[Federal Register Volume 88, Number 212 (Friday, November 3, 2023)]
[Notices]
[Pages 75596-75597]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2023-24331]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services


Privacy Act of 1974; Matching Program

AGENCY: Center for Consumer Information and Insurance Oversight 
(CCIIO), Centers for Medicare & Medicaid Services (CMS), Department of 
Health and Human Services (HHS).

ACTION: Notice of a new matching program.

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SUMMARY: In accordance with 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 re-establishment of 
a computer matching program between CMS and the Office of Personnel 
Management (OPM), ``Verification of Eligibility of Minimum Essential 
Coverage Under the Patient Protection and Affordable Care Act through 
an Office of Personnel Management Health Benefit Plan.''

DATES: The deadline for comments on this notice is December 4, 2023. 
The re-established 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 
December 8, 2023 to June 7, 2025) and within three months of expiration 
may be renewed for up to 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 comments on this notice 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 <a href="/cdn-cgi/l/email-protection#31735043535043501f75545c5e41445d5e4271525c421f5959421f565e47"><span class="__cf_email__" data-cfemail="21634053434053400f65444c4e51544d4e5261424c520f4949520f464e57">[email protected]</span></a>.

FOR FURTHER INFORMATION CONTACT: If you have questions about the 
matching program, you may contact Anne Pesto, Senior Advisor, 
Marketplace Eligibility and Enrollment Group, Center for Consumer 
Information and Insurance Oversight, Centers for Medicare & Medicaid 
Services, at 443-955-9966, by email at <a href="/cdn-cgi/l/email-protection#2f4e41414a015f4a5c5b406f4c425c0147475c01484059"><span class="__cf_email__" data-cfemail="1a7b74747f346a7f696e755a79776934727269347d756c">[email protected]</span></a>, 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

[[Page 75597]]

with the Privacy Act, approved by the Data Integrity Board 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 
Office of Personnel Management (OPM) is the source agency.

Authority for Conducting the Matching Program

    The principal authority for the matching program is 42 U.S.C. 
18001, et seq.

Purpose(s)

    The purpose of the matching program is to provide CMS with OPM data 
which CMS and state Administering Entities (AEs) need to determine 
individuals' eligibility for financial assistance in paying for private 
health insurance coverage, under provisions of the Patient Protection 
and Affordable Care Act. In this matching program, OPM provides CMS 
with monthly data identifying each active federal employee's status as 
enrolled in or eligible for coverage under an OPM Health Benefit Plan, 
and an annual premium spread index file identifying the lowest premium 
available to a federal employee in each of 32 premium localities. CMS 
and AEs use the OPM data to verify whether an individual who is 
applying for or is enrolled in private health insurance coverage under 
a qualified health plan through a federally-facilitated or state-based 
health insurance exchange is eligible for coverage under an OPM health 
benefit plan, for the purpose of determining if the individual is 
eligible for financial assistance (including an advance tax credit and 
cost sharing reduction, which are types of insurance affordability 
programs) in paying for the private coverage. OPM health benefit plans 
provide minimum essential coverage, and eligibility for such plans 
precludes eligibility for financial assistance in paying for private 
coverage.

Categories of Individuals

    The categories of individuals whose information is involved in the 
matching program are: (1) active federal employees, and (2) consumers 
who apply for or are enrolled in a qualified health plan through an 
exchange established under the Patient Protection and Affordable Care 
Act and receive determinations of eligibility for insurance 
affordability programs.

Categories of Records

    The categories of records used in the matching program are identity 
information about the above consumers, which are maintained by CMS, and 
identity information and minimum essential coverage period records 
about all active federal employees, and annual premium information, 
maintained by OPM. The data elements provided to CMS by OPM are as 
follows:
    <bullet> Monthly status file:
    a. Record type;
    b. Record number;
    c. Unique person ID;
    d. Social security number;
    e. Last name;
    f. Middle name;
    g. First name;
    h. Last name suffix;
    i. Gender;
    j. Date of birth; and
    k. Health plan code.
    <bullet> Annual Premium Spread Index File:
    a. State;
    b. Plan;
    c. Option;
    d. Enrollment code;
    e. Current total bi-weekly premium;
    f. Future total bi-weekly premium;
    g. Future government pays bi-weekly premium;
    h. Future employee pays bi-weekly premium
    i. Future change in employee payment bi-weekly premium;
    j. Current total monthly premium;
    k. Future total monthly premium;
    l. Future government pays monthly premium;
    m. Future employee pays monthly premium; and
    n. Future change in employee payment monthly premium.
    CMS will not send any data about individual applicants or enrollees 
to OPM in order to receive this data from OPM.

System(s) of Records

    The records used in the matching program are maintained in these 
systems of records:

A. System of Records Maintained by CMS

    CMS Health Insurance Exchanges System (HIX), System No. 09-70-0560, 
last published in full at 78 FR 63211 (Oct. 23, 2013), and amended at 
83 FR 6591 (Feb. 14, 2018).

B. System of Records Maintained by OPM

    OPM/GOVT-1 General Personnel Records, last published in full at 77 
FR 79694 (Dec. 11, 2012), and amended at 80 FR 74815 (Nov. 30, 2015) 
and 87 FR 5874 (Feb. 2, 2022). The disclosures of OPM data to CMS are 
authorized by Routine Use ``rr''.

[FR Doc. 2023-24331 Filed 11-2-23; 8:45 am]
BILLING CODE 4120-03-P


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