Privacy Act of 1974; Report of a New Routine Use for Selected CMS Systems of Records, 32257-32258 [2013-12690]
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Federal Register / Vol. 78, No. 103 / Wednesday, May 29, 2013 / Notices
Facsimile: (301) 492–4353, Email:
karen.mandelbaum@cms.hhs.gov.
CMS
proposes to alter the SOR to add
‘‘Relevant Individual(s)’’ as a category of
individuals whose PII is necessary for
determining the eligibility of applicants
for insurance affordability programs or a
certification of exemption under
provisions of the Patient Protection and
Affordable Care Act (Pub. L. 111–148),
as amended by the Health Care and
Education Reconciliation Act of 2010
(Pub. L. 111–152) (collectively referred
to as the Affordable Care Act) and CMS’
implementation of the Affordable Care
Act.
For the purpose of this SORN,
‘‘Relevant Individual(s)’’ means any
individual listed on an application for
an insurance affordability program or
certification of exemption whose PII
may bear upon the eligibility of an
individual for an insurance affordability
program (as defined in 42 CFR 435.4
and 45 CFR 155.20),1 or certification of
exemption. These individuals include
non-applicant household members/
family members, certain non-applicant
tax payers or tax filers, and spouses and
parents of applicants. Due to the
potential impact of the Relevant
Individuals’ PII on an individual’s
eligibility determination this category of
individuals is added to the SOR.
Additionally, Routine Use #3 is
proposed to be modified to permit CMS
to disclose information about Relevant
Individual(s), in addition to applicants,
in order to obtain information from
other Federal and State agencies and
third party data sources that provide
information to CMS, pursuant to
agreements with CMS, for purposes of
determining eligibility of applicants to
enroll in qualified health plans (QHP)
through an Exchange, in insurance
affordability programs, or for a
certification of exemption from the
individual responsibility requirement.
Routine Use #8 is proposed to be
modified to enable CMS to provide
information about Relevant
Individual(s), in addition to applicants,
to application filers who are filing on
behalf of those applicants for whom an
eligibility determination will require
information about the Relevant
Individual(s).
The proposed changes require the
following alterations to sections of the
notice.
1. Categories of Individuals Covered
by the System: Remove the ‘‘and’’ before
‘‘(7)’’ and add the following at the end
of this section:
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SUPPLEMENTARY INFORMATION:
1 See
also 78 FR 8539, 8540.
VerDate Mar<15>2010
18:07 May 28, 2013
Jkt 229001
‘‘and (8) Individuals, including nonapplicant household members/family
members, non-applicant tax payers or
tax filers, and spouses and parents of
applicants, who are listed on the
application and whose PII may bear
upon a determination of the eligibility
of an individual for an insurance
affordability program and for
certifications of exemption from the
individual responsibility requirement.
Such individuals will hereafter be
referred to as ‘‘Relevant Individual(s)’’.’’
2. Categories of Records in the
System: Add the following to the end of
the first paragraph of this section:
‘‘The system will collect and maintain
information pertaining to Relevant
Individual(s) that includes the
following: First name, last name, middle
initial, permanent residential address,
date of birth, SSN (if the Relevant
Individual has one or is required to
provide it as specified in 45 CFR
155.305(f)(6)), taxpayer status, gender,
residency, relationship to applicant,
employer information, and household
income, including tax information from
the IRS, income information from the
Social Security Administration, and
financial information from other third
party sources.’’
3. Purpose(s) of the System: Replace
the first sentence of the first paragraph
of this section with the following
sentence:
‘‘The purpose of this system is to
collect, create, use and disclose PII
about individuals who apply for
eligibility determinations for enrollment
in a QHP through the Exchange, for
insurance affordability programs, and
for certifications of exemption from the
individual responsibility requirement
and on Relevant Individual(s) whose PII
may bear upon a determination of the
eligibility of an individual for an
insurance affordability program and for
certifications of exemption from the
individual responsibility requirement.’’
4. Routine Use #3: Delete entry and
replace with:
‘‘To disclose information about
applicants and Relevant Individual(s) in
order to obtain information from other
Federal agencies and State agencies and
third party data sources that provide
information to CMS, pursuant to
agreements with CMS, for purposes of
determining the eligibility of applicants
to enroll in QHPs through an Exchange,
in insurance affordability programs, or
for a certification of exemption from the
individual responsibility requirement.’’
5. Routine Use #8: Delete entry and
replace with:
‘‘To provide information about
applicants and Relevant Individual(s) to
PO 00000
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Fmt 4703
Sfmt 4703
32257
applicants/enrollees, authorized
representatives of applicants/enrollees,
and application filers, who are filing on
behalf of those applicants, when
relevant and necessary to determine
eligibility for enrollment in a QHP
through an Exchange, insurance
affordability programs, or a certification
of exemption from the individual
responsibility requirement.’’
The information collected by this
system and the purposes for which it is
used and disclosed by CMS are
described in the modifications to the
SORN as stated above.
Michelle Snyder,
Deputy Chief Operating Officer, Centers for
Medicare & Medicaid Services.
[FR Doc. 2013–12691 Filed 5–28–13; 8:45 am]
BILLING CODE 4120–03–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Centers for Medicare & Medicaid
Services
Privacy Act of 1974; Report of a New
Routine Use for Selected CMS
Systems of Records
Centers for Medicare &
Medicaid Services (CMS) Department of
Health and Human Services (HHS).
ACTION: Altered System Notice, Adding
a New Routine Use for Selected CMS
Systems of Records.
AGENCY:
In accordance with the
requirements of the Privacy Act of 1974
(5 U.S.C. 552a), CMS is adding a new
routine use to twenty-three CMS
systems of records to assist in
preventing and detecting fraud, waste
and abuse. The new routine use will
authorize CMS to disclose provider and
beneficiary-identifiable records to
representatives of health plans for the
purpose of preventing and detecting
fraud, waste and abuse, pursuant to
section 1128C(a)(2) of the Social
Security Act (‘‘the Act’’). At section
1128C(c) of the Act, a health plan is
defined as a plan or program that
provides health benefits, whether
directly, through insurance, or
otherwise, and includes: (1) A policy of
health insurance; (2) a contract of a
service benefit organization; and (3) a
membership agreement with a health
maintenance organization or other
prepaid health plan.
Disclosures made pursuant to the
routine use will be coordinated through
CMS’ Data Sharing and Partnership
Group, Center for Program Integrity,
CMS. CMS has identified twenty-three
systems that contain the data potentially
SUMMARY:
E:\FR\FM\29MYN1.SGM
29MYN1
tkelley on DSK3SPTVN1PROD with NOTICES
32258
Federal Register / Vol. 78, No. 103 / Wednesday, May 29, 2013 / Notices
necessary to disclose to health plans for
the prevention and detection of fraud,
waste and abuse. These systems are
listed at the end of this notice.
DATES: Effective Dates: The new routine
use described in this notice will become
effective without further notice 30 days
after publication of this notice in the
Federal Register (FR), unless comments
received on or before that date result in
revisions to this notice.
ADDRESSES: The public should send
comments to: CMS Privacy Officer,
Division of Privacy Policy, Privacy
Policy and Compliance Group, Office of
E-Health Standards & Services, Office of
Enterprise Management, CMS, Room
S2–24–25, 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 9:00 a.m.–3:00
p.m., Eastern Time zone.
FOR FURTHER INFORMATION CONTACT:
Shantanu Agrawal, MD, MPhil, FAAEM,
Medical Director, Director, Data Sharing
and Partnership Group, CMS Center for
Program Integrity, 7500 Security
Boulevard, Mail Stop AR–18–50,
Baltimore, MD 21244, Office phone:
410.786.1795, Facsimile: 410.786.0604,
Email: shantanu.agrawal@cms.hhs.gov.
SUPPLEMENTARY INFORMATION: Section
1128C(a)(2) of the Act authorizes the
Secretary and the Attorney General to
consult with, and arrange for the sharing
of data with, representatives of health
plans. At section 1128C(c) of the Act, a
health plan is defined as a plan or
program that provides health benefits,
whether directly, through insurance, or
otherwise, and includes: (1) A policy of
health insurance; (2) a contract of a
service benefit organization; and (3) a
membership agreement with a health
maintenance organization or other
prepaid health plan. In order for CMS to
disclose data with representatives of
health plans pursuant to section
1128C(a)(2) of the Act, CMS is
establishing a new routine use for
twenty-three systems identified as
containing the data that may be used to
detect and prevent fraud, waste, and
abuse. The Secretary’s authority under
section 1128C(a)(2) of the Act has been
delegated to the Administrator of CMS.
Advance notice of the proposed new
routine use for the twenty-three systems
of record was provided to OMB and
Congress as required by the Privacy Act
at 5 U.S.C. 552a(r).
For the reasons described above, the
following routine use is added to the
twenty-three systems of records listed
below:
VerDate Mar<15>2010
18:07 May 28, 2013
Jkt 229001
‘‘To disclose to health plans, defined
for this purpose as plans or programs
that provide health benefits, whether
directly, through insurance, or
otherwise, and includes—(1) a policy of
health insurance; (2) a contract of a
service benefit organization; and (3) a
membership agreement with a health
maintenance organization or other
prepaid health plan 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.
Disclosures may include provider and
beneficiary-identifiable data.’’
1. Health Plan Management System
(HPMS), System No. 09–70–0500,
published at 73 Federal Register (FR)
2257 (January 14, 2008).
2. Medicare Multi-Carrier Claims
System (MCS), System No. 09–70–0501,
published at 71 FR 64968 (November 6,
2006).
3. Enrollment Database (EDB), System
No. 09–70–0502, published at 73 FR
10249 (February 26, 2008).
4. Fiscal Intermediary Shared System
(FISS), System No. 09–70–0503,
published at 71 FR 64961 (November 6,
2006).
5. Inpatient Rehabilitation Facilities—
Patient Assessment Instrument (IRF–
PAI), System No. 09–70–0521,
published at 71 FR 67143 (November
20, 2006).
6. HHA Outcome and Assessment
Information Set (OASIS), System No.
09–70–0522, published at 72 FR 63906
(November 13, 2007).
7. Unique Physician/Practitioner
Identification Number System (UPIN),
System No. 09–70–0525, published at
71 FR 66535 (November 15, 2006).
8. Common Working File (CWF),
System No, 09–70–0526, published at
71 FR 64955 (November 6, 2006).
9. Fraud Investigation Database (FID),
System No. 09–70–0527, published at
71 FR 77759 (December 27, 2006).
10. Long Term Care MDS (LTC MDS),
System No. 09–70–0528, published at
72 FR 12801 (March 19, 2007).
11. Medicare Supplier Identification
File (MSIF), System No. 09–70–0530,
published at 71 FR 70404 (December 4,
2006).
12. Provider Enrollment, Chain and
Ownership System (PECOS), System
No. 09–70–0532, published at 71 FR
60536 (October 13, 2006).
13. Medicare Exclusion Database
(MED), System No. 09–70–0534,
published at 71 FR 70967 (December 7,
2006).
14. Medicare Beneficiary Database
(MBD), System No. 09–70–0536,
PO 00000
Frm 00033
Fmt 4703
Sfmt 4703
published at 71 FR 70396 (December 4,
2006).
15. Medicaid Statistical Information
System (MSIS), System No. 09–70–0541,
published at 71 FR 65527 (November 8,
2006).
16. Medicare Retiree Drug Subsidy
Program (RDSP), System No. 09–70–
0550, published at 70 FR 41035 (July 15,
2005).
17. Medicare Drug Data Processing
System (DDPS), System No. 09–70–
0553, published at 73 FR 30943 (May
29, 2008).
18. National Plan and Provider
Enumeration System (NPPES), System
No. 09–70–0555, published at 75 FR
30411 (June 1, 2010).
19. National Claims History (NCH),
System No. 09–70–0558, published at
71 FR 67137 (November 20, 2006).
20. Integrated Data Repository (IDR)
System No. 09–70–0571, published at
71 FR 74915 (December 13, 2006).
21. Chronic Condition Data
Repository (CCDR), System No. 09–70–
0573, published at 71 FR 74915
(December 13, 2006).
22. Medicaid Integrity Program
System (MIPS), System No. 09–70–0599,
published at 73 FR 11639 (March 4,
2008).
23. Medicare Advantage Prescription
Drug System (MARx), System No. 09–
70–0588, published at 70 FR 60530
(October 18, 2005).
Michelle Snyder,
Deputy Chief Operating Officer, Centers for
Medicare & Medicaid Services.
[FR Doc. 2013–12690 Filed 5–28–13; 8:45 am]
BILLING CODE 4120–03–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Administration for Children and
Families
Proposed Information Collection
Activity; Comment Request
Proposed Projects
Title: Federally Assisted State
Transmitted Levy (FAST Levy).
OMB No.: New Collection.
Description: State IV–D child support
enforcement agencies are required to
secure assets in cases where there is a
support arrearage to satisfy any current
support obligation and the arrearage by
attaching and seizing assets of the
obligor held in financial institutions. To
assist states in fulfilling this statutory
requirement the federal Office of Child
Support Enforcement (OCSE) is
proposing a new information collection
using the Federally Assisted State
Transmitted Levy (FAST Levy), a new
E:\FR\FM\29MYN1.SGM
29MYN1
]]>Agencies
[Federal Register Volume 78, Number 103 (Wednesday, May 29, 2013)]
[Notices]
[Pages 32257-32258]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2013-12690]
-----------------------------------------------------------------------
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
Privacy Act of 1974; Report of a New Routine Use for Selected CMS
Systems of Records
AGENCY: Centers for Medicare & Medicaid Services (CMS) Department of
Health and Human Services (HHS).
ACTION: Altered System Notice, Adding a New Routine Use for Selected
CMS Systems of Records.
-----------------------------------------------------------------------
SUMMARY: In accordance with the requirements of the Privacy Act of 1974
(5 U.S.C. 552a), CMS is adding a new routine use to twenty-three CMS
systems of records to assist in preventing and detecting fraud, waste
and abuse. The new routine use will authorize CMS to disclose provider
and beneficiary-identifiable records to representatives of health plans
for the purpose of preventing and detecting fraud, waste and abuse,
pursuant to section 1128C(a)(2) of the Social Security Act (``the
Act''). At section 1128C(c) of the Act, a health plan is defined as a
plan or program that provides health benefits, whether directly,
through insurance, or otherwise, and includes: (1) A policy of health
insurance; (2) a contract of a service benefit organization; and (3) a
membership agreement with a health maintenance organization or other
prepaid health plan.
Disclosures made pursuant to the routine use will be coordinated
through CMS' Data Sharing and Partnership Group, Center for Program
Integrity, CMS. CMS has identified twenty-three systems that contain
the data potentially
[[Page 32258]]
necessary to disclose to health plans for the prevention and detection
of fraud, waste and abuse. These systems are listed at the end of this
notice.
DATES: Effective Dates: The new routine use described in this notice
will become effective without further notice 30 days after publication
of this notice in the Federal Register (FR), unless comments received
on or before that date result in revisions to this notice.
ADDRESSES: The public should send comments to: CMS Privacy Officer,
Division of Privacy Policy, Privacy Policy and Compliance Group, Office
of E-Health Standards & Services, Office of Enterprise Management, CMS,
Room S2-24-25, 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
9:00 a.m.-3:00 p.m., Eastern Time zone.
FOR FURTHER INFORMATION CONTACT: Shantanu Agrawal, MD, MPhil, FAAEM,
Medical Director, Director, Data Sharing and Partnership Group, CMS
Center for Program Integrity, 7500 Security Boulevard, Mail Stop AR-18-
50, Baltimore, MD 21244, Office phone: 410.786.1795, Facsimile:
410.786.0604, Email: shantanu.agrawal@cms.hhs.gov.
SUPPLEMENTARY INFORMATION: Section 1128C(a)(2) of the Act authorizes
the Secretary and the Attorney General to consult with, and arrange for
the sharing of data with, representatives of health plans. At section
1128C(c) of the Act, a health plan is defined as a plan or program that
provides health benefits, whether directly, through insurance, or
otherwise, and includes: (1) A policy of health insurance; (2) a
contract of a service benefit organization; and (3) a membership
agreement with a health maintenance organization or other prepaid
health plan. In order for CMS to disclose data with representatives of
health plans pursuant to section 1128C(a)(2) of the Act, CMS is
establishing a new routine use for twenty-three systems identified as
containing the data that may be used to detect and prevent fraud,
waste, and abuse. The Secretary's authority under section 1128C(a)(2)
of the Act has been delegated to the Administrator of CMS. Advance
notice of the proposed new routine use for the twenty-three systems of
record was provided to OMB and Congress as required by the Privacy Act
at 5 U.S.C. 552a(r).
For the reasons described above, the following routine use is added
to the twenty-three systems of records listed below:
``To disclose to health plans, defined for this purpose as plans or
programs that provide health benefits, whether directly, through
insurance, or otherwise, and includes--(1) a policy of health
insurance; (2) a contract of a service benefit organization; and (3) a
membership agreement with a health maintenance organization or other
prepaid health plan 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. Disclosures
may include provider and beneficiary-identifiable data.''
1. Health Plan Management System (HPMS), System No. 09-70-0500,
published at 73 Federal Register (FR) 2257 (January 14, 2008).
2. Medicare Multi-Carrier Claims System (MCS), System No. 09-70-
0501, published at 71 FR 64968 (November 6, 2006).
3. Enrollment Database (EDB), System No. 09-70-0502, published at
73 FR 10249 (February 26, 2008).
4. Fiscal Intermediary Shared System (FISS), System No. 09-70-0503,
published at 71 FR 64961 (November 6, 2006).
5. Inpatient Rehabilitation Facilities--Patient Assessment
Instrument (IRF-PAI), System No. 09-70-0521, published at 71 FR 67143
(November 20, 2006).
6. HHA Outcome and Assessment Information Set (OASIS), System No.
09-70-0522, published at 72 FR 63906 (November 13, 2007).
7. Unique Physician/Practitioner Identification Number System
(UPIN), System No. 09-70-0525, published at 71 FR 66535 (November 15,
2006).
8. Common Working File (CWF), System No, 09-70-0526, published at
71 FR 64955 (November 6, 2006).
9. Fraud Investigation Database (FID), System No. 09-70-0527,
published at 71 FR 77759 (December 27, 2006).
10. Long Term Care MDS (LTC MDS), System No. 09-70-0528, published
at 72 FR 12801 (March 19, 2007).
11. Medicare Supplier Identification File (MSIF), System No. 09-70-
0530, published at 71 FR 70404 (December 4, 2006).
12. Provider Enrollment, Chain and Ownership System (PECOS), System
No. 09-70-0532, published at 71 FR 60536 (October 13, 2006).
13. Medicare Exclusion Database (MED), System No. 09-70-0534,
published at 71 FR 70967 (December 7, 2006).
14. Medicare Beneficiary Database (MBD), System No. 09-70-0536,
published at 71 FR 70396 (December 4, 2006).
15. Medicaid Statistical Information System (MSIS), System No. 09-
70-0541, published at 71 FR 65527 (November 8, 2006).
16. Medicare Retiree Drug Subsidy Program (RDSP), System No. 09-70-
0550, published at 70 FR 41035 (July 15, 2005).
17. Medicare Drug Data Processing System (DDPS), System No. 09-70-
0553, published at 73 FR 30943 (May 29, 2008).
18. National Plan and Provider Enumeration System (NPPES), System
No. 09-70-0555, published at 75 FR 30411 (June 1, 2010).
19. National Claims History (NCH), System No. 09-70-0558, published
at 71 FR 67137 (November 20, 2006).
20. Integrated Data Repository (IDR) System No. 09-70-0571,
published at 71 FR 74915 (December 13, 2006).
21. Chronic Condition Data Repository (CCDR), System No. 09-70-
0573, published at 71 FR 74915 (December 13, 2006).
22. Medicaid Integrity Program System (MIPS), System No. 09-70-
0599, published at 73 FR 11639 (March 4, 2008).
23. Medicare Advantage Prescription Drug System (MARx), System No.
09-70-0588, published at 70 FR 60530 (October 18, 2005).
Michelle Snyder,
Deputy Chief Operating Officer, Centers for Medicare & Medicaid
Services.
[FR Doc. 2013-12690 Filed 5-28-13; 8:45 am]
BILLING CODE 4120-03-P
