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