Privacy Act of 1974; Matching Program, 45661-45662 [2024-11351]
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Federal Register / Vol. 89, No. 101 / Thursday, May 23, 2024 / Notices
U.S.C. 552a) provides certain
protections for individuals applying for
and receiving federal benefits. The law
Centers for Medicare & Medicaid
governs the use of computer matching
Services
by federal agencies when records in a
system of records (meaning, federal
Privacy Act of 1974; Matching Program agency records about individuals
retrieved by name or other personal
AGENCY: Centers for Medicare &
identifier) are matched with records of
Medicaid Services (CMS), Department
other federal or non-federal agencies.
of Health and Human Services (HHS)
The Privacy Act requires agencies
ACTION: Notice of a new matching
involved in a matching program to:
program.
1. Enter into a written agreement,
SUMMARY: In accordance with subsection which must be prepared in accordance
with the Privacy Act, approved by the
(e)(12) of the Privacy Act of 1974, as
amended, the Department of Health and Data Integrity Board (DIB) of each
source and recipient federal agency,
Human Services (HHS), Centers for
provided to Congress and the Office of
Medicare & Medicaid Services (CMS) is
providing notice of the establishment of Management and Budget (OMB), and
made available to the public, as required
a matching program between CMS and
the Department of Veterans Affairs (VA), by 5 U.S.C. 552a(o), (u)(3)(A), and (u)(4).
2. Notify the individuals whose
Veterans Health Administration (VHA)
information
will be used in the
for ‘‘Identification and Recovery of
matching program that the information
Duplicate Payments for Medical
they provide is subject to verification
Claims.’’
through matching, as required by 5
DATES: The deadline for comments on
U.S.C. 552a(o)(1)(D).
this notice is June 24, 2024. The new
3. Verify match findings before
matching program will commence not
suspending, terminating, reducing, or
sooner than 30 days after publication of making a final denial of an individual’s
this notice, provided no comments are
benefits or payments or taking other
received that warrant a change to this
adverse action against the individual, as
notice. The matching program will be
required by 5 U.S.C. 552a(p).
conducted for an initial term of 18
4. Report the matching program to
months (from approximately June 24,
Congress and the OMB, in advance and
2024 to December 23, 2025) and within
annually, as required by 5 U.S.C.
3 months of expiration may be renewed 552a(o) (2)(A)(i), (r), and (u)(3)(D).
5. Publish advance notice of the
for one additional year if the parties
matching program in the Federal
make no change to the matching
Register as required by 5 U.S.C.
program and certify that the program
has been conducted in compliance with 552a(e)(12).
This matching program meets these
the matching agreement.
requirements.
ADDRESSES: Interested parties may
submit written comments on the new
Barbara Demopulos,
matching program to the CMS Privacy
Privacy Act Officer, Division of Security,
Act Officer by mail at: Division of
Privacy Policy and Governance, Office of
Security, Privacy Policy & Governance,
Information Technology, Centers for Medicare
& Medicaid Services.
Information Security & Privacy Group,
Office of Information Technology,
Participating Agencies
Centers for Medicare & Medicaid
The Department of Health and Human
Services, Location: N1–14–56, 7500
Services (HHS), Centers for Medicare &
Security Blvd., Baltimore, MD 21244–
Medicaid Services (CMS) is the
1850, or by email at
recipient agency, and the Department of
Barbara.Demopulos@cms.hhs.gov.
Veterans Affairs (VA), Veterans Health
FOR FURTHER INFORMATION CONTACT: If
Administration (VHA) is the source
you have questions about the matching
agency.
program, you may contact Richard
lotter on DSK11XQN23PROD with NOTICES1
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Mazur, CMS Technical Adviser,
Division of Medicare Secondary Payer
Operations, Financial Services Group,
Office of Financial Management,
Centers for Medicare & Medicaid
Services, at 410–786–1418, by email at
richard.mazur2@cms.hhs.gov, or by
mail at 7500 Security Blvd., Baltimore,
MD 21244.
SUPPLEMENTARY INFORMATION: The
Privacy Act of 1974, as amended (5
VerDate Sep<11>2014
18:47 May 22, 2024
Jkt 262001
Authority for Conducting the Matching
Program
The authority for the matching
program is 42 U.S.C. 1320a-7k and 1395
et seq.; and 38 U.S.C. 1703 and 1725.
Purpose(s)
The purpose of the matching program
is to identify dual enrolled beneficiaries
and duplicate claims for the benefit of
both CMS and VHA. The matching
PO 00000
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Fmt 4703
Sfmt 4703
45661
program will assist both agencies in
identifying those VHA enrolled
beneficiaries who are also enrolled as
Medicare beneficiaries, the specific
claims where VHA and CMS made
duplicate payments for the same health
care services, and potential fraud, waste,
and abuse. The claims for which both
agencies made payment for the same
service(s) will be reviewed by both
agencies, and recoupment action will be
initiated against the providers as
appropriate.
Although Privacy Act records about
beneficiaries will be used to conduct the
matches, the match results will be used
to take actions affecting only providers
and suppliers. Some providers and
suppliers are solo practitioners
(individuals), but they are not Privacy
Act-covered individuals in this
matching program, because the claims
payment records to be used in this
matching program are retrieved by
beneficiary identifiers only.
Categories of Individuals
The categories of individuals whose
information will be used in the
matching program are: (1) Veterans
enrolled in VHA healthcare, and (2)
Medicare enrolled beneficiaries (Part A
and B) identified as dual enrolled
beneficiaries.
Categories of Records
The categories of records which will
be used in the matching program are
VHA beneficiary identifying
information and Medicare beneficiary
identifying information.
VHA Finder Files will include the
following data elements about VHA
beneficiaries:
a. Transaction type: Add or Update
b. SSN
c. Medicare Claim Number (if available)
d. Date of Birth
e. Beneficiary First Name
f. Beneficiary Last Name
g. Beneficiary Sex
h. Enrollment Category (Enrolled or Not
Enrolled)
i. Enrollment Status
j. Enrollment time frames: effective date
and/or, when applicable, end date
k. Date of Death (if applicable)
CMS Response Files will include the
following data elements about Medicare
beneficiaries identified as dual enrolled:
a. Action type: Add/Update/Delete
Record
b. SSN
c. MBI
d. Date of Birth
e. Beneficiary First Name
f. Beneficiary Last Name
g. Beneficiary Sex code
E:\FR\FM\23MYN1.SGM
23MYN1
45662
Federal Register / Vol. 89, No. 101 / Thursday, May 23, 2024 / Notices
h. Medicare Enrollment time frames:
Effective and termination dates
i. Medicare and VHA Dual enrollment
timeframes: Effective and termination
dates
j. Date of death
System(s) of Records
The records used in the matching
program will be disclosed from the
following systems of records, as
authorized by routine uses published in
the system of records notices (SORNs)
cited below:
lotter on DSK11XQN23PROD with NOTICES1
A. Systems of Records Maintained by
CMS
1. Common Working File (CWF),
System No. 09–70–0526, last published
in full at 71 FR 64955 (Nov. 6, 2006),
and partially updated at 78 FR 23938
(Apr. 23, 2013), 78 FR 32257 (May 29,
2013), and 83 FR 6591 (Feb. 14, 2018).
Routine uses 2a and 10 authorize
disclosures to VHA to contribute to the
accuracy of CMS’ proper payment of
Medicare benefits, and to investigate
potential fraud, waste, or abuse.
2. Medicare Beneficiary Database
(MBD), System No. 09–70–0536, last
published in full at 71 FR 70396 (Dec.
4, 2006), and partially updated at 78 FR
23938 (Apr. 23, 2013), 78 FR 32257
(May 29, 2013), and 83 FR 6591 (Feb.
14, 2018). Routine uses 2a and 11
authorize disclosures to VHA to
contribute to the accuracy of CMS’s
proper payment of Medicare benefits,
and to investigate potential fraud, waste,
or abuse.
3. Medicare Integrated Data
Repository (IDR), System No. 09–70–
0571, last published in full at 71 FR
74915 (Dec. 13, 2006), and partially
updated 76 FR 65196 (Oct. 20, 2011), 78
FR 23938 (Apr. 23, 2013), 78 FR 32257
(May 29, 2013), and 83 FR 6591 (Feb.
14, 2019). Routine uses 2a and 11
authorize disclosures to VHA to
contribute to the accuracy of CMS’s
proper payment of Medicare benefits,
and to investigate potential fraud, waste,
or abuse.
4. National Claims History (NCH),
System No. 09–70–0558, last published
in full at 71 FR 67137 (Nov. 20, 2006),
and partially updated at 76 FR 65196
(Oct 20, 2011), 78 FR 23938 (Apr. 23,
2013), 78 FR 32257 (May 29, 2013), and
83 FR 6591 (Feb. 14, 2018). Routine uses
2a and 10 authorize disclosure to VHA
to contribute to the accuracy of CMS’s
proper payment of Medicare benefits,
and to investigate potential fraud, waste,
or abuse.
VerDate Sep<11>2014
18:47 May 22, 2024
Jkt 262001
B. Systems of Records Maintained by
VHA
minimize the information collection
burden.
1. SOR 147VA10, entitled
‘‘Enrollment and Eligibility RecordVA,’’ last published at 86 FR 46090
(Aug. 17, 2021). Routine use 12
authorizes disclosures to federal
agencies for purposes of preventing and
detecting possible fraud or abuse by
individuals in their operations and
programs.
2. SOR 23VA10NB3, entitled ‘‘NonVA Care (Fee) Records,’’ last published
at 80 FR 45590 (July 30, 2015). Routine
use 12 authorizes disclosures to CMS for
its use in identifying potential duplicate
payments for healthcare services paid
by VA and CMS. Routine use 30
authorizes disclosure to assist in
preventing and detecting possible fraud
or abuse by individuals in federal
programs.
DATES:
[FR Doc. 2024–11351 Filed 5–22–24; 8:45 am]
BILLING CODE 4120–03–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Centers for Medicare & Medicaid
Services
[Document Identifiers: CMS–10526]
Agency Information Collection
Activities: Submission for OMB
Review; Comment Request
Centers for Medicare &
Medicaid Services, Health and Human
Services (HHS).
ACTION: Notice.
AGENCY:
The Centers for Medicare &
Medicaid Services (CMS) is announcing
an opportunity for the public to
comment on CMS’ intention to collect
information from the public. Under the
Paperwork Reduction Act of 1995
(PRA), federal agencies are required to
publish notice in the Federal Register
concerning each proposed collection of
information, including each proposed
extension or reinstatement of an existing
collection of information, and to allow
a second opportunity for public
comment on the notice. Interested
persons are invited to send comments
regarding the burden estimate or any
other aspect of this collection of
information, including the necessity and
utility of the proposed information
collection for the proper performance of
the agency’s functions, the accuracy of
the estimated burden, ways to enhance
the quality, utility, and clarity of the
information to be collected, and the use
of automated collection techniques or
other forms of information technology to
SUMMARY:
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Frm 00037
Fmt 4703
Sfmt 4703
Comments on the collection(s) of
information must be received by the
OMB desk officer by June 24, 2024.
ADDRESSES: Written comments and
recommendations for the proposed
information collection should be sent
within 30 days of publication of this
notice to www.reginfo.gov/public/do/
PRAMain. Find this particular
information collection by selecting
‘‘Currently under 30-day Review—Open
for Public Comments’’ or by using the
search function.
To obtain copies of a supporting
statement and any related forms for the
proposed collection(s) summarized in
this notice, please access the CMS PRA
website by copying and pasting the
following web address into your web
browser: https://www.cms.gov/
Regulations-and-Guidance/Legislation/
PaperworkReductionActof1995/PRAListing.
FOR FURTHER INFORMATION CONTACT:
William Parham at (410) 786–4669.
Under the
Paperwork Reduction Act of 1995 (PRA)
(44 U.S.C. 3501–3520), federal agencies
must obtain approval from the Office of
Management and Budget (OMB) for each
collection of information they conduct
or sponsor. The term ‘‘collection of
information’’ is defined in 44 U.S.C.
3502(3) and 5 CFR 1320.3(c) and
includes agency requests or
requirements that members of the public
submit reports, keep records, or provide
information to a third party. Section
3506(c)(2)(A) of the PRA (44 U.S.C.
3506(c)(2)(A)) requires federal agencies
to publish a 30-day notice in the
Federal Register concerning each
proposed collection of information,
including each proposed extension or
reinstatement of an existing collection
of information, before submitting the
collection to OMB for approval. To
comply with this requirement, CMS is
publishing this notice that summarizes
the following proposed collection(s) of
information for public comment:
1. Type of Information Collection
Request: Extension without change of a
currently approved collection; Title of
Information Collection: Cost-Sharing
Reduction Reconciliation Use: Under
established Department of Health and
Human Services (HHS) regulations,
although cost-sharing reduction (CSR)
payments are not being advanced to
qualified health plan (QHP) issuers at
the present time, issuers are still
permitted to submit data that compares
the CSR-eligible enrollment for each
issuer with their actual CSRs provided
SUPPLEMENTARY INFORMATION:
E:\FR\FM\23MYN1.SGM
23MYN1
]]>Agencies
[Federal Register Volume 89, Number 101 (Thursday, May 23, 2024)]
[Notices]
[Pages 45661-45662]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2024-11351]
[[Page 45661]]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
Privacy Act of 1974; Matching Program
AGENCY: Centers for Medicare & Medicaid Services (CMS), Department of
Health and Human Services (HHS)
ACTION: Notice of a new matching program.
-----------------------------------------------------------------------
SUMMARY: In accordance with subsection (e)(12) of the Privacy Act of
1974, as amended, the Department of Health and Human Services (HHS),
Centers for Medicare & Medicaid Services (CMS) is providing notice of
the establishment of a matching program between CMS and the Department
of Veterans Affairs (VA), Veterans Health Administration (VHA) for
``Identification and Recovery of Duplicate Payments for Medical
Claims.''
DATES: The deadline for comments on this notice is June 24, 2024. The
new matching program will commence not sooner than 30 days after
publication of this notice, provided no comments are received that
warrant a change to this notice. The matching program will be conducted
for an initial term of 18 months (from approximately June 24, 2024 to
December 23, 2025) and within 3 months of expiration may be renewed for
one additional year if the parties make no change to the matching
program and certify that the program has been conducted in compliance
with the matching agreement.
ADDRESSES: Interested parties may submit written comments on the new
matching program to the CMS Privacy Act Officer by mail at: Division of
Security, Privacy Policy & Governance, Information Security & Privacy
Group, Office of Information Technology, Centers for Medicare &
Medicaid Services, Location: N1-14-56, 7500 Security Blvd., Baltimore,
MD 21244-1850, or by email at [email protected].
FOR FURTHER INFORMATION CONTACT: If you have questions about the
matching program, you may contact Richard Mazur, CMS Technical Adviser,
Division of Medicare Secondary Payer Operations, Financial Services
Group, Office of Financial Management, Centers for Medicare & Medicaid
Services, at 410-786-1418, by email at [email protected], or
by mail at 7500 Security Blvd., Baltimore, MD 21244.
SUPPLEMENTARY INFORMATION: The Privacy Act of 1974, as amended (5
U.S.C. 552a) provides certain protections for individuals applying for
and receiving federal benefits. The law governs the use of computer
matching by federal agencies when records in a system of records
(meaning, federal agency records about individuals retrieved by name or
other personal identifier) are matched with records of other federal or
non-federal agencies. The Privacy Act requires agencies involved in a
matching program to:
1. Enter into a written agreement, which must be prepared in
accordance with the Privacy Act, approved by the Data Integrity Board
(DIB) of each source and recipient federal agency, provided to Congress
and the Office of Management and Budget (OMB), and made available to
the public, as required by 5 U.S.C. 552a(o), (u)(3)(A), and (u)(4).
2. Notify the individuals whose information will be used in the
matching program that the information they provide is subject to
verification through matching, as required by 5 U.S.C. 552a(o)(1)(D).
3. Verify match findings before suspending, terminating, reducing,
or making a final denial of an individual's benefits or payments or
taking other adverse action against the individual, as required by 5
U.S.C. 552a(p).
4. Report the matching program to Congress and the OMB, in advance
and annually, as required by 5 U.S.C. 552a(o) (2)(A)(i), (r), and
(u)(3)(D).
5. Publish advance notice of the matching program in the Federal
Register as required by 5 U.S.C. 552a(e)(12).
This matching program meets these requirements.
Barbara Demopulos,
Privacy Act Officer, Division of Security, Privacy Policy and
Governance, Office of Information Technology, Centers for Medicare &
Medicaid Services.
Participating Agencies
The Department of Health and Human Services (HHS), Centers for
Medicare & Medicaid Services (CMS) is the recipient agency, and the
Department of Veterans Affairs (VA), Veterans Health Administration
(VHA) is the source agency.
Authority for Conducting the Matching Program
The authority for the matching program is 42 U.S.C. 1320a-7k and
1395 et seq.; and 38 U.S.C. 1703 and 1725.
Purpose(s)
The purpose of the matching program is to identify dual enrolled
beneficiaries and duplicate claims for the benefit of both CMS and VHA.
The matching program will assist both agencies in identifying those VHA
enrolled beneficiaries who are also enrolled as Medicare beneficiaries,
the specific claims where VHA and CMS made duplicate payments for the
same health care services, and potential fraud, waste, and abuse. The
claims for which both agencies made payment for the same service(s)
will be reviewed by both agencies, and recoupment action will be
initiated against the providers as appropriate.
Although Privacy Act records about beneficiaries will be used to
conduct the matches, the match results will be used to take actions
affecting only providers and suppliers. Some providers and suppliers
are solo practitioners (individuals), but they are not Privacy Act-
covered individuals in this matching program, because the claims
payment records to be used in this matching program are retrieved by
beneficiary identifiers only.
Categories of Individuals
The categories of individuals whose information will be used in the
matching program are: (1) Veterans enrolled in VHA healthcare, and (2)
Medicare enrolled beneficiaries (Part A and B) identified as dual
enrolled beneficiaries.
Categories of Records
The categories of records which will be used in the matching
program are VHA beneficiary identifying information and Medicare
beneficiary identifying information.
VHA Finder Files will include the following data elements about VHA
beneficiaries:
a. Transaction type: Add or Update
b. SSN
c. Medicare Claim Number (if available)
d. Date of Birth
e. Beneficiary First Name
f. Beneficiary Last Name
g. Beneficiary Sex
h. Enrollment Category (Enrolled or Not Enrolled)
i. Enrollment Status
j. Enrollment time frames: effective date and/or, when applicable, end
date
k. Date of Death (if applicable)
CMS Response Files will include the following data elements about
Medicare beneficiaries identified as dual enrolled:
a. Action type: Add/Update/Delete Record
b. SSN
c. MBI
d. Date of Birth
e. Beneficiary First Name
f. Beneficiary Last Name
g. Beneficiary Sex code
[[Page 45662]]
h. Medicare Enrollment time frames: Effective and termination dates
i. Medicare and VHA Dual enrollment timeframes: Effective and
termination dates
j. Date of death
System(s) of Records
The records used in the matching program will be disclosed from the
following systems of records, as authorized by routine uses published
in the system of records notices (SORNs) cited below:
A. Systems of Records Maintained by CMS
1. Common Working File (CWF), System No. 09-70-0526, last published
in full at 71 FR 64955 (Nov. 6, 2006), and partially updated at 78 FR
23938 (Apr. 23, 2013), 78 FR 32257 (May 29, 2013), and 83 FR 6591 (Feb.
14, 2018). Routine uses 2a and 10 authorize disclosures to VHA to
contribute to the accuracy of CMS' proper payment of Medicare benefits,
and to investigate potential fraud, waste, or abuse.
2. Medicare Beneficiary Database (MBD), System No. 09-70-0536, last
published in full at 71 FR 70396 (Dec. 4, 2006), and partially updated
at 78 FR 23938 (Apr. 23, 2013), 78 FR 32257 (May 29, 2013), and 83 FR
6591 (Feb. 14, 2018). Routine uses 2a and 11 authorize disclosures to
VHA to contribute to the accuracy of CMS's proper payment of Medicare
benefits, and to investigate potential fraud, waste, or abuse.
3. Medicare Integrated Data Repository (IDR), System No. 09-70-
0571, last published in full at 71 FR 74915 (Dec. 13, 2006), and
partially updated 76 FR 65196 (Oct. 20, 2011), 78 FR 23938 (Apr. 23,
2013), 78 FR 32257 (May 29, 2013), and 83 FR 6591 (Feb. 14, 2019).
Routine uses 2a and 11 authorize disclosures to VHA to contribute to
the accuracy of CMS's proper payment of Medicare benefits, and to
investigate potential fraud, waste, or abuse.
4. National Claims History (NCH), System No. 09-70-0558, last
published in full at 71 FR 67137 (Nov. 20, 2006), and partially updated
at 76 FR 65196 (Oct 20, 2011), 78 FR 23938 (Apr. 23, 2013), 78 FR 32257
(May 29, 2013), and 83 FR 6591 (Feb. 14, 2018). Routine uses 2a and 10
authorize disclosure to VHA to contribute to the accuracy of CMS's
proper payment of Medicare benefits, and to investigate potential
fraud, waste, or abuse.
B. Systems of Records Maintained by VHA
1. SOR 147VA10, entitled ``Enrollment and Eligibility Record-VA,''
last published at 86 FR 46090 (Aug. 17, 2021). Routine use 12
authorizes disclosures to federal agencies for purposes of preventing
and detecting possible fraud or abuse by individuals in their
operations and programs.
2. SOR 23VA10NB3, entitled ``Non-VA Care (Fee) Records,'' last
published at 80 FR 45590 (July 30, 2015). Routine use 12 authorizes
disclosures to CMS for its use in identifying potential duplicate
payments for healthcare services paid by VA and CMS. Routine use 30
authorizes disclosure to assist in preventing and detecting possible
fraud or abuse by individuals in federal programs.
[FR Doc. 2024-11351 Filed 5-22-24; 8:45 am]
BILLING CODE 4120-03-P
