Privacy Act of 1974; System of Records, 79345-79348 [2010-31789]
Download as PDF
Federal Register / Vol. 75, No. 243 / Monday, December 20, 2010 / Notices
The Office of the Secretary of
Defense proposes to alter a system of
records in its inventory of record
systems subject to the Privacy Act of
1974 (5 U.S.C. 552a), as amended.
SUMMARY:
DEPARTMENT OF DEFENSE
Office of the Secretary
Closed Meeting of the Department of
Defense Wage Committee
Department of Defense.
Notice of closed meetings.
AGENCY:
ACTION:
Pursuant to the provisions of
section 10 of Public Law 92–463, the
Federal Advisory Committee Act, notice
is hereby given that closed meetings of
the Department of Defense Wage
Committee will be held.
DATES: January 11, 2011, and Tuesday,
January 25, 2011, at 10 a.m.
ADDRESSES: 1400 Key Boulevard, Level
A, Room A101, Rosslyn, Virginia.
FOR FURTHER INFORMATION CONTACT:
Chairman, Department of Defense Wage
Committee, 4000 Defense Pentagon,
Washington, DC 20301–4000.
SUPPLEMENTARY INFORMATION: Under the
provisions of section 10(d) of Public
Law 92–463, the Department of Defense
has determined that the meeting meets
the criteria to closed meetings to the
public because the matters to be
considered are related to internal rules
and practices of the Department of
Defense and the detailed wage data to be
considered were obtained from officials
of private establishments with a
guarantee that the data will be held in
confidence.
However, members of the public who
may wish to do so are invited to submit
material in writing to the chairman
concerning matters believed to be
deserving of the Committee’s attention.
Additional information concerning
the meetings may be obtained by writing
to the Chairman, Department of Defense
Wage Committee, 4000 Defense
Pentagon, Washington, DC 20301–4000.
SUMMARY:
Dated: December 14, 2010.
Morgan F. Park,
Alternate OSD Federal Register Liaison
Officer, Department of Defense.
[FR Doc. 2010–31790 Filed 12–17–10; 8:45 am]
BILLING CODE 5001–06–P
DEPARTMENT OF DEFENSE
Office of the Secretary
jlentini on DSKJ8SOYB1PROD with NOTICES
[Docket ID: DOD–2010–OS–0167]
Privacy Act of 1974; System of
Records
Office of the Secretary of
Defense, DoD.
ACTION: Notice to Alter a System of
Records
AGENCY:
VerDate Mar<15>2010
17:18 Dec 17, 2010
Jkt 223001
This proposed action would be
effective without further notice on
January 19, 2011 unless comments are
received which result in a contrary
determination.
DATES:
You may submit comments,
identified by docket number and/
Regulatory Information Number (RIN)
and title, by any of the following
methods:
• Federal Rulemaking Portal: https://
www.regulations.gov.Follow the
instructions for submitting comments.
• Mail: Federal Docket Management
System Office, Room 3C843, 1160
Defense Pentagon, Washington, DC
20301–1160.
Instructions: All submissions received
must include the agency name and
docket number or Regulatory
Information Number (RIN) for this
Federal Register document. The general
policy for comments and other
submissions from members of the public
is to make these submissions available
for public viewing on the Internet at
https://www.regulations.gov as they are
received without change, including any
personal identifiers or contact
information.
ADDRESSES:
FOR FURTHER INFORMATION CONTACT:
Chief, OSD/JS Privacy Office, Freedom
of Information Directorate, Washington
Headquarters Services, 1155 Defense
Pentagon, Washington, DC 20301–1155,
or Ms. Cindy Allard at (703) 588–6830.
The Office
of the Secretary of Defense notices for
systems of records subject to the Privacy
Act of 1974 (5 U.S.C. 552a), as amended,
have been published in the Federal
Register and are available from the FOR
FURTHER INFORMATION CONTACT address
above. The proposed system report, as
required by 5 U.S.C. 552a(r) of the
Privacy Act of 1974, as amended, was
submitted on December 10, 2010, to the
House Committee on Oversight and
Government Reform, the Senate
Committee on Governmental Affairs,
and the Office of Management and
Budget (OMB) pursuant to paragraph 4c
of Appendix I to OMB Circular No. A–
130, ‘‘Federal Agency Responsibilities
for Maintaining Records About
Individuals,’’ dated February 8, 1996
(February 20, 1996, 61 FR 6427).
SUPPLEMENTARY INFORMATION:
PO 00000
Frm 00012
Fmt 4703
Sfmt 4703
79345
Dated: December 10, 2010.
Morgan F. Park,
Alternate OSD Federal Register Liaison
Officer, Department of Defense.
DHA 12
SYSTEM NAME:
Third Party Collection System (March
29, 2005, 70 FR 15847).
CHANGES:
SYSTEM LOCATION:
Delete entry and replace with
‘‘Defense Health Services Systems, Suite
1599, 5203 Leesburg Pike, Falls Church,
VA 22041–3891.’’
CATEGORIES OF INDIVIDUALS COVERED BY THE
SYSTEM:
Delete entry and replace with
‘‘Members of the uniformed services
(and their dependents) and retired
military members (and their
dependents) who receive or have
received health services approved by
the Department of Defense, contractors
participating in military deployments or
related operations who receive or have
received medical or dental care at a
military treatment facility, Department
of Defense civilian employees (to
include non-appropriated fund
employees) who receive or have
received medical or dental care at a
military treatment facility, and other
individuals who receive or have
received medical or dental care at a
military treatment facility.’’
CATEGORIES OF RECORDS IN THE SYSTEM:
Delete entry and replace with
‘‘Individual Data: This includes patient
name, Social Security Number (SSN)(or
foreign identification), whether
treatment was outpatient or inpatient,
outpatient visit date and time, date of
birth, mailing address, home telephone
number, family member prefix, and
relationship to policy holder; sponsor or
insurance policy holder name, Social
Security Number (SSN), and date of
birth; other covered family member
name(s), Social Security Number (SSN),
and date(s) of birth; and, if applicable,
Medicare and Medicaid coverage data.
INSURANCE POLICY INFORMATION DATA:
This includes policy number or
identification, card holder
identification, group number, group
name, enrollment plan/code, policy
effective date, policy category, policy
end date, insurance company name,
address and telephone number,
insurance type, policy holder, whether
policy holder is insured through their
employer, and drug coverage data
regarding authority to bill for
pharmaceuticals.
E:\FR\FM\20DEN1.SGM
20DEN1
79346
Federal Register / Vol. 75, No. 243 / Monday, December 20, 2010 / Notices
EMPLOYER INFORMATION DATA:
This includes employer name,
address, and telephone number.
BILLING INFORMATION DATA:
This includes bill type (military
treatment facility, clinic, pharmacy,
laboratory/radiology, ambulance), name
and location of military treatment
facility, whether treatment was
outpatient or inpatient, outpatient visit
date and time, inpatient admission and
discharge dates and time, patient
identification number, patient name,
provider code/description, office visit
code description, Medical Expense and
Performance Reporting System code/
description, diagnosis code/description,
billing amount, user who created the
bill, date bill was created, and status of
bill and source of billing data.
ACCOUNTING INFORMATION DATA:
This includes control number,
transaction code, debit amount, credit
amount, check number, Batch posting
number, balance, patient identification,
patient name, encounter date,
comments, entry date and follow-up
date.
INSURANCE COMPANY DATA:
This contains tables for insurance
company, policy, provider, fees, codes,
rates, and procedure maintenance.’’
AUTHORITY FOR MAINTENANCE OF THE SYSTEM:
Delete entry and replace with ‘‘10
U.S.C. 1095, Health care services
incurred on behalf of covered
beneficiaries: collection from third-party
payers; 10 U.S.C. 1079b, Procedures for
charging fees for care provided to
civilians; retention and use of fees
collected; 42 U.S.C. Chapter 32, ‘‘Third
Party Liability For Hospital and Medical
Care;’’ 28 CFR Part 43, ‘‘Recovery of
Costs of Hospital and Medical Care and
Treatment Furnished by the United
States;’’ 45 CFR parts 160 and 164,
Health and Human Services, General
Administrative Requirements and
Security & Privacy; 32 CFR part 220,
Collection from Third Party Payers of
Reasonable Charges for Healthcare
Services; DoD 6010.15–M, Chapter 3,
Medical Services Account; and E.O.
9397 (SSN), as amended.’’
jlentini on DSKJ8SOYB1PROD with NOTICES
PURPOSE(S):
Delete entry and replace with ‘‘To
establish a standard patient accounting
system for health care billing practices.
It shall assist military treatment
facilities in the collection, tracking, and
reporting of data required for the
Department of Defense Third Party
Collection Program billing process by
the adoption of standard commercial
VerDate Mar<15>2010
17:18 Dec 17, 2010
Jkt 223001
medical coding and billing practices to
military treatment facilities.
The Defense Finance Accounting
Service (DFAS) uses this information to
bill person(s) or organization(s) liable
for payment on behalf those receiving
care at a military treatment facility.’’
ROUTINE USES OF RECORDS MAINTAINED IN THE
SYSTEM, INCLUDING CATEGORIES OF USERS AND
THE PURPOSES OF SUCH USES:
Delete entry and replace with ‘‘In
addition to those disclosures generally
permitted under 5 U.S.C. 552a(b) of the
Privacy Act of 1974, as amended, these
records may specifically be disclosed
outside the Department of Defense as a
routine use pursuant to 5 U.S.C.
552a(b)(3) as follows:
To interface with all commercial
insurance carriers and parties against
whom recovery has been sought by the
Department of Defense Military Health
System, as well as all parties involved
in support of the collection activities for
health care approved by the Department
of Defense.
To the National Data Clearinghouse,
an electronic healthcare clearinghouse,
for purposes of converting the data to an
industry-wide format prior to
forwarding the billing information to the
insurance companies for payment.
The DoD ‘Blanket Routine Uses’ set
forth at the beginning of Office of the
Secretary of Defense’s compilation of
systems of records notices apply to this
system.
Note 1: This system of records contains
individually identifiable health information.
The Department of Defense Health
Information Privacy Regulation (DoD
6025.18–R) issued pursuant to the Health
Insurance Portability and Accountability Act
of 1996, applies to most such health
information. DoD 6025.18–R may place
additional procedural requirements on the
uses and disclosures of such information
beyond what is found in the Privacy Act of
1974 or mentioned in this system of records
notice.
Note 2: Personal identity, diagnosis,
prognosis or treatment information of any
patient maintained in connection with the
performance of any program or activity
relating to substance abuse education,
prevention, training, treatment,
rehabilitation, or research, which is
conducted, regulated, or directly or indirectly
assisted by any department or agency of the
United States is, except as per 42 U.S.C.
290dd–2, treated as confidential and
disclosed only for the purposes and under
the circumstances expressly authorized
under 42 U.S.C. 290dd–2.’’
PO 00000
Frm 00013
Fmt 4703
Sfmt 4703
POLICIES AND PRACTICES FOR STORING,
RETRIEVING, ACCESSING, RETAINING, AND
DISPOSING OF RECORDS IN THE SYSTEM:
STORAGE:
Delete entry and replace with ‘‘Paper
file folders and electronic storage
media.’’
RETRIEVABILITY:
Delete entry and replace with
‘‘Records are retrieved by the sponsor or
patient name, Social Security Number
(SSN), Department of Defense Benefits
Number, third party payer identification
number assigned to individual, family
member prefix (a two-digit code
identifying the person’s relationship to
the Military Sponsor), and/or Patient
Control Number.’’
SAFEGUARDS:
Delete entry and replace with
‘‘Physical access to system location
restricted by cipher locks, visitor escort,
access rosters, and photo identification.
Adequate locks on doors and server
components secured in a locked
computer room with limited access.
Each system end user device protected
within a locked storage container, room,
or building outside of normal business
hours. All visitors and other persons
that require access to facilities that
house servers and other network devices
supporting the system that do not have
authorization for access escorted by
appropriately screened/cleared
personnel at all times.
Access to the system is role-based and
a valid user account is required. The
system provides two-factor
authentication, using either a Common
Access Card and Personal Identification
Number or a unique logon identification
and password. Where a unique logon
identification and password is used,
passwords must be renewed every sixty
(60) days. Authorized personnel must
have appropriate Information Assurance
training, Health Insurance Portability
and Accountability Act training, and
Privacy Act of 1974 training.’’
RETENTION AND DISPOSAL:
Delete entry and replace with
‘‘Records are destroyed five years after
the end of the year in which the record
was closed.’’
SYSTEM MANAGER(S) AND ADDRESS:
Delete entry and replace with
‘‘Program Manager, Defense Health
Services Systems, Suite 1500, 5203
Leesburg Pike, Falls Church, VA 22041–
3891.’’
NOTIFICATION PROCEDURE:
Delete entry and replace with
‘‘Individuals seeking to determine
E:\FR\FM\20DEN1.SGM
20DEN1
Federal Register / Vol. 75, No. 243 / Monday, December 20, 2010 / Notices
whether this system contains
information about themselves should
address written inquires to the
TRICARE Management Activity,
Department of Defense, ATTN: TMA
Privacy Officer, Suite 810, 5111
Leesburg Pike, Falls Church VA 22041–
3206.
Request should contain participant’s
and/or sponsor’s full name, their Social
Security Number (SSN), and current
address and telephone number and the
names of the military treatment facility
or facilities in which they have received
medical treatment.
If requesting health information of a
minor (or legally incompetent person),
the request must be made by a custodial
parent, legal guardian, or party acting in
loco parentis of such individual(s).
Written proof of the capacity of the
requestor may be required.’’
RECORD ACCESS PROCEDURES:
Delete entry and replace with
‘‘Individuals seeking access to records
about themselves contained in this
system should address written inquiries
to TRICARE Management Activity,
Attention: Freedom of Information Act
Requester Service Center, 16401 East
Centretech Parkway, Aurora, CO 80011–
9066.
Requests should contain participant’s
and/or sponsor’s full name, their Social
Security Number (SSN), and current
address and telephone number and the
names of the military treatment facility
or facilities in which they have received
medical treatment.
If requesting health information of a
minor (or legally incompetent person),
the request must be made by a custodial
parent, legal guardian, or party acting in
loco parentis of such individual(s).
Written proof of the capacity of the
requestor may be required.’’
CONTESTING RECORD PROCEDURES:
Delete entry and replace with ‘‘The
Office of the Secretary of Defense rules
for accessing records, for contesting
contents and appealing initial agency
determinations are published in Office
of the Secretary of Defense
Administrative Instruction 81 (32 CFR
part 311) or may be obtained from the
system manager.’’
jlentini on DSKJ8SOYB1PROD with NOTICES
RECORD SOURCE CATEGORIES:
Delete entry and replace with
‘‘Information is obtained from an
automated medical records system, the
Composite Health Care System
(specifically, the Ambulatory Data
Module), which is automatically sent to
the Third Party Collection System.
Other information may be obtained from
VerDate Mar<15>2010
17:18 Dec 17, 2010
Jkt 223001
the AHLTA System and the Theater
Data Medical Stores System.’’
*
*
*
*
*
DHA 12
SYSTEM NAME:
Third Party Collection System.
SYSTEM LOCATION:
Defense Health Services Systems,
Suite 1599, 5203 Leesburg Pike, Falls
Church, VA 22041–3891.
CATEGORIES OF INDIVIDUALS COVERED BY THE
SYSTEM:
Members of the uniformed services
(and their dependents) and retired
military members (and their
dependents) who receive or have
received health services approved by
the Department of Defense, contractors
participating in military deployments or
related operations who receive or have
received medical or dental care at a
military treatment facility, Department
of Defense civilian employees (to
include non-appropriated fund
employees) who receive or have
received medical or dental care at a
military treatment facility, and other
individuals who receive or have
received medical or dental care at a
military treatment facility.
CATEGORIES OF RECORDS IN THE SYSTEM:
INDIVIDUAL DATA:
This includes patient name, Social
Security Number (SSN) (or foreign
identification), whether treatment was
outpatient or inpatient, outpatient visit
date and time, date of birth, mailing
address, home telephone number,
family member prefix, and relationship
to policy holder; sponsor or insurance
policy holder name, Social Security
Number (SSN), and date of birth; other
covered family member name(s), Social
Security Number (SSN), and date of
birth; and, if applicable, Medicare and
Medicaid coverage data.
INSURANCE POLICY INFORMATION DATA:
This includes policy number or
identification, card holder
identification, group number, group
name, enrollment plan/code, policy
effective date, policy category, policy
end date, insurance company name,
address and telephone number,
insurance type, policy holder, whether
policy holder is insured through their
employer, and drug coverage data
regarding authority to bill for
pharmaceuticals.
EMPLOYER INFORMATION DATA:
This includes employer name,
address, and telephone number.
PO 00000
Frm 00014
Fmt 4703
Sfmt 4703
79347
BILLING INFORMATION DATA:
This includes bill type (military
treatment facility, clinic, pharmacy,
laboratory/radiology, ambulance), name
and location of military treatment
facility, whether treatment was
outpatient or inpatient, outpatient visit
date and time, inpatient admission and
discharge dates and time, patient
identification number, patient name,
provider code/description, office visit
code description, Medical Expense and
Performance Reporting System code/
description, diagnosis code/description,
billing amount, user who created the
bill, date bill was created, and status of
bill and source of billing data.
ACCOUNTING INFORMATION DATA:
This includes control number,
transaction code, debit amount, credit
amount, check number, Batch posting
number, balance, patient identification,
patient name, encounter date,
comments, entry date and follow-up
date.
INSURANCE COMPANY DATA:
This contains tables for insurance
company, policy, provider, fees, codes,
rates, and procedure maintenance.
AUTHORITY FOR MAINTENANCE OF THE SYSTEM:
10 U.S.C. 1095, Health care services
incurred on behalf of covered
beneficiaries: collection from third-party
payers; 10 U.S.C. 1079b, Procedures for
charging fees for care provided to
civilians; retention and use of fees
collected; 42 U.S.C. Chapter 32, ‘‘Third
Party Liability For Hospital and Medical
Care;’’ 28 CFR part 43, ‘‘Recovery of
Costs of Hospital and Medical Care and
Treatment Furnished by the United
States;’’ 45 CFR parts 160 and 164,
Health and Human Services, General
Administrative Requirements and
Security & Privacy; 32 CFR part 220,
Collection from Third Party Payers of
Reasonable Charges for Healthcare
Services; DoD 6010.15–M, Chapter 3,
Medical Services Account; and E.O.
9397 (SSN), as amended.
PURPOSE(S):
To establish a standard patient
accounting system for health care billing
practices. It shall assist military
treatment facilities in the collection,
tracking, and reporting of data required
for the Department of Defense Third
Party Collection Program billing process
by the adoption of standard commercial
medical coding and billing practices to
military treatment facilities.
The Defense Finance Accounting
Service (DFAS) uses this information to
bill person(s) or organization(s) liable
for payment on behalf those receiving
care at a military treatment facility.
E:\FR\FM\20DEN1.SGM
20DEN1
79348
Federal Register / Vol. 75, No. 243 / Monday, December 20, 2010 / Notices
ROUTINE USES OF RECORDS MAINTAINED IN THE
SYSTEM, INCLUDING CATEGORIES OF USERS AND
THE PURPOSES OF SUCH USES:
In addition to those disclosures
generally permitted under 5 U.S.C.
552a(b) of the Privacy Act, as amended,
these records may specifically be
disclosed outside the Department of
Defense as a routine use pursuant to 5
U.S.C. 552a(b)(3) as follows:
To interface with all commercial
insurance carriers and parties against
whom recovery has been sought by the
Department of Defense Military Health
System, as well as all parties involved
in support of the collection activities for
health care approved by the Department
of Defense.
To the National Data Clearinghouse,
an electronic healthcare clearinghouse,
for purposes of converting the data to an
industry-wide format prior to
forwarding the billing information to the
insurance companies for payment.
The DoD ‘Blanket Routine Uses’ set
forth at the beginning of Office of the
Secretary of Defense’s compilation of
systems of records notices apply to this
system.
Note 1: This system of records contains
individually identifiable health information.
The Department of Defense Health
Information Privacy Regulation (DoD
6025.18–R) issued pursuant to the Health
Insurance Portability and Accountability Act
of 1996, applies to most such health
information. DoD 6025.18–R may place
additional procedural requirements on the
uses and disclosures of such information
beyond what is found in the Privacy Act of
1974 or mentioned in this system of records
notice.
Note 2: Personal identity, diagnosis,
prognosis or treatment information of any
patient maintained in connection with the
performance of any program or activity
relating to substance abuse education,
prevention, training, treatment,
rehabilitation, or research, which is
conducted, regulated, or directly or indirectly
assisted by any department or agency of the
United States is, except as per 42 U.S.C.
290dd–2, treated as confidential and
disclosed only for the purposes and under
the circumstances expressly authorized
under 42 U.S.C. 290dd–2.
POLICIES AND PRACTICES FOR STORING,
RETRIEVING, ACCESSING, RETAINING, AND
DISPOSING OF RECORDS IN THE SYSTEM:
jlentini on DSKJ8SOYB1PROD with NOTICES
STORAGE:
Paper file folders and electronic
storage media.
RETRIEVABILITY:
Records are retrieved by the sponsor
or patient name, Social Security
Number, Department of Defense
Benefits Number, third party payer
identification number assigned to
VerDate Mar<15>2010
17:18 Dec 17, 2010
Jkt 223001
individual, family member prefix (a
two-digit code identifying the person’s
relationship to the Military Sponsor),
and/or Patient Control Number.
SAFEGUARDS:
Physical access to system location
restricted by cipher locks, visitor escort,
access rosters, and photo identification.
Adequate locks on doors and server
components secured in a locked
computer room with limited access.
Each system end user device protected
within a locked storage container, room,
or building outside of normal business
hours. All visitors and other persons
that require access to facilities that
house servers and other network devices
supporting the system that do not have
authorization for access escorted by
appropriately screened/cleared
personnel at all times.
Access to the system is role-based and
a valid user account is required. The
system provides two-factor
authentication, using either a Common
Access Card and Personal Identification
Number or a unique logon identification
and password. Where a unique logon
identification and password is used,
passwords must be renewed every sixty
(60) days. Authorized personnel must
have appropriate Information Assurance
training, Health Insurance Portability
and Accountability Act training, and
Privacy Act of 1974 training.
RETENTION AND DISPOSAL:
Records are destroyed five years after
the end of the year in which the record
was closed.
SYSTEM MANAGER(S) AND ADDRESS:
Program Manager, Defense Health
Services Systems, Suite 1500, 5203
Leesburg Pike, Falls Church, VA 22041–
3891.
NOTIFICATION PROCEDURE:
Individuals seeking to determine
whether this system contains
information about themselves should
address written inquires to the
TRICARE Management Activity,
Department of Defense, ATTN: TMA
Privacy Officer, Suite 810, 5111
Leesburg Pike, Falls Church, VA 22041–
3206.
Request should contain participant’s
and/or sponsor’s full name, their Social
Security Number (SSN), and current
address and telephone number and the
names of the military treatment facility
or facilities in which they have received
medical treatment.
If requesting health information of a
minor (or legally incompetent person),
the request must be made by a custodial
parent, legal guardian, or party acting in
PO 00000
Frm 00015
Fmt 4703
Sfmt 4703
loco parentis of such individual(s).
Written proof of the capacity of the
requestor may be required.
RECORD ACCESS PROCEDURES:
Individuals seeking access to records
about themselves contained in this
system should address written inquiries
to TRICARE Management Activity,
Attention: Freedom of Information Act
Requester Service Center, 16401 East
Centretech Parkway, Aurora, CO 80011–
9066.
Requests should contain participant’s
and/or sponsor’s full name, their Social
Security Number (SSN), and current
address and telephone number and the
names of the military treatment facility
or facilities in which they have received
medical treatment.
If requesting health information of a
minor (or legally incompetent person),
the request must be made by a custodial
parent, legal guardian, or party acting in
loco parentis of such individual(s).
Written proof of the capacity of the
requestor may be required.
CONTESTING RECORD PROCEDURES:
The Office of the Secretary of Defense
rules for accessing records, for
contesting contents and appealing
initial agency determinations are
published in Office of the Secretary of
Defense Administrative Instruction 81
(32 CFR part 311) or may be obtained
from the system manager.
RECORD SOURCE CATEGORIES:
Information is obtained from an
automated medical records system, the
Composite Health Care System
(specifically, the Ambulatory Data
Module), which is automatically sent to
the Third Party Collection System.
Other information may be obtained from
the AHLTA System and the Theater
Data Medical Stores System.
EXEMPTIONS CLAIMED FOR THE SYSTEM:
None.
[FR Doc. 2010–31789 Filed 12–17–10; 8:45 am]
BILLING CODE 5001–06–P
DEPARTMENT OF DEFENSE
Office of the Secretary
TRICARE; Formerly Known as the
Civilian Health and Medical Program of
the Uniformed Services (CHAMPUS);
Fiscal Year 2011 Diagnosis-Related
Group (DRG) Updates
Office of the Secretary, DoD.
Notice of DRG revised rates.
AGENCY:
ACTION:
This notice describes the
changes made to the TRICARE DRG-
SUMMARY:
E:\FR\FM\20DEN1.SGM
20DEN1
Agencies
[Federal Register Volume 75, Number 243 (Monday, December 20, 2010)]
[Notices]
[Pages 79345-79348]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2010-31789]
-----------------------------------------------------------------------
DEPARTMENT OF DEFENSE
Office of the Secretary
[Docket ID: DOD-2010-OS-0167]
Privacy Act of 1974; System of Records
AGENCY: Office of the Secretary of Defense, DoD.
ACTION: Notice to Alter a System of Records
-----------------------------------------------------------------------
SUMMARY: The Office of the Secretary of Defense proposes to alter a
system of records in its inventory of record systems subject to the
Privacy Act of 1974 (5 U.S.C. 552a), as amended.
DATES: This proposed action would be effective without further notice
on January 19, 2011 unless comments are received which result in a
contrary determination.
ADDRESSES: You may submit comments, identified by docket number and/
Regulatory Information Number (RIN) and title, by any of the following
methods:
Federal Rulemaking Portal: https://www.regulations.gov.Follow the instructions for submitting comments.
Mail: Federal Docket Management System Office, Room 3C843,
1160 Defense Pentagon, Washington, DC 20301-1160.
Instructions: All submissions received must include the agency name
and docket number or Regulatory Information Number (RIN) for this
Federal Register document. The general policy for comments and other
submissions from members of the public is to make these submissions
available for public viewing on the Internet at https://www.regulations.gov as they are received without change, including any
personal identifiers or contact information.
FOR FURTHER INFORMATION CONTACT: Chief, OSD/JS Privacy Office, Freedom
of Information Directorate, Washington Headquarters Services, 1155
Defense Pentagon, Washington, DC 20301-1155, or Ms. Cindy Allard at
(703) 588-6830.
SUPPLEMENTARY INFORMATION: The Office of the Secretary of Defense
notices for systems of records subject to the Privacy Act of 1974 (5
U.S.C. 552a), as amended, have been published in the Federal Register
and are available from the FOR FURTHER INFORMATION CONTACT address
above. The proposed system report, as required by 5 U.S.C. 552a(r) of
the Privacy Act of 1974, as amended, was submitted on December 10,
2010, to the House Committee on Oversight and Government Reform, the
Senate Committee on Governmental Affairs, and the Office of Management
and Budget (OMB) pursuant to paragraph 4c of Appendix I to OMB Circular
No. A-130, ``Federal Agency Responsibilities for Maintaining Records
About Individuals,'' dated February 8, 1996 (February 20, 1996, 61 FR
6427).
Dated: December 10, 2010.
Morgan F. Park,
Alternate OSD Federal Register Liaison Officer, Department of Defense.
DHA 12
System Name:
Third Party Collection System (March 29, 2005, 70 FR 15847).
Changes:
System location:
Delete entry and replace with ``Defense Health Services Systems,
Suite 1599, 5203 Leesburg Pike, Falls Church, VA 22041-3891.''
Categories of individuals covered by the system:
Delete entry and replace with ``Members of the uniformed services
(and their dependents) and retired military members (and their
dependents) who receive or have received health services approved by
the Department of Defense, contractors participating in military
deployments or related operations who receive or have received medical
or dental care at a military treatment facility, Department of Defense
civilian employees (to include non-appropriated fund employees) who
receive or have received medical or dental care at a military treatment
facility, and other individuals who receive or have received medical or
dental care at a military treatment facility.''
Categories of records in the system:
Delete entry and replace with ``Individual Data: This includes
patient name, Social Security Number (SSN)(or foreign identification),
whether treatment was outpatient or inpatient, outpatient visit date
and time, date of birth, mailing address, home telephone number, family
member prefix, and relationship to policy holder; sponsor or insurance
policy holder name, Social Security Number (SSN), and date of birth;
other covered family member name(s), Social Security Number (SSN), and
date(s) of birth; and, if applicable, Medicare and Medicaid coverage
data.
Insurance Policy Information Data:
This includes policy number or identification, card holder
identification, group number, group name, enrollment plan/code, policy
effective date, policy category, policy end date, insurance company
name, address and telephone number, insurance type, policy holder,
whether policy holder is insured through their employer, and drug
coverage data regarding authority to bill for pharmaceuticals.
[[Page 79346]]
Employer Information data:
This includes employer name, address, and telephone number.
Billing Information Data:
This includes bill type (military treatment facility, clinic,
pharmacy, laboratory/radiology, ambulance), name and location of
military treatment facility, whether treatment was outpatient or
inpatient, outpatient visit date and time, inpatient admission and
discharge dates and time, patient identification number, patient name,
provider code/description, office visit code description, Medical
Expense and Performance Reporting System code/description, diagnosis
code/description, billing amount, user who created the bill, date bill
was created, and status of bill and source of billing data.
Accounting Information Data:
This includes control number, transaction code, debit amount,
credit amount, check number, Batch posting number, balance, patient
identification, patient name, encounter date, comments, entry date and
follow-up date.
Insurance Company Data:
This contains tables for insurance company, policy, provider, fees,
codes, rates, and procedure maintenance.''
Authority for maintenance of the system:
Delete entry and replace with ``10 U.S.C. 1095, Health care
services incurred on behalf of covered beneficiaries: collection from
third-party payers; 10 U.S.C. 1079b, Procedures for charging fees for
care provided to civilians; retention and use of fees collected; 42
U.S.C. Chapter 32, ``Third Party Liability For Hospital and Medical
Care;'' 28 CFR Part 43, ``Recovery of Costs of Hospital and Medical
Care and Treatment Furnished by the United States;'' 45 CFR parts 160
and 164, Health and Human Services, General Administrative Requirements
and Security & Privacy; 32 CFR part 220, Collection from Third Party
Payers of Reasonable Charges for Healthcare Services; DoD 6010.15-M,
Chapter 3, Medical Services Account; and E.O. 9397 (SSN), as amended.''
Purpose(s):
Delete entry and replace with ``To establish a standard patient
accounting system for health care billing practices. It shall assist
military treatment facilities in the collection, tracking, and
reporting of data required for the Department of Defense Third Party
Collection Program billing process by the adoption of standard
commercial medical coding and billing practices to military treatment
facilities.
The Defense Finance Accounting Service (DFAS) uses this information
to bill person(s) or organization(s) liable for payment on behalf those
receiving care at a military treatment facility.''
Routine uses of records maintained in the system, including categories
of users and the purposes of such uses:
Delete entry and replace with ``In addition to those disclosures
generally permitted under 5 U.S.C. 552a(b) of the Privacy Act of 1974,
as amended, these records may specifically be disclosed outside the
Department of Defense as a routine use pursuant to 5 U.S.C. 552a(b)(3)
as follows:
To interface with all commercial insurance carriers and parties
against whom recovery has been sought by the Department of Defense
Military Health System, as well as all parties involved in support of
the collection activities for health care approved by the Department of
Defense.
To the National Data Clearinghouse, an electronic healthcare
clearinghouse, for purposes of converting the data to an industry-wide
format prior to forwarding the billing information to the insurance
companies for payment.
The DoD `Blanket Routine Uses' set forth at the beginning of Office
of the Secretary of Defense's compilation of systems of records notices
apply to this system.
Note 1: This system of records contains individually
identifiable health information. The Department of Defense Health
Information Privacy Regulation (DoD 6025.18-R) issued pursuant to
the Health Insurance Portability and Accountability Act of 1996,
applies to most such health information. DoD 6025.18-R may place
additional procedural requirements on the uses and disclosures of
such information beyond what is found in the Privacy Act of 1974 or
mentioned in this system of records notice.
Note 2: Personal identity, diagnosis, prognosis or treatment
information of any patient maintained in connection with the
performance of any program or activity relating to substance abuse
education, prevention, training, treatment, rehabilitation, or
research, which is conducted, regulated, or directly or indirectly
assisted by any department or agency of the United States is, except
as per 42 U.S.C. 290dd-2, treated as confidential and disclosed only
for the purposes and under the circumstances expressly authorized
under 42 U.S.C. 290dd-2.''
Policies and practices for storing, retrieving, accessing, retaining,
and disposing of records in the system:
Storage:
Delete entry and replace with ``Paper file folders and electronic
storage media.''
Retrievability:
Delete entry and replace with ``Records are retrieved by the
sponsor or patient name, Social Security Number (SSN), Department of
Defense Benefits Number, third party payer identification number
assigned to individual, family member prefix (a two-digit code
identifying the person's relationship to the Military Sponsor), and/or
Patient Control Number.''
Safeguards:
Delete entry and replace with ``Physical access to system location
restricted by cipher locks, visitor escort, access rosters, and photo
identification. Adequate locks on doors and server components secured
in a locked computer room with limited access. Each system end user
device protected within a locked storage container, room, or building
outside of normal business hours. All visitors and other persons that
require access to facilities that house servers and other network
devices supporting the system that do not have authorization for access
escorted by appropriately screened/cleared personnel at all times.
Access to the system is role-based and a valid user account is
required. The system provides two-factor authentication, using either a
Common Access Card and Personal Identification Number or a unique logon
identification and password. Where a unique logon identification and
password is used, passwords must be renewed every sixty (60) days.
Authorized personnel must have appropriate Information Assurance
training, Health Insurance Portability and Accountability Act training,
and Privacy Act of 1974 training.''
Retention and disposal:
Delete entry and replace with ``Records are destroyed five years
after the end of the year in which the record was closed.''
System manager(s) and address:
Delete entry and replace with ``Program Manager, Defense Health
Services Systems, Suite 1500, 5203 Leesburg Pike, Falls Church, VA
22041-3891.''
Notification procedure:
Delete entry and replace with ``Individuals seeking to determine
[[Page 79347]]
whether this system contains information about themselves should
address written inquires to the TRICARE Management Activity, Department
of Defense, ATTN: TMA Privacy Officer, Suite 810, 5111 Leesburg Pike,
Falls Church VA 22041-3206.
Request should contain participant's and/or sponsor's full name,
their Social Security Number (SSN), and current address and telephone
number and the names of the military treatment facility or facilities
in which they have received medical treatment.
If requesting health information of a minor (or legally incompetent
person), the request must be made by a custodial parent, legal
guardian, or party acting in loco parentis of such individual(s).
Written proof of the capacity of the requestor may be required.''
Record access procedures:
Delete entry and replace with ``Individuals seeking access to
records about themselves contained in this system should address
written inquiries to TRICARE Management Activity, Attention: Freedom of
Information Act Requester Service Center, 16401 East Centretech
Parkway, Aurora, CO 80011-9066.
Requests should contain participant's and/or sponsor's full name,
their Social Security Number (SSN), and current address and telephone
number and the names of the military treatment facility or facilities
in which they have received medical treatment.
If requesting health information of a minor (or legally incompetent
person), the request must be made by a custodial parent, legal
guardian, or party acting in loco parentis of such individual(s).
Written proof of the capacity of the requestor may be required.''
Contesting record procedures:
Delete entry and replace with ``The Office of the Secretary of
Defense rules for accessing records, for contesting contents and
appealing initial agency determinations are published in Office of the
Secretary of Defense Administrative Instruction 81 (32 CFR part 311) or
may be obtained from the system manager.''
Record source categories:
Delete entry and replace with ``Information is obtained from an
automated medical records system, the Composite Health Care System
(specifically, the Ambulatory Data Module), which is automatically sent
to the Third Party Collection System. Other information may be obtained
from the AHLTA System and the Theater Data Medical Stores System.''
* * * * *
DHA 12
System Name:
Third Party Collection System.
System location:
Defense Health Services Systems, Suite 1599, 5203 Leesburg Pike,
Falls Church, VA 22041-3891.
Categories of individuals covered by the system:
Members of the uniformed services (and their dependents) and
retired military members (and their dependents) who receive or have
received health services approved by the Department of Defense,
contractors participating in military deployments or related operations
who receive or have received medical or dental care at a military
treatment facility, Department of Defense civilian employees (to
include non-appropriated fund employees) who receive or have received
medical or dental care at a military treatment facility, and other
individuals who receive or have received medical or dental care at a
military treatment facility.
Categories of records in the system:
Individual Data:
This includes patient name, Social Security Number (SSN) (or
foreign identification), whether treatment was outpatient or inpatient,
outpatient visit date and time, date of birth, mailing address, home
telephone number, family member prefix, and relationship to policy
holder; sponsor or insurance policy holder name, Social Security Number
(SSN), and date of birth; other covered family member name(s), Social
Security Number (SSN), and date of birth; and, if applicable, Medicare
and Medicaid coverage data.
Insurance Policy Information Data:
This includes policy number or identification, card holder
identification, group number, group name, enrollment plan/code, policy
effective date, policy category, policy end date, insurance company
name, address and telephone number, insurance type, policy holder,
whether policy holder is insured through their employer, and drug
coverage data regarding authority to bill for pharmaceuticals.
Employer Information data:
This includes employer name, address, and telephone number.
Billing Information Data:
This includes bill type (military treatment facility, clinic,
pharmacy, laboratory/radiology, ambulance), name and location of
military treatment facility, whether treatment was outpatient or
inpatient, outpatient visit date and time, inpatient admission and
discharge dates and time, patient identification number, patient name,
provider code/description, office visit code description, Medical
Expense and Performance Reporting System code/description, diagnosis
code/description, billing amount, user who created the bill, date bill
was created, and status of bill and source of billing data.
Accounting Information Data:
This includes control number, transaction code, debit amount,
credit amount, check number, Batch posting number, balance, patient
identification, patient name, encounter date, comments, entry date and
follow-up date.
Insurance Company Data:
This contains tables for insurance company, policy, provider, fees,
codes, rates, and procedure maintenance.
Authority for maintenance of the system:
10 U.S.C. 1095, Health care services incurred on behalf of covered
beneficiaries: collection from third-party payers; 10 U.S.C. 1079b,
Procedures for charging fees for care provided to civilians; retention
and use of fees collected; 42 U.S.C. Chapter 32, ``Third Party
Liability For Hospital and Medical Care;'' 28 CFR part 43, ``Recovery
of Costs of Hospital and Medical Care and Treatment Furnished by the
United States;'' 45 CFR parts 160 and 164, Health and Human Services,
General Administrative Requirements and Security & Privacy; 32 CFR part
220, Collection from Third Party Payers of Reasonable Charges for
Healthcare Services; DoD 6010.15-M, Chapter 3, Medical Services
Account; and E.O. 9397 (SSN), as amended.
Purpose(s):
To establish a standard patient accounting system for health care
billing practices. It shall assist military treatment facilities in the
collection, tracking, and reporting of data required for the Department
of Defense Third Party Collection Program billing process by the
adoption of standard commercial medical coding and billing practices to
military treatment facilities.
The Defense Finance Accounting Service (DFAS) uses this information
to bill person(s) or organization(s) liable for payment on behalf those
receiving care at a military treatment facility.
[[Page 79348]]
Routine uses of records maintained in the system, including categories
of users and the purposes of such uses:
In addition to those disclosures generally permitted under 5 U.S.C.
552a(b) of the Privacy Act, as amended, these records may specifically
be disclosed outside the Department of Defense as a routine use
pursuant to 5 U.S.C. 552a(b)(3) as follows:
To interface with all commercial insurance carriers and parties
against whom recovery has been sought by the Department of Defense
Military Health System, as well as all parties involved in support of
the collection activities for health care approved by the Department of
Defense.
To the National Data Clearinghouse, an electronic healthcare
clearinghouse, for purposes of converting the data to an industry-wide
format prior to forwarding the billing information to the insurance
companies for payment.
The DoD `Blanket Routine Uses' set forth at the beginning of Office
of the Secretary of Defense's compilation of systems of records notices
apply to this system.
Note 1: This system of records contains individually
identifiable health information. The Department of Defense Health
Information Privacy Regulation (DoD 6025.18-R) issued pursuant to
the Health Insurance Portability and Accountability Act of 1996,
applies to most such health information. DoD 6025.18-R may place
additional procedural requirements on the uses and disclosures of
such information beyond what is found in the Privacy Act of 1974 or
mentioned in this system of records notice.
Note 2: Personal identity, diagnosis, prognosis or treatment
information of any patient maintained in connection with the
performance of any program or activity relating to substance abuse
education, prevention, training, treatment, rehabilitation, or
research, which is conducted, regulated, or directly or indirectly
assisted by any department or agency of the United States is, except
as per 42 U.S.C. 290dd-2, treated as confidential and disclosed only
for the purposes and under the circumstances expressly authorized
under 42 U.S.C. 290dd-2.
Policies and practices for storing, retrieving, accessing, retaining,
and disposing of records in the system:
Storage:
Paper file folders and electronic storage media.
Retrievability:
Records are retrieved by the sponsor or patient name, Social
Security Number, Department of Defense Benefits Number, third party
payer identification number assigned to individual, family member
prefix (a two-digit code identifying the person's relationship to the
Military Sponsor), and/or Patient Control Number.
Safeguards:
Physical access to system location restricted by cipher locks,
visitor escort, access rosters, and photo identification. Adequate
locks on doors and server components secured in a locked computer room
with limited access. Each system end user device protected within a
locked storage container, room, or building outside of normal business
hours. All visitors and other persons that require access to facilities
that house servers and other network devices supporting the system that
do not have authorization for access escorted by appropriately
screened/cleared personnel at all times.
Access to the system is role-based and a valid user account is
required. The system provides two-factor authentication, using either a
Common Access Card and Personal Identification Number or a unique logon
identification and password. Where a unique logon identification and
password is used, passwords must be renewed every sixty (60) days.
Authorized personnel must have appropriate Information Assurance
training, Health Insurance Portability and Accountability Act training,
and Privacy Act of 1974 training.
Retention and disposal:
Records are destroyed five years after the end of the year in which
the record was closed.
System manager(s) and address:
Program Manager, Defense Health Services Systems, Suite 1500, 5203
Leesburg Pike, Falls Church, VA 22041-3891.
Notification procedure:
Individuals seeking to determine whether this system contains
information about themselves should address written inquires to the
TRICARE Management Activity, Department of Defense, ATTN: TMA Privacy
Officer, Suite 810, 5111 Leesburg Pike, Falls Church, VA 22041-3206.
Request should contain participant's and/or sponsor's full name,
their Social Security Number (SSN), and current address and telephone
number and the names of the military treatment facility or facilities
in which they have received medical treatment.
If requesting health information of a minor (or legally incompetent
person), the request must be made by a custodial parent, legal
guardian, or party acting in loco parentis of such individual(s).
Written proof of the capacity of the requestor may be required.
Record access procedures:
Individuals seeking access to records about themselves contained in
this system should address written inquiries to TRICARE Management
Activity, Attention: Freedom of Information Act Requester Service
Center, 16401 East Centretech Parkway, Aurora, CO 80011-9066.
Requests should contain participant's and/or sponsor's full name,
their Social Security Number (SSN), and current address and telephone
number and the names of the military treatment facility or facilities
in which they have received medical treatment.
If requesting health information of a minor (or legally incompetent
person), the request must be made by a custodial parent, legal
guardian, or party acting in loco parentis of such individual(s).
Written proof of the capacity of the requestor may be required.
Contesting record procedures:
The Office of the Secretary of Defense rules for accessing records,
for contesting contents and appealing initial agency determinations are
published in Office of the Secretary of Defense Administrative
Instruction 81 (32 CFR part 311) or may be obtained from the system
manager.
Record source categories:
Information is obtained from an automated medical records system,
the Composite Health Care System (specifically, the Ambulatory Data
Module), which is automatically sent to the Third Party Collection
System. Other information may be obtained from the AHLTA System and the
Theater Data Medical Stores System.
Exemptions claimed for the system:
None.
[FR Doc. 2010-31789 Filed 12-17-10; 8:45 am]
BILLING CODE 5001-06-P