Privacy Act of 1974; System of Records, 45590-45595 [2015-18646]
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Budget, Attention: Desk Officer for
Treasury, New Executive Office
Building, Room 10235, Washington, DC
20503, or email at OIRA_Submission@
OMB.EOP.gov and (2) Treasury PRA
Clearance Officer, 1750 Pennsylvania
Ave. NW., Suite 8140, Washington, DC
20220, or email at PRA@treasury.gov.
FOR FURTHER INFORMATION CONTACT:
Copies of the submission may be
obtained by emailing PRA@treasury.gov,
calling (202) 927–5331, or viewing the
entire information collection request at
www.reginfo.gov.
SUPPLEMENTARY INFORMATION:
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OMB Number: 1530–0035.
Type of Review: Extension without
change of a currently approved
collection.
Title: Request by Fiduciary for
Reissue of United States Savings Bonds.
Form: FS Form 1455.
Abstract: One or more fiduciaries
(individual or corporate) must use this
form to establish entitlement and
request distribution of United States
Treasury Securities and/or related
payments to the person lawfully entitled
due to termination of a trust,
distribution of an estate, attainment of
majority, restoration to competency, or
other reason.
Affected Public: Individuals or
Households.
Estimated Annual Burden Hours:
8,850.
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BILLING CODE 4810–AS–P
DEPARTMENT OF VETERANS
AFFAIRS
Privacy Act of 1974; System of
Records
Department of Veterans Affairs
(VA).
Notice of amendment to system
of records.
OMB Number: 1530–0019.
Type of Review: Extension without
change of a currently approved
collection.
Title: Request for Payment of Federal
Benefit by Check, EFT Waiver Form.
Form: FS Form 1201W, 1201W (SP),
1201W–DFAS.
Abstract: Title 31 CFR part 208
requires that all Federal non-tax
payments be made by electronic funds
transfer (EFT). This form is used to
collect information from individuals
requesting a waiver from the EFT
requirement because of a mental
impairment and/or who live in a remote
geographic location that does not
support the use of EFT. These
individuals may continue to receive
payment by check; however, 31 CFR
part 208 requires individuals requesting
one of these waiver conditions to submit
a written justification.
Affected Public: Individuals or
Households.
Estimated Annual Burden Hours:
1,083.
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[FR Doc. 2015–18662 Filed 7–29–15; 8:45 am]
AGENCY:
As required by the Privacy
Act of 1974, 5 U.S.C. 552a(e), notice is
hereby given that the Department of
Veteran Affairs (VA) is amending the
system of records currently entitled
‘‘Non-VA Fee Basis Records—VA’’
(23VA16) as set forth in the Federal
Register 74 FR 44905–44911, August 31,
2009. VA is amending the system of
records by revising the System Name,
System Number, System Location,
Category of Records in the System,
Authority for Maintenance, Purpose,
Retention and Disposal, System
Manager and Address, and Record
Access Procedure, and Records Source
Categories. VA is republishing the
system notice in its entirety.
DATES: Comments on the amendment of
this system of records must be received
no later than August 31, 2015. If no
public comment is received, the
amended system will become effective
August 31, 2015.
ADDRESSES: Written comments may be
submitted through
www.Regulations.gov; by mail or handdelivery to Director, Regulations
Management (02REG), Department of
Veterans Affairs, 810 Vermont Avenue
NW., Room 1068, Washington, DC
20420; or by fax to (202) 273–9026.
Comments received will be available for
public inspection in the Office of
Regulation Policy and Management,
Room 1063B, between the hours of 8:00
a.m. and 4:30 p.m., Monday through
Friday (except holidays). Please call
(202) 461–4902 (this is not a toll-free
number) for an appointment. In
addition, during the comment period,
comments may be viewed online
through the Federal Docket Management
System (FDMS) at www.Regulations.gov.
FOR FURTHER INFORMATION CONTACT:
Veterans Health Administration (VHA)
Privacy Officer, Department of Veterans
Affairs, 810 Vermont Avenue NW.,
Washington, DC 20420; telephone (704)
245–2492.
SUMMARY:
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VA is
renaming the system of records from
Non-VA Fee Basis Records-VA to NonVA Care (Fee) Records-VA. The system
number is changed from 23VA16 to
23VA10NB3 to reflect the current
organizational alignment.
The System Location in this system of
records is being amended to include the
VA Financial Services Center (FSC),
Austin, Texas; Austin Information
Technology Center (AITC), Austin,
Texas. This section will remove
electronic images of fee claims
processed as certified payments retained
at the VA Financial Service Center
(FSC) & Austin Information Technology
Center (AITC), Austin, Texas. The
words Non-VA Care and Purchased Care
have also been included.
The Category of Records in the
System is amended to include
Explanation of Benefits. The Authority
for Maintenance of the System is being
amended to include Title 26 U.S.C 61,
U.S.C. 31, 1151,1741–1743, 1781, 1786,
1787, 3102, 5701 (b)(6)(g)(2)(g)(4)(c)(1),
5724, 7332, 8131–8137. 38 Code of
Federal Regulations 2.6 and 45 CFR part
160 and 164. Title 44 U.S.C and Title 45
U.S.C. Veterans Access, Choice, and
Accountability Act of 2014.
The Purpose in this system of records
is being amended to include Third Party
Liability. Also, this section will include
the VA FSC as one of the agencies
conducting audits, reviews, and
investigations.
The Retention and Disposal is being
amended to include Non-VA Care. The
System Manager and Address is
amending the official maintaining the
System as the Director, National NonVA Care (Fee) Program Office, VHA
Chief Business Office Purchased Care.
The Record Access Procedure section
is being amended to include health
records. Also including those
individuals seeking information
regarding access to claims and/or billing
records will write to the VHA Chief
Business Office Purchased Care, Privacy
Act Office, P.O. BOX 469060, Denver,
CO. All Requests for records about
another person are required to provide
a Request for an Authorization to
Release Medical Records or Health
Information signed by the record subject
by using form VA Form 10–5345.
The Record Source Categories is being
amended to include the VA FSC as a
source of information to the record
system.
The Report of Intent to Amend a
System on Records Notice and an
advance copy of the system notice have
been sent to the appropriate
Congressional committees and to the
Director of the Office of Management
SUPPLEMENTARY INFORMATION:
ACTION:
Bureau of the Fiscal Service (FS)
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Dated: July 27, 2015.
Dawn D. Wolfgang,
Treasury PRA Clearance Officer.
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and Budget (OMB) as required by 5
U.S.C. 552a(r) (Privacy Act) and
guidelines issued by OMB (65 FR
77677), December 12, 2000.
Signing Authority: The Secretary of
Veterans Affairs, or designee, approved
this document and authorized the
undersigned to sign and submit the
document to the Office of the Federal
Register for publication electronically as
an official document of the Department
of Veterans Affairs. Robert L. Nabors II,
Chief of Staff, approved this document
on [insert date], for publication.
Approved: July 9, 2015.
Kathleen M. Manwell,
Program Analyst, VA Privacy Service, Office
of Privacy and Records Management,
Department of Veterans Affairs.
23VA10NB3
SYSTEM NAME:
Non-VA Care (Fee) Records-VA
SYSTEM LOCATION:
Paper and electronic records,
including electronic images of Non-VA
Care (fee) claims are maintained at the
authorizing VA healthcare facility; the
VA Financial Services Center (FSC),
Austin, Texas; Austin. Information
Technology Center (AITC), Austin,
Texas; and Federal record centers.
Information is also stored in automated
storage media records that are
maintained at the authorizing VA
healthcare facility; VA Chief Business
Office Purchased Care (CBOPC), Denver,
Colorado; Department of Veterans
Affairs Headquarters, Washington, DC;
VA Allocation Resource Center (ARC),
Braintree, Massachusetts; VA Office of
Information Field Offices (OIFOs); and
FSC & AITC. Address locations for VA
facilities are listed in VA Appendix 1 of
the biennial Privacy Act Issuances
publication.
CATEGORIES OF INDIVIDUALS COVERED BY THE
SYSTEM:
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1. Veterans who seek healthcare
services under 38 U.S.C. Chapter 17.
2. Beneficiaries of other Federal
agencies authorized VA medical
services.
3. Pensioned members of allied forces
seeking healthcare services under 38
U.S.C.109.
4. Healthcare providers treating
individuals who receive care under 38
U.S.C. Chapters 1 and 17.
CATEGORIES OF RECORDS IN THE SYSTEM:
Records maintained in this system
include application, eligibility, and
claim information regarding payment
determination for medical services
provided to VA beneficiaries by non-VA
healthcare institutions and providers.
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Application and eligibility data may
include personal information of the
claimant (e.g., name, address, social
security number, date of birth, date of
death, VA claim number, other health
insurance data), description of VA
adjudicated compensable or noncompensable medical conditions, and
military service data (e.g., dates, branch
and character of service, medical
information). Claim data in this system
may include information needed to
properly consider claims for payment
such as an Explanation of Benefit (EOB),
description of the medical conditions
treated and services provided,
authorization and treatment dates,
amounts claimed for healthcare
services, health records including films,
and payment information (e.g., invoice
number, account number, date of
payment, payment amount, check
number, payee identifiers). Additional
information may include the healthcare
provider’s name, address, and taxpayer
identification number, correspondence
concerning individuals and documents
pertaining to claims for medical
services, reasons for denial of payment,
and appellate determinations.
AUTHORITY FOR MAINTENANCE OF THE SYSTEM:
Title 5 U.S.C 301, Title 26 U.S.C 61.
Title 38, U.S.C. sections 31, 109, 111,
501, 1151 1703, 1705, 1710, 1712, 1717,
1720, 1721, 1724, 1725, 1727, 1728,
1741–1743, 1781, 1786, 1787, 3102,
5701 (b)(6)(g)(2)(g)(4)(c)(1), 5724, 7105,
7332, and 8131–8137. 38 Code of
Federal Regulations 2.6 and 45 CFR part
160 and 164. Title 44 U.S.C and Title 45
U.S.C. Veterans Access, Choice, and
Accountability Act of 2014.
PURPOSE(S):
Records may be used to establish,
determine, and monitor eligibility to
receive VA benefits and for authorizing
and paying Non-VA healthcare services
furnished to veterans and beneficiaries.
Other uses of this information include
reporting healthcare provider earnings
to the Internal Revenue Service; Third
Party Liability, preparing responses to
inquiries; performing statistical analyses
for use in managerial activities, resource
allocation and planning; processing and
adjudicating administrative benefit
claims by VBA Regional Office (RO)
staff; conducting audits, reviews and
investigations by staff of the VA
healthcare facility, Veterans Integrated
Service Network (VISN) Offices, VA
FSC, VA Headquarters, and the VA
Office of Inspector General (OIG); in the
conduct of law enforcement
investigations; and in the performance
of quality assurance audits, reviews and
investigations.
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ROUTINE USES OF RECORDS MAINTAINED IN THE
SYSTEM, INCLUDING CATEGORIES OF USERS AND
THE PURPOSES OF SUCH USES:
To the extent that records contained
in the system include information
protected by 45 CFR parts 160 and 164,
i.e., individually identifiable health
information, and 38 U.S.C. 7332, i.e.,
medical treatment information related to
drug abuse, alcoholism or alcohol abuse,
sickle cell anemia or infection with the
human immunodeficiency virus, that
information cannot be disclosed under a
routine use unless there is also specific
statutory authority in 38 U.S.C. 7332
and regulatory authority in 45 CFR parts
160 and 164 permitting disclosure.
1. VA may disclose on its own
initiative any information in this
system, except the names and home
addresses of veterans and their
beneficiaries, which is relevant to a
suspected or reasonably imminent
violation of law, whether civil, criminal
or regulatory in nature, and whether
arising by general or program statute or
by regulation, rule or order issued
pursuant thereto, to a Federal, State,
local, or Tribal agency charged with the
responsibility of investigating or
prosecuting such violation, or charged
with enforcing or implementing the
statute, regulation, rule or order. VA
may disclose on its own initiative the
names and addresses of Veterans and
their beneficiaries to a Federal agency
charged with the responsibility of
investigating or prosecuting civil,
criminal, or regulatory violations of law,
or charged with enforcing or
implementing the statute, regulation,
rule or order issued pursuant thereto.
2. A record from this system of
records may be disclosed to a Federal,
State, or local government agency,
maintaining civil, criminal, or other
relevant information, such as current
licenses, registration or certification, if
necessary, to obtain information
relevant to an agency decision
concerning the hiring or retention of an
employee, the use of an individual as a
consultant, attending or to provide NonVA Care (fee), the issuance of a security
clearance, the letting of a contract, or
the issuance of a license, grant, or other
health, educational or welfare benefits.
Any information in this system also may
be disclosed to any of the above-listed
governmental organizations as part of a
series of ongoing computer matches to
determine if VA healthcare practitioners
and private practitioners used by the VA
hold current, unrestricted licenses, or
are currently registered in a State, and
are board certified in their specialty, if
any.
3. VA may disclose information from
this system of records to a Federal
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agency or the District of Columbia
government, in response to its request,
in connection with the hiring or
retention of an employee and the
issuance of a security clearance as
required by law, the reporting of an
investigation of an employee, the
issuance of a license, grant, or other
benefit by the requesting agency, to the
extent that the information is relevant
and necessary to the requesting agency’s
decision.
4. Information from this system of
records may be disclosed to the
Department of the Treasury to facilitate
VA payment to physicians, clinics, and
pharmacies for reimbursement of
services rendered, to facilitate payments
to veterans for reimbursements of
authorized expenses, or to collect, by set
off or otherwise, debts owed the United
States.
5. Disclosure may be made to a
congressional office, from the record of
an individual, in response to an inquiry
from the congressional office made at
the request of that individual.
6. Disclosure may be made to National
Archives and Records Administration
(NARA), and General Services
Administration (GSA) in records
management inspections conducted
under authority of 44 United States
Code.
7. Records from this system of records
may be disclosed to a Federal agency or
to a State or local government licensing
board and/or to the Federation of State
Medical Boards or a similar
nongovernment entity which maintains
records concerning individuals’
employment histories or concerning the
issuance, retention or revocation of
licenses, certifications, or registration
necessary to practice an occupation,
profession or specialty, in order for the
agency to obtain information relevant to
an agency decision concerning the
hiring, retention or termination of an
employee or to inform a Federal agency
or licensing boards or the appropriate
non-government entities about the
healthcare practices of a terminated,
resigned or retired healthcare employee
whose professional healthcare activity
so significantly failed to conform to
generally accepted standards of
professional medical practice as to raise
reasonable concern for the health and
safety of patients in the private sector or
from another Federal agency. These
records may also be disclosed as part of
an ongoing computer-matching program
to accomplish these purposes.
8. Identifying information in this
system, including name, address, social
security number, and other information
as is reasonably necessary to identify
such individual, may be disclosed to the
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National Practitioner Data Bank at the
time of hiring and/or clinical privileging
of healthcare practitioners, and other
times as deemed necessary by VA, in
order for VA to obtain information
relevant to a Department decision
concerning the hiring, privileging,
retention or termination of the applicant
or employee.
9. Relevant information from this
system of records may be disclosed to
the National Practitioner Data Bank and/
or State Licensing Board in the State(s)
in which a practitioner is licensed, in
which the VA facility is located, and/or
in which an act or omission occurred
upon which a medical malpractice
claim was based when VA reports
information concerning: (a) Any
payment for the benefit of a physician,
dentist, or other licensed healthcare
practitioner which was made as the
result of a settlement or judgment of a
claim of medical malpractice if an
appropriate determination is made in
accordance with agency policy that
payment was related to substandard
care, professional incompetence or
professional misconduct on the part of
the individual; (b) a final decision
which relates to possible incompetence
or improper professional conduct that
adversely affects the clinical privileges
of a physician or dentist for a period
longer than 30 days; or (c) the
acceptance of the surrender of clinical
privileges or any restriction of such
privileges by a physician or dentist
either while under investigation by the
healthcare entity relating to possible
incompetence or improper professional
conduct, or in return for not conducting
such an investigation or proceeding.
These records may also be disclosed as
part of a computer-matching program to
accomplish these purposes.
10. Relevant identifying and medical
treatment information (excluding
medical treatment information related to
drug or alcohol abuse, infection with the
human immunodeficiency virus or
sickle cell anemia) may be disclosed to
a Federal agency or non-VA healthcare
provider or institution, including their
billing or collection agent, when VA
refers a patient for treatment or medical
services, or authorizes a patient to
obtain non-VA medical services and the
information is needed by the Federal
agency or non-VA institution or
provider to perform the services, or for
VA to obtain sufficient information in
order to consider or make payment for
health care services, to evaluate the
services rendered, or to determine the
need for additional services.
11. Information maintained in this
system concerning non-VA healthcare
institutions and providers, including
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name, address, social security or
employer’s taxpayer identification
numbers, may be disclosed to the
Department of the Treasury, Internal
Revenue Service, to report calendar year
earnings of $600 or more for income tax
reporting purposes.
12. The name, date of birth and social
security number of a Veteran or
beneficiary, and any other identifying
and claim information as is reasonably
necessary, such as provider
identification, description of services
furnished, and VA payment amount,
may be disclosed to another Federal
agency for its use in identifying
potential duplicate payments for
healthcare services paid by Department
of Veteran Affairs and that agency. This
information may also be disclosed as
part of a computer matching agreement
to accomplish this purpose.
13. Relevant information from this
system of records may be disclosed to
individuals, organizations, or private or
public agencies, with whom VA has a
contract or agreement to perform such
services as VA may deem practicable for
the purposes of laws administered by
VA, in order for the contractor or
subcontractor to perform the services of
the contract or agreement.
14. Any relevant information in this
system of records may be disclosed to
attorneys, insurance companies,
employers, and courts, boards, or
commissions; such disclosures may be
made only to the extent necessary to aid
VA in the preparation, presentation, and
prosecution of claims authorized under
Federal, State, or local laws, and
regulations promulgated thereunder.
15. VA may disclose information from
this system of records to the Department
of Justice (DoJ), either on VA’s initiative
or in response to DoJ’s request for the
information, after either VA or DoJ
determines that such information is
relevant to DoJ’s representation of the
United States or any of its components
in legal proceedings before a court or
adjudicative body, provided that, in
each case, the agency also determines
prior to disclosure that release of the
records to the DoJ is a use of the
information contained in the records
that is compatible with the purpose for
which VA collected the records. VA, on
its own initiative, may disclose records
in this system of records in legal
proceedings before a court or
administrative body after determining
that the disclosure of the records to the
court or administrative body is a use of
the information contained in the records
that is compatible with the purpose for
which VA collected the records.
16. Any information in this system
may be disclosed in connection with
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any proceeding for the collection of an
amount owed to the United States by
virtue of a person’s participation in any
benefit program administered by the
Veterans Health Administration when
in the judgment of the Secretary, or an
official generally delegated such
authority under standard agency
delegation of authority rules (38 CFR
2.6), such disclosure is deemed
necessary and proper, in accordance
with 38 U.S.C. 5701(b)(6).
17. The name and address of a veteran
or beneficiary, and other information as
is reasonably necessary to identify such
individual, including personal
information obtained from other Federal
agencies through computer matching
programs, and any information
concerning the individual’s
indebtedness to the United States by
virtue of the individual’s participation
in a benefits program administered by
VA, may be disclosed to a consumer
reporting agency for the purpose of
locating the individual, obtaining a
consumer report to determine the ability
of the individual to repay an
indebtedness, or assisting in the
collection of such indebtedness
provided that the applicable
requirements of 38 U.S.C. 5701(g)(2) and
38 U.S.C. 5701(g)(4) have been met.
18. In response to an inquiry about a
named individual from a member of the
general public, information from this
system may be disclosed to report the
amount of VA monetary benefits being
received by the individual. This
disclosure is consistent with 38 U.S.C.
5701(c)(1).
19. VA may disclose information from
this system to a Federal agency for the
purpose of conducting research and data
analysis to perform a statutory purpose
of that Federal agency upon the prior
written request of that agency, provided
that there is legal authority under all
applicable confidentiality statutes and
regulations to provide the data and VA
has determined prior to the disclosure
that the VA data handling requirements
are satisfied.
20. Any information in this system of
records relevant to a claim of a Veteran
or beneficiary, such as the name,
address, the basis and nature of a claim,
amount of benefit payment information,
medical information and military
service and active duty separation
information may be disclosed to
accredited service organizations, VA
approved claim agents and attorneys
acting under a declaration of
representation, so that these individuals
can aid claimants in the preparation,
presentation and prosecution of claims
under the laws administered by VA. The
name and address of a claimant will not,
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however, be disclosed to these
individuals under this routine use if the
claimant has not requested the
assistance of an accredited service
organization, claims agent or an
attorney.
21. Any information in this system,
including medical information, the basis
and nature of claim, the amount of
benefits, and other personal information
may be disclosed to a VA Federal
fiduciary or a guardian ad litem in
relation to his or her representation of
a claimant, but only to the extent
necessary to fulfill the duties of the VA
Federal fiduciary or the guardian ad
litem.
22. The individual’s name, address,
social security number and the amount
(excluding interest) of any indebtedness
which is waived under 38 U.S.C. 3102,
compromised under 4 CFR part 103,
otherwise forgiven, or for which the
applicable statute of limitations for
enforcing collection has expired, may be
disclosed to the Department of the
Treasury, Internal Revenue Service, as a
report of income under 26 U.S.C.
61(a)(12).
23. The name of a veteran or
beneficiary, other information as is
reasonably necessary to identify such
individual, and any other information
concerning the individual’s
indebtedness by virtue of a person’s
participation in a benefits program
administered by VA, may be disclosed
to the Department of the Treasury,
Internal Revenue Service, for the
collection of Title 38 benefit
overpayments, overdue indebtedness,
and/or costs of services provided to an
individual not entitled to such services,
by the withholding of all or a portion of
the person’s Federal income tax refund.
24. The name, date of birth, and social
security number of a Veteran or
beneficiary, and other identifying
information as is reasonably necessary
may be disclosed to Social Security
Administration for the purpose of
validating social security numbers. This
information may also be disclosed as
part of a computer matching agreement
to accomplish this purpose.
25. The name and address of any
healthcare provider in this system of
records who has received payment for
claimed services in behalf of a Veteran
or beneficiary may be disclosed in
response to an inquiry from a member
of the general public.
26. Relevant information from this
system of records may be disclosed to
an accrediting Quality Review and Peer
Review Organization with which VA
has an agreement or contract to conduct
such reviews in connection with the
review of claims or other review
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activities associated with VA healthcare
facility accreditation to professionally
accepted standards, such as The Joint
Commission or Utilization Review
Accreditation Commission (URAC) or
American Accreditation HealthCare
Commission.
27. Eligibility and claim information
from this system of records may be
disclosed verbally or to a healthcare
provider seeking reimbursement for
claimed medical services to facilitate
billing processes, verify eligibility for
requested healthcare services, and
provide payment information for
claimed services. Eligibility or
entitlement information disclosed may
include the name, social security
number, effective dates of eligibility,
reasons for any period of ineligibility,
and evidence of other health insurance
information of the named individual.
Claim information disclosed may
include payment information such as
payment identification number, date of
payment, date of service, amount billed,
amount paid, name of payee, and
reasons for non-payment.
28. Identifying information, including
social security number of Veterans,
spouse(s) of Veterans, and dependents
of Veterans, may be disclosed to other
Federal agencies for purposes of
conducting computer matches, to obtain
information to determine or verify
eligibility of Veterans who are receiving
VA medical care under relevant sections
of Title 38 U.S.C.
29. VA may disclose patient
identifying information to Federal
agencies and VA and government-wide
third-party insurers responsible for
payment of the cost of medical care for
the identified patients, in order for VA
to seek recovery of the medical care
costs. These records may also be
disclosed as part of a computer
matching program to accomplish this
purpose.
30. Disclosure to other Federal
agencies may be made to assist such
agencies in preventing and detecting
possible fraud or abuse by individuals
in their operations and programs.
31. VA may, on its own initiative,
disclose any information or records to
appropriate agencies, entities, and
persons when (1) VA suspects or has
confirmed that the integrity or
confidentiality of information in the
system of records has been
compromised; (2) the Department has
determined that as a result of the
suspected or confirmed compromise,
there is a risk of embarrassment or harm
to the reputations of the record subjects,
harm to economic or property interests,
identity theft or fraud, or harm to the
security, confidentiality, or integrity of
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this system or other systems or
programs (whether maintained by the
Department or another agency or entity)
that rely upon the potentially
compromised information; and (3) the
disclosure is to agencies, entities, or
persons whom VA determines are
reasonably necessary to assist or carry
out the Department’s efforts to respond
to the suspected or confirmed
compromise and prevent, minimize, or
remedy such harm. This routine use
permits disclosures by the Department
to respond to a suspected or confirmed
data breach, including the conduct of
any risk analysis or provision of credit
protection services as provided in 38
U.S.C. 5724, as the terms are defined in
38 U.S.C. 5727.
POLICIES AND PRACTICES FOR STORING,
RETRIEVING, ACCESSING, RETAINING, AND
DISPOSING OF RECORDS IN THE SYSTEM:
STORAGE:
Records are maintained on paper
documents or stored electronically by
magnetic discs, magnetic tape, and
optical or digital imaging at the
authorizing VA healthcare facility.
Reports and information on automated
storage media (e.g., microfilm,
microfiche, magnetic tape and disks,
and digital and laser optical media) is
stored at the authorizing VA healthcare
facility, VA Headquarters, ARC, OIFOs,
FSC, AITC, and Veterans Integrated
Service Network (VISN) offices.
Information pertaining to electronic
claims submitted to VA for payment
consideration may be stored at the
authorizing VA healthcare facility, FSC,
AITC, and at CBOPC. Records
maintained at CBOPC are stored
electronically.
RETRIEVABILITY:
Paper and electronic records
pertaining to the individual may be
retrieved by the name or Social Security
number of the record subject. Records
pertaining to the healthcare provider are
retrieved by the name or Social Security
and taxpayer identification number of
the non-VA healthcare institution or
provider. Records at the ARC are
retrieved only by Social Security
number.
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SAFEGUARDS:
1. VA will maintain the data in
compliance with applicable VA security
policy directives that specify the
standards that will be applied to protect
sensitive personal information.
Contractors and their subcontractors
who access the data are required to
maintain the same level of security as
VA staff. Working spaces and record
storage areas in VA facilities are
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14:54 Jul 29, 2015
Jkt 235001
restricted to VA employees. Generally,
file areas are locked after normal duty
hours and healthcare facilities are
protected from outside access by
security personnel. Access to the
records is restricted to VA employees
who have a need for the information in
the performance of their official duties.
Employee records or records of public
figures or otherwise sensitive records
are generally stored in separate locked
files.
2. Electronic data security complies
with applicable Federal Information
Processing Standards (FIPS) issued by
the National Institute of Standards and
Technology (NIST). Access to computer
rooms at healthcare facilities is
generally limited by appropriate locking
devices and restricted to authorized VA
employees and vendor personnel.
Peripheral devices are generally placed
in secure areas (areas that are locked or
have limited access) or are otherwise
protected. Access to file information is
controlled at two levels: The system
recognizes authorized employees by a
series of individually unique
passwords/codes that must be changed
periodically by the employee, and
employees are limited by role-based
access to only that information in the
file which is needed in the performance
of their official duties. Information that
is downloaded and maintained on
personal computers is afforded similar
storage and access protections as the
data that is maintained in the original
files. Remote access to file information
by staff of the OIFOs, and access by OIG
staff conducting an audit or
investigation at the healthcare facility or
an OIG office location remote from the
healthcare facility is controlled in the
same manner.
3. Access to FSC and AITC is
generally restricted to each Center’s
employees, custodial personnel and
security personnel. Access to computer
rooms is restricted to authorized
operational personnel through
electronic locking devices. All other
persons gaining access to computer
rooms are escorted. Authorized VA
employees at remote locations,
including VA healthcare facilities,
OIFOs, VA Headquarters, VISN offices,
and OIG headquarters and field staff,
may access information stored in the
computer. Access is controlled by
individually unique passwords/codes
that must be changed periodically by
the employee.
4. Access to records maintained at VA
Headquarters, ARC, OIFOs, and VISN
offices is restricted to VA employees
who have a need for the information in
the performance of their official duties.
Access to information stored on
PO 00000
Frm 00094
Fmt 4703
Sfmt 4703
automated storage media is controlled
by individually unique passwords/
codes that must be changed periodically
by the employee. Authorized VA
employees at remote locations including
VA healthcare facilities may access
information stored in the computer.
Access is controlled by individually
unique passwords/codes. Records are
maintained in manned rooms during
nonworking hours. The facilities are
protected from outside access during
working hours by security personnel.
5. Information downloaded and
maintained by the OIG Headquarters
and field offices on automated storage
media is secured in storage areas or
facilities to which only OIG staff
members have access. Paper documents
are similarly secured. Access to paper
documents and information on
automated storage media is limited to
OIG employees who have a need for the
information in the performance of their
official duties. Access to information
stored on automated storage media is
controlled by individually unique
passwords/codes.
6. Access to records maintained at
CBOPC Office of Information and
Technology (OI&T) is restricted to VA
employees who have a need for the
information in the performance of their
official duties. Access to information
stored on automated storage media is
controlled by individually unique
passwords/codes that must be changed
periodically by the employee.
Authorized VA employees at remote
locations including VA healthcare
facilities may access and print
information stored in the computer.
Access is controlled by individually
assigned unique passwords/codes.
Records are maintained in a secured,
pass card protected and alarmed room.
The facilities are protected from outside
access during non-working hours by
security personnel.
RETENTION AND DISPOSAL:
Paper and electronic documents at the
authorizing healthcare facility related to
authorizing the Non-VA Care (fee) and
the services authorized, billed and paid
for are maintained in ‘‘Patient Medical
Records—VA’’ (24VA10P2). These
records are retained at healthcare
facilities for a minimum of three years
after the last episode of care. After the
third year of inactivity the paper records
are transferred to a records facility for
seventy-two (72) more years of storage.
Automated storage media, imaged
Non-VA Care (fee) claims, and other
paper documents that are included in
this system of records and not
maintained in ‘‘Patient Medical
Records—VA’’ (24VA10P2) are retained
E:\FR\FM\30JYN1.SGM
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Federal Register / Vol. 80, No. 146 / Thursday, July 30, 2015 / Notices
and disposed of in accordance with
disposition authority approved by the
Archivist of the United States.
Paper records that are imaged for
viewing electronically are destroyed
after they have been scanned, and the
electronic copy is determined to be an
accurate and complete copy of the paper
record imaged.
SYSTEM MANAGER(S) AND ADDRESS:
Official responsible for policies and
procedures: Chief Business Officer
(10NB), Department of Veterans Affairs,
Veterans Health Administration, VA
Central Office, 810 Vermont Avenue
NW., Washington, DC 20420. Official
Maintaining the System: Director,
National Non-VA Care (Fee) Program
Office, VHA Chief Business Office
Purchased Care, P.O. Box 469066,
Denver, CO 80246.
NOTIFICATION PROCEDURE:
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An individual who wishes to
determine whether a record is being
maintained in this system under the
individual’s name or other personal
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14:54 Jul 29, 2015
Jkt 235001
identifier, or who wants to determine
the contents of such record, should
submit a written request or apply in
person to the last VA healthcare facility
where care was authorized or rendered.
Addresses of VA healthcare facilities
may be found in VA Appendix 1 of the
Biennial Publication of Privacy Act
Issuances. All inquiries must reasonably
identify the portion of the Non-VA Care
(fee) record involved and the place and
approximate date that medical care was
provided. Inquiries should include the
patient’s full name, social security
number, and return address.
RECORD ACCESS PROCEDURE:
Individuals seeking information
regarding access to health records and/
or contesting health l records may write,
call or visit the VA facility where
medical care was last authorized or
provided. Individuals seeking
information regarding access to claims
and/or billing records will write to the
VHA Chief Business Office Purchased
Care, Privacy Office, PO BOX 469060,
PO 00000
Frm 00095
Fmt 4703
Sfmt 9990
45595
Denver, CO. All Requests for records
about another person are required to
provide a Request for an Authorization
to Release Medical Records or Health
Information signed by the record subject
by using form VA Form 10–5345.
CONTESTING RECORD PROCEDURES:
(See Record Access Procedures
above.)
RECORD SOURCE CATEGORIES:
The Veteran or other VA beneficiary,
family members or accredited
representatives, and other third parties;
military service departments; private
medical facilities and healthcare
professionals; electronic trading
partners; other Federal agencies;
Veterans Health Administration
facilities and automated systems;
Veterans Benefits Administration
facilities and automated systems; VA
FSC facility and automated systems; and
deployment status and availability.
[FR Doc. 2015–18646 Filed 7–29–15; 8:45 am]
BILLING CODE 8320–01–P
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Agencies
[Federal Register Volume 80, Number 146 (Thursday, July 30, 2015)]
[Notices]
[Pages 45590-45595]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2015-18646]
=======================================================================
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DEPARTMENT OF VETERANS AFFAIRS
Privacy Act of 1974; System of Records
AGENCY: Department of Veterans Affairs (VA).
ACTION: Notice of amendment to system of records.
-----------------------------------------------------------------------
SUMMARY: As required by the Privacy Act of 1974, 5 U.S.C. 552a(e),
notice is hereby given that the Department of Veteran Affairs (VA) is
amending the system of records currently entitled ``Non-VA Fee Basis
Records--VA'' (23VA16) as set forth in the Federal Register 74 FR
44905-44911, August 31, 2009. VA is amending the system of records by
revising the System Name, System Number, System Location, Category of
Records in the System, Authority for Maintenance, Purpose, Retention
and Disposal, System Manager and Address, and Record Access Procedure,
and Records Source Categories. VA is republishing the system notice in
its entirety.
DATES: Comments on the amendment of this system of records must be
received no later than August 31, 2015. If no public comment is
received, the amended system will become effective August 31, 2015.
ADDRESSES: Written comments may be submitted through
www.Regulations.gov; by mail or hand-delivery to Director, Regulations
Management (02REG), Department of Veterans Affairs, 810 Vermont Avenue
NW., Room 1068, Washington, DC 20420; or by fax to (202) 273-9026.
Comments received will be available for public inspection in the Office
of Regulation Policy and Management, Room 1063B, between the hours of
8:00 a.m. and 4:30 p.m., Monday through Friday (except holidays).
Please call (202) 461-4902 (this is not a toll-free number) for an
appointment. In addition, during the comment period, comments may be
viewed online through the Federal Docket Management System (FDMS) at
www.Regulations.gov.
FOR FURTHER INFORMATION CONTACT: Veterans Health Administration (VHA)
Privacy Officer, Department of Veterans Affairs, 810 Vermont Avenue
NW., Washington, DC 20420; telephone (704) 245-2492.
SUPPLEMENTARY INFORMATION: VA is renaming the system of records from
Non-VA Fee Basis Records-VA to Non-VA Care (Fee) Records-VA. The system
number is changed from 23VA16 to 23VA10NB3 to reflect the current
organizational alignment.
The System Location in this system of records is being amended to
include the VA Financial Services Center (FSC), Austin, Texas; Austin
Information Technology Center (AITC), Austin, Texas. This section will
remove electronic images of fee claims processed as certified payments
retained at the VA Financial Service Center (FSC) & Austin Information
Technology Center (AITC), Austin, Texas. The words Non-VA Care and
Purchased Care have also been included.
The Category of Records in the System is amended to include
Explanation of Benefits. The Authority for Maintenance of the System is
being amended to include Title 26 U.S.C 61, U.S.C. 31, 1151,1741-1743,
1781, 1786, 1787, 3102, 5701 (b)(6)(g)(2)(g)(4)(c)(1), 5724, 7332,
8131-8137. 38 Code of Federal Regulations 2.6 and 45 CFR part 160 and
164. Title 44 U.S.C and Title 45 U.S.C. Veterans Access, Choice, and
Accountability Act of 2014.
The Purpose in this system of records is being amended to include
Third Party Liability. Also, this section will include the VA FSC as
one of the agencies conducting audits, reviews, and investigations.
The Retention and Disposal is being amended to include Non-VA Care.
The System Manager and Address is amending the official maintaining the
System as the Director, National Non-VA Care (Fee) Program Office, VHA
Chief Business Office Purchased Care.
The Record Access Procedure section is being amended to include
health records. Also including those individuals seeking information
regarding access to claims and/or billing records will write to the VHA
Chief Business Office Purchased Care, Privacy Act Office, P.O. BOX
469060, Denver, CO. All Requests for records about another person are
required to provide a Request for an Authorization to Release Medical
Records or Health Information signed by the record subject by using
form VA Form 10-5345.
The Record Source Categories is being amended to include the VA FSC
as a source of information to the record system.
The Report of Intent to Amend a System on Records Notice and an
advance copy of the system notice have been sent to the appropriate
Congressional committees and to the Director of the Office of
Management
[[Page 45591]]
and Budget (OMB) as required by 5 U.S.C. 552a(r) (Privacy Act) and
guidelines issued by OMB (65 FR 77677), December 12, 2000.
Signing Authority: The Secretary of Veterans Affairs, or designee,
approved this document and authorized the undersigned to sign and
submit the document to the Office of the Federal Register for
publication electronically as an official document of the Department of
Veterans Affairs. Robert L. Nabors II, Chief of Staff, approved this
document on [insert date], for publication.
Approved: July 9, 2015.
Kathleen M. Manwell,
Program Analyst, VA Privacy Service, Office of Privacy and Records
Management, Department of Veterans Affairs.
23VA10NB3
SYSTEM NAME:
Non-VA Care (Fee) Records-VA
SYSTEM LOCATION:
Paper and electronic records, including electronic images of Non-VA
Care (fee) claims are maintained at the authorizing VA healthcare
facility; the VA Financial Services Center (FSC), Austin, Texas;
Austin. Information Technology Center (AITC), Austin, Texas; and
Federal record centers. Information is also stored in automated storage
media records that are maintained at the authorizing VA healthcare
facility; VA Chief Business Office Purchased Care (CBOPC), Denver,
Colorado; Department of Veterans Affairs Headquarters, Washington, DC;
VA Allocation Resource Center (ARC), Braintree, Massachusetts; VA
Office of Information Field Offices (OIFOs); and FSC & AITC. Address
locations for VA facilities are listed in VA Appendix 1 of the biennial
Privacy Act Issuances publication.
CATEGORIES OF INDIVIDUALS COVERED BY THE SYSTEM:
1. Veterans who seek healthcare services under 38 U.S.C. Chapter
17.
2. Beneficiaries of other Federal agencies authorized VA medical
services.
3. Pensioned members of allied forces seeking healthcare services
under 38 U.S.C.109.
4. Healthcare providers treating individuals who receive care under
38 U.S.C. Chapters 1 and 17.
CATEGORIES OF RECORDS IN THE SYSTEM:
Records maintained in this system include application, eligibility,
and claim information regarding payment determination for medical
services provided to VA beneficiaries by non-VA healthcare institutions
and providers. Application and eligibility data may include personal
information of the claimant (e.g., name, address, social security
number, date of birth, date of death, VA claim number, other health
insurance data), description of VA adjudicated compensable or non-
compensable medical conditions, and military service data (e.g., dates,
branch and character of service, medical information). Claim data in
this system may include information needed to properly consider claims
for payment such as an Explanation of Benefit (EOB), description of the
medical conditions treated and services provided, authorization and
treatment dates, amounts claimed for healthcare services, health
records including films, and payment information (e.g., invoice number,
account number, date of payment, payment amount, check number, payee
identifiers). Additional information may include the healthcare
provider's name, address, and taxpayer identification number,
correspondence concerning individuals and documents pertaining to
claims for medical services, reasons for denial of payment, and
appellate determinations.
AUTHORITY FOR MAINTENANCE OF THE SYSTEM:
Title 5 U.S.C 301, Title 26 U.S.C 61. Title 38, U.S.C. sections 31,
109, 111, 501, 1151 1703, 1705, 1710, 1712, 1717, 1720, 1721, 1724,
1725, 1727, 1728, 1741-1743, 1781, 1786, 1787, 3102, 5701
(b)(6)(g)(2)(g)(4)(c)(1), 5724, 7105, 7332, and 8131-8137. 38 Code of
Federal Regulations 2.6 and 45 CFR part 160 and 164. Title 44 U.S.C and
Title 45 U.S.C. Veterans Access, Choice, and Accountability Act of
2014.
PURPOSE(S):
Records may be used to establish, determine, and monitor
eligibility to receive VA benefits and for authorizing and paying Non-
VA healthcare services furnished to veterans and beneficiaries. Other
uses of this information include reporting healthcare provider earnings
to the Internal Revenue Service; Third Party Liability, preparing
responses to inquiries; performing statistical analyses for use in
managerial activities, resource allocation and planning; processing and
adjudicating administrative benefit claims by VBA Regional Office (RO)
staff; conducting audits, reviews and investigations by staff of the VA
healthcare facility, Veterans Integrated Service Network (VISN)
Offices, VA FSC, VA Headquarters, and the VA Office of Inspector
General (OIG); in the conduct of law enforcement investigations; and in
the performance of quality assurance audits, reviews and
investigations.
ROUTINE USES OF RECORDS MAINTAINED IN THE SYSTEM, INCLUDING CATEGORIES
OF USERS AND THE PURPOSES OF SUCH USES:
To the extent that records contained in the system include
information protected by 45 CFR parts 160 and 164, i.e., individually
identifiable health information, and 38 U.S.C. 7332, i.e., medical
treatment information related to drug abuse, alcoholism or alcohol
abuse, sickle cell anemia or infection with the human immunodeficiency
virus, that information cannot be disclosed under a routine use unless
there is also specific statutory authority in 38 U.S.C. 7332 and
regulatory authority in 45 CFR parts 160 and 164 permitting disclosure.
1. VA may disclose on its own initiative any information in this
system, except the names and home addresses of veterans and their
beneficiaries, which is relevant to a suspected or reasonably imminent
violation of law, whether civil, criminal or regulatory in nature, and
whether arising by general or program statute or by regulation, rule or
order issued pursuant thereto, to a Federal, State, local, or Tribal
agency charged with the responsibility of investigating or prosecuting
such violation, or charged with enforcing or implementing the statute,
regulation, rule or order. VA may disclose on its own initiative the
names and addresses of Veterans and their beneficiaries to a Federal
agency charged with the responsibility of investigating or prosecuting
civil, criminal, or regulatory violations of law, or charged with
enforcing or implementing the statute, regulation, rule or order issued
pursuant thereto.
2. A record from this system of records may be disclosed to a
Federal, State, or local government agency, maintaining civil,
criminal, or other relevant information, such as current licenses,
registration or certification, if necessary, to obtain information
relevant to an agency decision concerning the hiring or retention of an
employee, the use of an individual as a consultant, attending or to
provide Non-VA Care (fee), the issuance of a security clearance, the
letting of a contract, or the issuance of a license, grant, or other
health, educational or welfare benefits. Any information in this system
also may be disclosed to any of the above-listed governmental
organizations as part of a series of ongoing computer matches to
determine if VA healthcare practitioners and private practitioners used
by the VA hold current, unrestricted licenses, or are currently
registered in a State, and are board certified in their specialty, if
any.
3. VA may disclose information from this system of records to a
Federal
[[Page 45592]]
agency or the District of Columbia government, in response to its
request, in connection with the hiring or retention of an employee and
the issuance of a security clearance as required by law, the reporting
of an investigation of an employee, the issuance of a license, grant,
or other benefit by the requesting agency, to the extent that the
information is relevant and necessary to the requesting agency's
decision.
4. Information from this system of records may be disclosed to the
Department of the Treasury to facilitate VA payment to physicians,
clinics, and pharmacies for reimbursement of services rendered, to
facilitate payments to veterans for reimbursements of authorized
expenses, or to collect, by set off or otherwise, debts owed the United
States.
5. Disclosure may be made to a congressional office, from the
record of an individual, in response to an inquiry from the
congressional office made at the request of that individual.
6. Disclosure may be made to National Archives and Records
Administration (NARA), and General Services Administration (GSA) in
records management inspections conducted under authority of 44 United
States Code.
7. Records from this system of records may be disclosed to a
Federal agency or to a State or local government licensing board and/or
to the Federation of State Medical Boards or a similar nongovernment
entity which maintains records concerning individuals' employment
histories or concerning the issuance, retention or revocation of
licenses, certifications, or registration necessary to practice an
occupation, profession or specialty, in order for the agency to obtain
information relevant to an agency decision concerning the hiring,
retention or termination of an employee or to inform a Federal agency
or licensing boards or the appropriate non-government entities about
the healthcare practices of a terminated, resigned or retired
healthcare employee whose professional healthcare activity so
significantly failed to conform to generally accepted standards of
professional medical practice as to raise reasonable concern for the
health and safety of patients in the private sector or from another
Federal agency. These records may also be disclosed as part of an
ongoing computer-matching program to accomplish these purposes.
8. Identifying information in this system, including name, address,
social security number, and other information as is reasonably
necessary to identify such individual, may be disclosed to the National
Practitioner Data Bank at the time of hiring and/or clinical
privileging of healthcare practitioners, and other times as deemed
necessary by VA, in order for VA to obtain information relevant to a
Department decision concerning the hiring, privileging, retention or
termination of the applicant or employee.
9. Relevant information from this system of records may be
disclosed to the National Practitioner Data Bank and/or State Licensing
Board in the State(s) in which a practitioner is licensed, in which the
VA facility is located, and/or in which an act or omission occurred
upon which a medical malpractice claim was based when VA reports
information concerning: (a) Any payment for the benefit of a physician,
dentist, or other licensed healthcare practitioner which was made as
the result of a settlement or judgment of a claim of medical
malpractice if an appropriate determination is made in accordance with
agency policy that payment was related to substandard care,
professional incompetence or professional misconduct on the part of the
individual; (b) a final decision which relates to possible incompetence
or improper professional conduct that adversely affects the clinical
privileges of a physician or dentist for a period longer than 30 days;
or (c) the acceptance of the surrender of clinical privileges or any
restriction of such privileges by a physician or dentist either while
under investigation by the healthcare entity relating to possible
incompetence or improper professional conduct, or in return for not
conducting such an investigation or proceeding. These records may also
be disclosed as part of a computer-matching program to accomplish these
purposes.
10. Relevant identifying and medical treatment information
(excluding medical treatment information related to drug or alcohol
abuse, infection with the human immunodeficiency virus or sickle cell
anemia) may be disclosed to a Federal agency or non-VA healthcare
provider or institution, including their billing or collection agent,
when VA refers a patient for treatment or medical services, or
authorizes a patient to obtain non-VA medical services and the
information is needed by the Federal agency or non-VA institution or
provider to perform the services, or for VA to obtain sufficient
information in order to consider or make payment for health care
services, to evaluate the services rendered, or to determine the need
for additional services.
11. Information maintained in this system concerning non-VA
healthcare institutions and providers, including name, address, social
security or employer's taxpayer identification numbers, may be
disclosed to the Department of the Treasury, Internal Revenue Service,
to report calendar year earnings of $600 or more for income tax
reporting purposes.
12. The name, date of birth and social security number of a Veteran
or beneficiary, and any other identifying and claim information as is
reasonably necessary, such as provider identification, description of
services furnished, and VA payment amount, may be disclosed to another
Federal agency for its use in identifying potential duplicate payments
for healthcare services paid by Department of Veteran Affairs and that
agency. This information may also be disclosed as part of a computer
matching agreement to accomplish this purpose.
13. Relevant information from this system of records may be
disclosed to individuals, organizations, or private or public agencies,
with whom VA has a contract or agreement to perform such services as VA
may deem practicable for the purposes of laws administered by VA, in
order for the contractor or subcontractor to perform the services of
the contract or agreement.
14. Any relevant information in this system of records may be
disclosed to attorneys, insurance companies, employers, and courts,
boards, or commissions; such disclosures may be made only to the extent
necessary to aid VA in the preparation, presentation, and prosecution
of claims authorized under Federal, State, or local laws, and
regulations promulgated thereunder.
15. VA may disclose information from this system of records to the
Department of Justice (DoJ), either on VA's initiative or in response
to DoJ's request for the information, after either VA or DoJ determines
that such information is relevant to DoJ's representation of the United
States or any of its components in legal proceedings before a court or
adjudicative body, provided that, in each case, the agency also
determines prior to disclosure that release of the records to the DoJ
is a use of the information contained in the records that is compatible
with the purpose for which VA collected the records. VA, on its own
initiative, may disclose records in this system of records in legal
proceedings before a court or administrative body after determining
that the disclosure of the records to the court or administrative body
is a use of the information contained in the records that is compatible
with the purpose for which VA collected the records.
16. Any information in this system may be disclosed in connection
with
[[Page 45593]]
any proceeding for the collection of an amount owed to the United
States by virtue of a person's participation in any benefit program
administered by the Veterans Health Administration when in the judgment
of the Secretary, or an official generally delegated such authority
under standard agency delegation of authority rules (38 CFR 2.6), such
disclosure is deemed necessary and proper, in accordance with 38 U.S.C.
5701(b)(6).
17. The name and address of a veteran or beneficiary, and other
information as is reasonably necessary to identify such individual,
including personal information obtained from other Federal agencies
through computer matching programs, and any information concerning the
individual's indebtedness to the United States by virtue of the
individual's participation in a benefits program administered by VA,
may be disclosed to a consumer reporting agency for the purpose of
locating the individual, obtaining a consumer report to determine the
ability of the individual to repay an indebtedness, or assisting in the
collection of such indebtedness provided that the applicable
requirements of 38 U.S.C. 5701(g)(2) and 38 U.S.C. 5701(g)(4) have been
met.
18. In response to an inquiry about a named individual from a
member of the general public, information from this system may be
disclosed to report the amount of VA monetary benefits being received
by the individual. This disclosure is consistent with 38 U.S.C.
5701(c)(1).
19. VA may disclose information from this system to a Federal
agency for the purpose of conducting research and data analysis to
perform a statutory purpose of that Federal agency upon the prior
written request of that agency, provided that there is legal authority
under all applicable confidentiality statutes and regulations to
provide the data and VA has determined prior to the disclosure that the
VA data handling requirements are satisfied.
20. Any information in this system of records relevant to a claim
of a Veteran or beneficiary, such as the name, address, the basis and
nature of a claim, amount of benefit payment information, medical
information and military service and active duty separation information
may be disclosed to accredited service organizations, VA approved claim
agents and attorneys acting under a declaration of representation, so
that these individuals can aid claimants in the preparation,
presentation and prosecution of claims under the laws administered by
VA. The name and address of a claimant will not, however, be disclosed
to these individuals under this routine use if the claimant has not
requested the assistance of an accredited service organization, claims
agent or an attorney.
21. Any information in this system, including medical information,
the basis and nature of claim, the amount of benefits, and other
personal information may be disclosed to a VA Federal fiduciary or a
guardian ad litem in relation to his or her representation of a
claimant, but only to the extent necessary to fulfill the duties of the
VA Federal fiduciary or the guardian ad litem.
22. The individual's name, address, social security number and the
amount (excluding interest) of any indebtedness which is waived under
38 U.S.C. 3102, compromised under 4 CFR part 103, otherwise forgiven,
or for which the applicable statute of limitations for enforcing
collection has expired, may be disclosed to the Department of the
Treasury, Internal Revenue Service, as a report of income under 26
U.S.C. 61(a)(12).
23. The name of a veteran or beneficiary, other information as is
reasonably necessary to identify such individual, and any other
information concerning the individual's indebtedness by virtue of a
person's participation in a benefits program administered by VA, may be
disclosed to the Department of the Treasury, Internal Revenue Service,
for the collection of Title 38 benefit overpayments, overdue
indebtedness, and/or costs of services provided to an individual not
entitled to such services, by the withholding of all or a portion of
the person's Federal income tax refund.
24. The name, date of birth, and social security number of a
Veteran or beneficiary, and other identifying information as is
reasonably necessary may be disclosed to Social Security Administration
for the purpose of validating social security numbers. This information
may also be disclosed as part of a computer matching agreement to
accomplish this purpose.
25. The name and address of any healthcare provider in this system
of records who has received payment for claimed services in behalf of a
Veteran or beneficiary may be disclosed in response to an inquiry from
a member of the general public.
26. Relevant information from this system of records may be
disclosed to an accrediting Quality Review and Peer Review Organization
with which VA has an agreement or contract to conduct such reviews in
connection with the review of claims or other review activities
associated with VA healthcare facility accreditation to professionally
accepted standards, such as The Joint Commission or Utilization Review
Accreditation Commission (URAC) or American Accreditation HealthCare
Commission.
27. Eligibility and claim information from this system of records
may be disclosed verbally or to a healthcare provider seeking
reimbursement for claimed medical services to facilitate billing
processes, verify eligibility for requested healthcare services, and
provide payment information for claimed services. Eligibility or
entitlement information disclosed may include the name, social security
number, effective dates of eligibility, reasons for any period of
ineligibility, and evidence of other health insurance information of
the named individual. Claim information disclosed may include payment
information such as payment identification number, date of payment,
date of service, amount billed, amount paid, name of payee, and reasons
for non-payment.
28. Identifying information, including social security number of
Veterans, spouse(s) of Veterans, and dependents of Veterans, may be
disclosed to other Federal agencies for purposes of conducting computer
matches, to obtain information to determine or verify eligibility of
Veterans who are receiving VA medical care under relevant sections of
Title 38 U.S.C.
29. VA may disclose patient identifying information to Federal
agencies and VA and government-wide third-party insurers responsible
for payment of the cost of medical care for the identified patients, in
order for VA to seek recovery of the medical care costs. These records
may also be disclosed as part of a computer matching program to
accomplish this purpose.
30. Disclosure to other Federal agencies may be made to assist such
agencies in preventing and detecting possible fraud or abuse by
individuals in their operations and programs.
31. VA may, on its own initiative, disclose any information or
records to appropriate agencies, entities, and persons when (1) VA
suspects or has confirmed that the integrity or confidentiality of
information in the system of records has been compromised; (2) the
Department has determined that as a result of the suspected or
confirmed compromise, there is a risk of embarrassment or harm to the
reputations of the record subjects, harm to economic or property
interests, identity theft or fraud, or harm to the security,
confidentiality, or integrity of
[[Page 45594]]
this system or other systems or programs (whether maintained by the
Department or another agency or entity) that rely upon the potentially
compromised information; and (3) the disclosure is to agencies,
entities, or persons whom VA determines are reasonably necessary to
assist or carry out the Department's efforts to respond to the
suspected or confirmed compromise and prevent, minimize, or remedy such
harm. This routine use permits disclosures by the Department to respond
to a suspected or confirmed data breach, including the conduct of any
risk analysis or provision of credit protection services as provided in
38 U.S.C. 5724, as the terms are defined in 38 U.S.C. 5727.
POLICIES AND PRACTICES FOR STORING, RETRIEVING, ACCESSING, RETAINING,
AND DISPOSING OF RECORDS IN THE SYSTEM:
STORAGE:
Records are maintained on paper documents or stored electronically
by magnetic discs, magnetic tape, and optical or digital imaging at the
authorizing VA healthcare facility. Reports and information on
automated storage media (e.g., microfilm, microfiche, magnetic tape and
disks, and digital and laser optical media) is stored at the
authorizing VA healthcare facility, VA Headquarters, ARC, OIFOs, FSC,
AITC, and Veterans Integrated Service Network (VISN) offices.
Information pertaining to electronic claims submitted to VA for
payment consideration may be stored at the authorizing VA healthcare
facility, FSC, AITC, and at CBOPC. Records maintained at CBOPC are
stored electronically.
RETRIEVABILITY:
Paper and electronic records pertaining to the individual may be
retrieved by the name or Social Security number of the record subject.
Records pertaining to the healthcare provider are retrieved by the name
or Social Security and taxpayer identification number of the non-VA
healthcare institution or provider. Records at the ARC are retrieved
only by Social Security number.
SAFEGUARDS:
1. VA will maintain the data in compliance with applicable VA
security policy directives that specify the standards that will be
applied to protect sensitive personal information. Contractors and
their subcontractors who access the data are required to maintain the
same level of security as VA staff. Working spaces and record storage
areas in VA facilities are restricted to VA employees. Generally, file
areas are locked after normal duty hours and healthcare facilities are
protected from outside access by security personnel. Access to the
records is restricted to VA employees who have a need for the
information in the performance of their official duties. Employee
records or records of public figures or otherwise sensitive records are
generally stored in separate locked files.
2. Electronic data security complies with applicable Federal
Information Processing Standards (FIPS) issued by the National
Institute of Standards and Technology (NIST). Access to computer rooms
at healthcare facilities is generally limited by appropriate locking
devices and restricted to authorized VA employees and vendor personnel.
Peripheral devices are generally placed in secure areas (areas that are
locked or have limited access) or are otherwise protected. Access to
file information is controlled at two levels: The system recognizes
authorized employees by a series of individually unique passwords/codes
that must be changed periodically by the employee, and employees are
limited by role-based access to only that information in the file which
is needed in the performance of their official duties. Information that
is downloaded and maintained on personal computers is afforded similar
storage and access protections as the data that is maintained in the
original files. Remote access to file information by staff of the
OIFOs, and access by OIG staff conducting an audit or investigation at
the healthcare facility or an OIG office location remote from the
healthcare facility is controlled in the same manner.
3. Access to FSC and AITC is generally restricted to each Center's
employees, custodial personnel and security personnel. Access to
computer rooms is restricted to authorized operational personnel
through electronic locking devices. All other persons gaining access to
computer rooms are escorted. Authorized VA employees at remote
locations, including VA healthcare facilities, OIFOs, VA Headquarters,
VISN offices, and OIG headquarters and field staff, may access
information stored in the computer. Access is controlled by
individually unique passwords/codes that must be changed periodically
by the employee.
4. Access to records maintained at VA Headquarters, ARC, OIFOs, and
VISN offices is restricted to VA employees who have a need for the
information in the performance of their official duties. Access to
information stored on automated storage media is controlled by
individually unique passwords/codes that must be changed periodically
by the employee. Authorized VA employees at remote locations including
VA healthcare facilities may access information stored in the computer.
Access is controlled by individually unique passwords/codes. Records
are maintained in manned rooms during nonworking hours. The facilities
are protected from outside access during working hours by security
personnel.
5. Information downloaded and maintained by the OIG Headquarters
and field offices on automated storage media is secured in storage
areas or facilities to which only OIG staff members have access. Paper
documents are similarly secured. Access to paper documents and
information on automated storage media is limited to OIG employees who
have a need for the information in the performance of their official
duties. Access to information stored on automated storage media is
controlled by individually unique passwords/codes.
6. Access to records maintained at CBOPC Office of Information and
Technology (OI&T) is restricted to VA employees who have a need for the
information in the performance of their official duties. Access to
information stored on automated storage media is controlled by
individually unique passwords/codes that must be changed periodically
by the employee. Authorized VA employees at remote locations including
VA healthcare facilities may access and print information stored in the
computer. Access is controlled by individually assigned unique
passwords/codes. Records are maintained in a secured, pass card
protected and alarmed room. The facilities are protected from outside
access during non-working hours by security personnel.
RETENTION AND DISPOSAL:
Paper and electronic documents at the authorizing healthcare
facility related to authorizing the Non-VA Care (fee) and the services
authorized, billed and paid for are maintained in ``Patient Medical
Records--VA'' (24VA10P2). These records are retained at healthcare
facilities for a minimum of three years after the last episode of care.
After the third year of inactivity the paper records are transferred to
a records facility for seventy-two (72) more years of storage.
Automated storage media, imaged Non-VA Care (fee) claims, and other
paper documents that are included in this system of records and not
maintained in ``Patient Medical Records--VA'' (24VA10P2) are retained
[[Page 45595]]
and disposed of in accordance with disposition authority approved by
the Archivist of the United States.
Paper records that are imaged for viewing electronically are
destroyed after they have been scanned, and the electronic copy is
determined to be an accurate and complete copy of the paper record
imaged.
SYSTEM MANAGER(S) AND ADDRESS:
Official responsible for policies and procedures: Chief Business
Officer (10NB), Department of Veterans Affairs, Veterans Health
Administration, VA Central Office, 810 Vermont Avenue NW., Washington,
DC 20420. Official Maintaining the System: Director, National Non-VA
Care (Fee) Program Office, VHA Chief Business Office Purchased Care,
P.O. Box 469066, Denver, CO 80246.
NOTIFICATION PROCEDURE:
An individual who wishes to determine whether a record is being
maintained in this system under the individual's name or other personal
identifier, or who wants to determine the contents of such record,
should submit a written request or apply in person to the last VA
healthcare facility where care was authorized or rendered. Addresses of
VA healthcare facilities may be found in VA Appendix 1 of the Biennial
Publication of Privacy Act Issuances. All inquiries must reasonably
identify the portion of the Non-VA Care (fee) record involved and the
place and approximate date that medical care was provided. Inquiries
should include the patient's full name, social security number, and
return address.
RECORD ACCESS PROCEDURE:
Individuals seeking information regarding access to health records
and/or contesting health l records may write, call or visit the VA
facility where medical care was last authorized or provided.
Individuals seeking information regarding access to claims and/or
billing records will write to the VHA Chief Business Office Purchased
Care, Privacy Office, PO BOX 469060, Denver, CO. All Requests for
records about another person are required to provide a Request for an
Authorization to Release Medical Records or Health Information signed
by the record subject by using form VA Form 10-5345.
CONTESTING RECORD PROCEDURES:
(See Record Access Procedures above.)
RECORD SOURCE CATEGORIES:
The Veteran or other VA beneficiary, family members or accredited
representatives, and other third parties; military service departments;
private medical facilities and healthcare professionals; electronic
trading partners; other Federal agencies; Veterans Health
Administration facilities and automated systems; Veterans Benefits
Administration facilities and automated systems; VA FSC facility and
automated systems; and deployment status and availability.
[FR Doc. 2015-18646 Filed 7-29-15; 8:45 am]
BILLING CODE 8320-01-P