency Management Agency, DHS. ACTION: Notice. SUMMARY: This notice amends the notice of an emergency declaration for the State of Minnesota (FEMA–3310–EM), dated March 19, 2010, and related determinations. DATES: Effective Date: April 26, 2010. FOR FURTHER INFORMATION CONTACT: Peggy Miller, Recovery Directorate, Federal Emergency Management Agency, 500 C Street, SW., Washington, DC 20472, (202) 646–3886. SUPPLEMENTARY INFORMATION: Notice is hereby given that the incident period for this emergency is closed effective April 26, 2010. (The following Catalog of Federal Domestic Assistance Numbers (CFDA) are to be used for reporting and drawing funds: 97.030, Community Disaster Loans; 97.031, Cora Brown Fund; 97.032, Crisis Counseling; 97.033, Disaster Legal Services; 97.034, Disaster Unemployment Assistance (DUA); PO 00000 Frm 00052 Fmt 4703 Sfmt 4703 30415 97.046, Fire Management Assistance Grant; 97.048, Disaster Housing Assistance to Individuals and Households in Presidentially Declared Disaster Areas; 97.049, Presidentially Declared Disaster Assistance— Disaster Housing Operations for Individuals and Households; 97.050, Presidentially Declared Disaster Assistance to Individuals and Households—Other Needs; 97.036, Disaster Grants—Public Assistance (Presidentially Declared Disasters); 97.039, Hazard Mitigation Grant.) W. Craig Fugate, Administrator, Federal Emergency Management Agency. [FR Doc. 2010–13047 Filed 5–28–10; 8:45 am] BILLING CODE 9111–23–P DEPARTMENT OF HOMELAND SECURITY Federal Emergency Management Agency [Internal Agency Docket No. FEMA–1898– DR; Docket ID FEMA–2010–0002] Pennsylvania; Amendment No. 1 to Notice of a Major Disaster Declaration AGENCY: Federal Emergency Management Agency, DHS. ACTION: Notice. SUMMARY: This notice amends the notice of a major disaster declaration for the Commonwealth of Pennsylvania (FEMA–1898–DR), dated April 16, 2010, and related determinations. DATES: Effective Date: May 24, 2010. FOR FURTHER INFORMATION CONTACT: Peggy Miller, Recovery Directorate, Federal Emergency Management Agency, 500 C Street, SW., Washington, DC 20472, (202) 646–3886. SUPPLEMENTARY INFORMATION: The notice of a major disaster declaration for the Commonwealth of Pennsylvania is hereby amended to include the following areas among those areas determined to have been adversely affected by the event declared a major disaster by the President in his declaration of April 16, 2010. All counties in the Commonwealth of Pennsylvania are eligible to apply for assistance under the Hazard Mitigation Grant Program. The following Catalog of Federal Domestic Assistance Numbers (CFDA) are to be used for reporting and drawing funds: 97.030, Community Disaster Loans; 97.031, Cora Brown Fund; 97.032, Crisis Counseling; 97.033, Disaster Legal Services; 97.034, Disaster Unemployment Assistance (DUA); 97.046, Fire Management Assistance Grant; 97.048, Disaster Housing Assistance to Individuals and Households in Presidentially Declared Disaster Areas; 97.049, Presidentially Declared Disaster Assistance— E:\FR\FM\01JNN1.SGM 01JNN1

Agencies

[Federal Register Volume 75, Number 104 (Tuesday, June 1, 2010)]
[Notices]
[Pages 30411-30415]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2010-12996]



[[Page 30411]]

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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).

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, CMS is proposing to modify or alter existing system of records 
titled ``National Provider System,'' System No. 09-70-0008. Under the 
authority of the Health Insurance Portability and Accountability Act of 
1996 (HIPAA) Public Law (Pub. L.) 104-191, this system was established 
and published in the Federal Register (FR) at 63 FR 40297 (July 28, 
1998). The system name ``National Provider System'' describes the 
original system designed to enumerate individual health care providers 
and maintain the information submitted in their application, the 
National Provider Identifier (NPI) Application/Update Form (Form CMS-
10114). Expectation of the adoption of a standard unique health 
identifier for health plans would broaden the function of the system to 
enable it to assign health plan identifiers to health plans; as a 
result, the name of the system is proposed to read: the ``National Plan 
and Provider Enumeration System (NPPES).'' Although the Federal 
Register Notice (July 28, 1998) stated that both organizational 
providers and providers who are individuals are included in the NPS 
database, and the system may be expanded in the future to include 
enumerated health plans, this system of records will be applicable only 
to the collection and maintenance of information about enumerated 
health care providers who are individuals (e.g., physicians and non-
physician practitioners), containing the information they submitted on 
their NPI applications and their assigned NPI.
    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. 09-70-0555.
    We propose to delete published routine use number 1 authorizing 
disclosure to Federal and Medicaid health plans that are enumerators 
and their agents. Published routine use number 1 will be deleted 
because the proposal to have Federal and Medicaid health plans serving 
as enumerators was not implemented.
    We propose to delete published routine use number 2 authorizing 
disclosures to entities implementing or maintaining systems and data 
files necessary for compliance with Title XI, Part C of the Social 
Security Act because the information necessary for this use is 
available in accordance with the NPS Data Dissemination Notice (CMS-
6060-N) published in the Federal Register on May 30, 2007.
    We propose to 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 delete published routine use number 4 authorizing 
disclosures to another Federal agency for use in processing research 
and statistical data related to the administration of its programs 
because the information from NPPES that would be used for this purpose 
is available in accordance with the Notice published in the Federal 
Register on May 30, 2007 (CMS-6060-N).
    We propose to delete published routine use number 6 authorizing 
disclosures to an individual or organization for a research, 
demonstration, evaluation, or epidemiological project because the 
information in NPPES that would be used for this purpose is available 
in accordance with the Notice published in the Federal Register on May 
30, 2007 (CMS-6060-N).
    We propose to delete published routine use number 7 authorizing 
disclosures to contractors for the purpose of refining ADP or 
telecommunication systems or supporting records in the system. 
Disclosures allowed by published routine use number 7 will be covered 
by a new routine use for contractors, consultants, or grantees who have 
been contracted by the Agency to assist with a CMS assigned task and 
who need access to the records in order to complete that task. The new 
routine use will be numbered as routine use number 1.
    We propose to delete routine use number 8 authorizing disclosures 
to an agency of the State government for purposes of determining 
effectiveness of health care services provided in the State because the 
information in NPPES that would be used for this purpose is available 
in accordance with the Notice published in the Federal Register on May 
30, 2007 (CMS-6060-N).
    We propose to delete in part routine use number 9 authorizing 
disclosures to another Federal or State agency to fulfill a Federal or 
State statute or regulation that implements a program funded in whole 
or in part with Federal funds because the information in NPPES that 
would be used for this purpose is available in accordance with the 
Notice published in the Federal Register on May 30, 2007 (CMS-6060-N). 
We retain routine use number 9 for purposes of identifying health care 
providers for Debt Collection Information Act of 1996 and the Balanced 
Budget Act of 1997 and include this as routine use number 2.
    Routine use number 5 authorizing disclosures to the Department of 
Justice, to a court or other tribunal, or to another party before such 
tribunal, is revised for clarity and is renumbered as routine use 
number 3.
    We have added two new routine uses for the purposes of combating 
fraud, waste, and abuse in CMS-administered health benefits programs 
and to support other Federal agencies, States, and local government 
agencies in combating fraud, waste, and abuse in programs funded in 
whole or in part by Federal funds. These two routine uses are routine 
use numbers 4 and 5.
    In addition, we propose to add a new routine use to disclose 
information maintained in this system to respond to a suspected or 
confirmed breach of the security or confidentiality of information 
maintained in the system. This new routine use will be numbered as 
routine use 6.
    The security classification previously reported as ``None'' will be 
modified to reflect that data in this system are considered to be 
``Level Three Privacy Act Sensitive.'' 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. We 
will also take the opportunity to update any sections of the System of 
Records Notice that were affected by the reorganization of CMS or to 
update language in the administrative sections to correspond with 
language used in other CMS SORs where appropriate.
    The purpose of the NPPES is to collect and maintain, on behalf of 
the Secretary, information needed to

[[Page 30412]]

uniquely identify an individual physician or non-physician 
practitioner, assign a National Provider Identifier (NPI) to that 
physician or non-physician practitioner, and maintain and update the 
information in that health care provider's record in NPPES. Information 
maintained in this system will also be disclosed to: (1) Support the 
NPI Enumerator and other agency contractors who need NPPES data to 
perform their contractual requirements; (2) to assist Federal and State 
agencies to identify health care providers for debt collection under 
Federal statutes; (3) to assist the Department of Justice in 
litigation; (4) to support CMS contractors in combating fraud, waste, 
and abuse in CMS-administered health benefits programs; (5) to support 
other Federal agencies or States in combating fraud, waste, and abuse 
in federally-funded programs; and (6) to assist Federal agencies in 
responding to security breaches of information contained in NPPES. We 
have provided background information about the system in the 
SUPPLEMENTARY INFORMATION section below. Although the Privacy Act 
requires only that CMS provide an opportunity for interested persons to 
comment on the proposed routine uses, CMS invites comments on all 
portions of this notice. See ``Effective Dates'' section for comment 
period.

DATES: Effective 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 May 25, 
2010. 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 Information Security and Privacy Management, Enterprise 
Architecture and Strategy Group, Office of Information Services, CMS, 
Room N2-24-08, 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: Patricia Peyton, Office of Financial 
Management, Program Integrity Staff, Division of Provider/Supplier 
Enrollment, Centers for Medicare & Medicaid Services, 7500 Security 
Boulevard, Mail Stop C3-02-16, Baltimore, Maryland 21244-1850. The 
telephone number is 410-786-1812 or contact 
Patricia.Peyton@cms.hhs.gov.

SUPPLEMENTARY INFORMATION:

I. Description of the Modified or Altered System of Records

A. Statutory and Regulatory Basis for this SOR

    Authority for maintenance of this system is given under Sec. Sec.  
1173 and 1175 of the Act; as amended by Public Law 104-191, authorize 
the assignment of a unique identifier to all health care providers and 
the maintenance of a data base containing the information they 
furnished in their application for an NPI.

B. Collection and Maintenance of Data in the System

    For purposes of this SOR, the system contains information related 
to health care providers who are individuals who have applied for and 
have been assigned a NPI. The definition of a health care provider is 
limited to those entities that furnish or bill and are paid for, health 
care services in the normal course of business. The statutory 
definition of a health care provider is found at 45 CFR 160.103.
    The system contains name(s), demographic information, (gender, date 
of birth), provider taxonomy information, address data, contact 
information, practice location information, and certain optional 
information such as social security numbers and provider identifiers 
assigned to these health care providers by health plans.

II. Agency Policies, Procedures, and Restrictions on 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 NPPES information that can be 
associated with an individual as provided for under ``Section III. 
Proposed Routine Use Disclosures of Data in the System.'' Both 
individually identifiable and non-individually-identifiable data may be 
disclosed under a routine use.
    We will only disclose the minimum personal data necessary to 
achieve the purpose of NPPES. CMS has the following policies and 
procedures concerning disclosures of information that is maintained in 
the system. Disclosure of information from the system will be approved 
only to the extent necessary to accomplish the purpose of the 
disclosure and only after CMS:
    1. Determines that the use or disclosure is consistent with the 
reason that the data is being collected; e.g., maintain information to 
uniquely identify an individual physician or non-physician 
practitioner, assign a National Provider Identifier (NPI) to that 
physician or non-physician practitioner, and maintain and update 
information about that physician or non-physician.
    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 or disclosure of the record;
    b. Remove or destroy at the earliest time all individually-
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:

[[Page 30413]]

    1. To support Agency contractors (such as the NPI Enumerator 
contractor), consultants, or grantees that have been contracted by the 
Agency to assist in accomplishment of a CMS function relating to the 
purposes for this system and who need access to the records in order to 
assist CMS.
    We contemplate disclosing information under this routine use only 
in situations in which CMS may enter into a contractual or similar 
agreement with a third party to assist in accomplishing a 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, consultant, or grantee 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 or consultant to return or 
destroy all information at the completion of the contract.
    2. To assist another Federal or State agency, agency of a State 
government, agency established by State law, or its fiscal agent to 
identify health care providers for debt collection under the provisions 
of the Debt Collection Information Act of 1996 and the Balanced Budget 
Act of 1997.
    3. Federal or State agencies, agencies of State governments, 
agencies established by State law, or their fiscal agents may need 
NPPES data to assist them in collecting debts from health care 
providers as authorized by the Debt Collection Information Act of 1996 
and the Balanced Budget Act of 1997. To assist 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 of litigation or has an 
interest in such litigation and, by careful review, CMS determines that 
the records are both relevant and necessary to the litigation and that 
the use of such records by the DOJ, court, or adjudicatory body is 
compatible with the purpose for which the agency collected the records.
    Whenever CMS is involved in litigation, or occasionally when 
another party is involved in litigation and CMS's policies or 
operations could be affected by the outcome of the litigation, CMS 
would be able to disclose information to the DOJ, court, or 
adjudicatory body involved.
    4. To support a CMS contractor 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 programs.
    5. 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, or 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 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.
    6. To support another Federal agency or 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 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 NPPES information for the purpose of 
combating fraud, waste, or abuse in such Federally-funded programs.
    7. To assist appropriate Federal agencies and Department 
contractors that have a need to know the information for the purpose of 
assisting the Department's efforts to respond to a suspected or 
confirmed breach of the security or confidentiality of information 
maintained in this system of records, and the information disclosed is 
relevant and unnecessary for the assistance.
    Other Federal agencies and contractors may require NPPES 
information for the purpose of assisting in a response to a suspected 
or confirmed breach of the security or confidentiality of information.

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 to maintain the confidentiality of protected 
information.
    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 physicians and non-physician practitioners 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

[[Page 30414]]

disclosure from the proposed system only with consent of the subject 
individual, or his/her legal representative, 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: May 25, 2010.
Michelle Snyder,
Deputy Chief Operating Officer, Centers for Medicare & Medicaid 
Services.
SYSTEM NUMBER: 09-70-0555

SYSTEM NAME:
    ``National Plan and Provider Enumeration System'' (NPPES), 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.

CATEGORIES OF INDIVIDUALS COVERED BY THE SYSTEM:
    For purposes of this SOR, the system contains information related 
to health care providers who are individuals who have applied for and 
have been assigned a NPI. The definition of a health care provider is 
limited to those entities that furnish or bill and are paid for, health 
care services in the normal course of business. The statutory 
definition of a health care provider is found at 45 CFR 160.103.

CATEGORIES OF RECORDS IN THE SYSTEM:
    The system contains name(s), demographic information, (gender, date 
of birth), provider taxonomy information, address data, contact 
information, practice location information, and certain optional 
information such as social security numbers and provider identifiers 
assigned to these health care providers by health plans.

AUTHORITY FOR MAINTENANCE OF THE SYSTEM:
    Authority for maintenance of this system is given under Sec. Sec.  
1173 and 1175 of the Act; as amended by Public Law 104-191, authorize 
the assignment of a unique identifier to all health care providers and 
the maintenance of a data base on containing the information they 
furnished in their application for an NPI.

PURPOSE(S) OF THE SYSTEM:
    The purpose of the NPPES is to collect and maintain, on behalf of 
the Secretary, information needed to uniquely identify an individual 
physician or non-physician practitioner, assign a National Provider 
Identifier (NPI) to that physician or non-physician practitioner, and 
maintain and update the information in that health care provider's 
record in NPPES. Information maintained in this system will also be 
disclosed to: (1) Support the NPI Enumerator and other agency 
contractors who need NPPES data to perform their contractual 
requirements; (2) to assist Federal and State agencies to identify 
health care providers for debt collection under Federal statutes; (3) 
to assist the Department of Justice in litigation; (4) to support CMS 
contractors in combating fraud, waste, and abuse in CMS-administered 
health benefits programs; (5) to support other Federal agencies or 
States in combating fraud, waste, and abuse in federally-funded 
programs; and (6) to assist Federal agencies in responding to security 
breaches of information contained in NPPES.

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 (such as the NPI Enumerator 
contractor), consultants, or grantees that have been contracted by the 
Agency to assist in accomplishment of a CMS function relating to the 
purposes for this system and who need access to the records in order to 
assist CMS.
    2. To assist another Federal or State agency, agency of a State 
government, agency established by State law, or its fiscal agent to 
identify health care providers for debt collection under the provisions 
of the Debt Collection Information Act of 1996 and the Balanced Budget 
Act of 1997.
    3. To assist 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.
    4. To support a CMS contractor 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 programs.
    5. To support 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 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.
    6. To assist appropriate Federal agencies and Department 
contractors that have a need to know the information for the purpose of 
assisting the Department's efforts to respond to a suspected or 
confirmed breach of the security or confidentiality of information 
maintained in this system of records, and the information disclosed is 
relevant and unnecessary for the assistance.

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 health care 
provider or the NPI. Paper records are retrieved alphabetically by name 
of health care provider or the NPI.

SAFEGUARDS:
    CMS has safeguards in place for authorized users and monitors such

[[Page 30415]]

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 to maintain the confidentiality of 
protected information.
    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 identifiable data indefinitely in accordance with 
69 FR 3434.

SYSTEM MANAGERS AND ADDRESS:
    Director, Division of Provider/Supplier Enrollment, Office of 
Financial Management, CMS, 7500 Security Boulevard, Baltimore, Maryland 
21244-1850.

NOTIFICATION PROCEDURE:
    For purpose of access by a subject individual, the subject 
individual may access to view or update his or her own record in NPPES 
by using his or her NPPES User ID and password or the subject 
individual should write to the system manager who will require the 
system name, the subject individual's SSN, and, for verification 
purposes, the subject individual's name (woman's maiden name, if 
applicable). NPPES data that are publicly available may be found in the 
NPI Registry at https://nppes.cms.gov/NPPES/NPIRegistryHome.do and in 
the downloadable monthly NPPES File at https://nppesdata.cms.gov/CMS_NPI_files.html.

RECORD ACCESS PROCEDURE:
    For purpose of access, the same procedures outlined in Notification 
Procedures above are applicable to subject individuals. Other 
requestors must write to the system manager and specify the record 
contents being sought. (These procedures are in accordance with 
Department regulation 45 CFR 5b.5 (a)(2).)

CONTESTING RECORD PROCEDURES:
    The subject individual should contact the system manager named 
above, and reasonably identify the record and specify the information 
to be contested. State the corrective action sought and the reasons for 
the correction with supporting justification. (These procedures are in 
accordance with Department regulation 45 CFR 5b.7.)

RECORD SOURCE CATEGORIES:
    Information contained in this system is received from the Form(s) 
CMS-10114, ``National Provider Identifier Application/Update Form.''

SYSTEMS EXEMPTED FROM CERTAIN PROVISIONS OF THE ACT:
    None.

[FR Doc. 2010-12996 Filed 5-28-10; 8:45 am]
BILLING CODE 4120-03-P
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