Federal Register / Vol. 78, No. 103 / Wednesday, May 29, 2013 / Notices 32257 

1See also 78 FR 8539, 8540. 

Facsimile: (301) 492–4353, Email: 

karen.mandelbaum@cms.hhs.gov. 

SUPPLEMENTARY INFORMATION: CMS 

proposes to alter the SOR to add 

‘‘Relevant Individual(s)’’ as a category of 

individuals whose PII is necessary for 

determining the eligibility of applicants 

for insurance affordability programs or a 

certification of exemption under 

provisions of the Patient Protection and 

Affordable Care Act (Pub. L. 111–148), 

as amended by the Health Care and 

Education Reconciliation Act of 2010 

(Pub. L. 111–152) (collectively referred 

to as the Affordable Care Act) and CMS’ 

implementation of the Affordable Care 

Act. 

For the purpose of this SORN, 

‘‘Relevant Individual(s)’’ means any 

individual listed on an application for 

an insurance affordability program or 

certification of exemption whose PII 

may bear upon the eligibility of an 

individual for an insurance affordability 

program (as defined in 42 CFR 435.4 

and 45 CFR 155.20),1 or certification of 

exemption. These individuals include 

non-applicant household members/ 

family members, certain non-applicant 

tax payers or tax filers, and spouses and 

parents of applicants. Due to the 

potential impact of the Relevant 

Individuals’ PII on an individual’s 

eligibility determination this category of 

individuals is added to the SOR. 

Additionally, Routine Use #3 is 

proposed to be modified to permit CMS 

to disclose information about Relevant 

Individual(s), in addition to applicants, 

in order to obtain information from 

other Federal and State agencies and 

third party data sources that provide 

information to CMS, pursuant to 

agreements with CMS, for purposes of 

determining eligibility of applicants to 

enroll in qualified health plans (QHP) 

through an Exchange, in insurance 

affordability programs, or for a 

certification of exemption from the 

individual responsibility requirement. 

Routine Use #8 is proposed to be 

modified to enable CMS to provide 

information about Relevant 

Individual(s), in addition to applicants, 

to application filers who are filing on 

behalf of those applicants for whom an 

eligibility determination will require 

information about the Relevant 

Individual(s). 

The proposed changes require the 

following alterations to sections of the 

notice. 

1. Categories of Individuals Covered 

by the System: Remove the ‘‘and’’ before 

‘‘(7)’’ and add the following at the end 

of this section: 

‘‘and (8) Individuals, including nonapplicant household members/family 

members, non-applicant tax payers or 

tax filers, and spouses and parents of 

applicants, who are listed on the 

application and whose PII may bear 

upon a determination of the eligibility 

of an individual for an insurance 

affordability program and for 

certifications of exemption from the 

individual responsibility requirement. 

Such individuals will hereafter be 

referred to as ‘‘Relevant Individual(s)’’.’’ 

2. Categories of Records in the 

System: Add the following to the end of 

the first paragraph of this section: 

‘‘The system will collect and maintain 

information pertaining to Relevant 

Individual(s) that includes the 

following: First name, last name, middle 

initial, permanent residential address, 

date of birth, SSN (if the Relevant 

Individual has one or is required to 

provide it as specified in 45 CFR 

155.305(f)(6)), taxpayer status, gender, 

residency, relationship to applicant, 

employer information, and household 

income, including tax information from 

the IRS, income information from the 

Social Security Administration, and 

financial information from other third 

party sources.’’ 

3. Purpose(s) of the System: Replace 

the first sentence of the first paragraph 

of this section with the following 

sentence: 

‘‘The purpose of this system is to 

collect, create, use and disclose PII 

about individuals who apply for 

eligibility determinations for enrollment 

in a QHP through the Exchange, for 

insurance affordability programs, and 

for certifications of exemption from the 

individual responsibility requirement 

and on Relevant Individual(s) whose PII 

may bear upon a determination of the 

eligibility of an individual for an 

insurance affordability program and for 

certifications of exemption from the 

individual responsibility requirement.’’ 

4. Routine Use #3: Delete entry and 

replace with: 

‘‘To disclose information about 

applicants and Relevant Individual(s) in 

order to obtain information from other 

Federal agencies and State agencies and 

third party data sources that provide 

information to CMS, pursuant to 

agreements with CMS, for purposes of 

determining the eligibility of applicants 

to enroll in QHPs through an Exchange, 

in insurance affordability programs, or 

for a certification of exemption from the 

individual responsibility requirement.’’ 

5. Routine Use #8: Delete entry and 

replace with: 

‘‘To provide information about 

applicants and Relevant Individual(s) to 

applicants/enrollees, authorized 

representatives of applicants/enrollees, 

and application filers, who are filing on 

behalf of those applicants, when 

relevant and necessary to determine 

eligibility for enrollment in a QHP 

through an Exchange, insurance 

affordability programs, or a certification 

of exemption from the individual 

responsibility requirement.’’ 

The information collected by this 

system and the purposes for which it is 

used and disclosed by CMS are 

described in the modifications to the 

SORN as stated above. 

Michelle Snyder, 

Deputy Chief Operating Officer, Centers for 

Medicare & Medicaid Services. 

[FR Doc. 2013–12691 Filed 5–28–13; 8:45 am] 

BILLING CODE 4120–03–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

Privacy Act of 1974; Report of a New 

Routine Use for Selected CMS 

Systems of Records 

AGENCY: Centers for Medicare & 

Medicaid Services (CMS) Department of 

Health and Human Services (HHS). 

ACTION: Altered System Notice, Adding 

a New Routine Use for Selected CMS 

Systems of Records. 

SUMMARY: In accordance with the 

requirements of the Privacy Act of 1974 

(5 U.S.C. 552a), CMS is adding a new 

routine use to twenty-three CMS 

systems of records to assist in 

preventing and detecting fraud, waste 

and abuse. The new routine use will 

authorize CMS to disclose provider and 

beneficiary-identifiable records to 

representatives of health plans for the 

purpose of preventing and detecting 

fraud, waste and abuse, pursuant to 

section 1128C(a)(2) of the Social 

Security Act (‘‘the Act’’). At section 

1128C(c) of the Act, a health plan is 

defined as a plan or program that 

provides health benefits, whether 

directly, through insurance, or 

otherwise, and includes: (1) A policy of 

health insurance; (2) a contract of a 

service benefit organization; and (3) a 

membership agreement with a health 

maintenance organization or other 

prepaid health plan. 

Disclosures made pursuant to the 

routine use will be coordinated through 

CMS’ Data Sharing and Partnership 

Group, Center for Program Integrity, 

CMS. CMS has identified twenty-three 

systems that contain the data potentially 


tkelley on DSK3SPTVN1PROD with NOTICES
32258 Federal Register / Vol. 78, No. 103 / Wednesday, May 29, 2013 / Notices 

necessary to disclose to health plans for 

the prevention and detection of fraud, 

waste and abuse. These systems are 

listed at the end of this notice. 

DATES: Effective Dates: The new routine 

use described in this notice will become 

effective without further notice 30 days 

after publication of this notice in the 

Federal Register (FR), unless comments 

received on or before that date result in 

revisions to this notice. 

ADDRESSES: The public should send 

comments to: CMS Privacy Officer, 

Division of Privacy Policy, Privacy 

Policy and Compliance Group, Office of 

E-Health Standards & Services, Office of 

Enterprise Management, CMS, Room 

S2–24–25, 7500 Security Boulevard, 

Baltimore, Maryland 21244–1850. 

Comments received will be available for 

review at this location, by appointment, 

during regular business hours, Monday 

through Friday from 9:00 a.m.–3:00 

p.m., Eastern Time zone. 

FOR FURTHER INFORMATION CONTACT: 

Shantanu Agrawal, MD, MPhil, FAAEM, 

Medical Director, Director, Data Sharing 

and Partnership Group, CMS Center for 

Program Integrity, 7500 Security 

Boulevard, Mail Stop AR–18–50, 

Baltimore, MD 21244, Office phone: 

410.786.1795, Facsimile: 410.786.0604, 

Email: shantanu.agrawal@cms.hhs.gov. 

SUPPLEMENTARY INFORMATION: Section 

1128C(a)(2) of the Act authorizes the 

Secretary and the Attorney General to 

consult with, and arrange for the sharing 

of data with, representatives of health 

plans. At section 1128C(c) of the Act, a 

health plan is defined as a plan or 

program that provides health benefits, 

whether directly, through insurance, or 

otherwise, and includes: (1) A policy of 

health insurance; (2) a contract of a 

service benefit organization; and (3) a 

membership agreement with a health 

maintenance organization or other 

prepaid health plan. In order for CMS to 

disclose data with representatives of 

health plans pursuant to section 

1128C(a)(2) of the Act, CMS is 

establishing a new routine use for 

twenty-three systems identified as 

containing the data that may be used to 

detect and prevent fraud, waste, and 

abuse. The Secretary’s authority under 

section 1128C(a)(2) of the Act has been 

delegated to the Administrator of CMS. 

Advance notice of the proposed new 

routine use for the twenty-three systems 

of record was provided to OMB and 

Congress as required by the Privacy Act 

at 5 U.S.C. 552a(r). 

For the reasons described above, the 

following routine use is added to the 

twenty-three systems of records listed 

below: 

‘‘To disclose to health plans, defined 

for this purpose as plans or programs 

that provide health benefits, whether 

directly, through insurance, or 

otherwise, and includes—(1) a policy of 

health insurance; (2) a contract of a 

service benefit organization; and (3) a 

membership agreement with a health 

maintenance organization or other 

prepaid health plan when disclosure is 

deemed reasonably necessary by CMS to 

prevent, deter, discover, detect, 

investigate, examine, prosecute, sue 

with respect to, defend against, correct, 

remedy, or otherwise combat fraud, 

waste, or abuse in such programs. 

Disclosures may include provider and 

beneficiary-identifiable data.’’ 

1. Health Plan Management System 

(HPMS), System No. 09–70–0500, 

published at 73 Federal Register (FR) 

2257 (January 14, 2008). 

2. Medicare Multi-Carrier Claims 

System (MCS), System No. 09–70–0501, 

published at 71 FR 64968 (November 6, 

2006). 

3. Enrollment Database (EDB), System 

No. 09–70–0502, published at 73 FR 

10249 (February 26, 2008). 

4. Fiscal Intermediary Shared System 

(FISS), System No. 09–70–0503, 

published at 71 FR 64961 (November 6, 

2006). 

5. Inpatient Rehabilitation Facilities— 

Patient Assessment Instrument (IRF– 

PAI), System No. 09–70–0521, 

published at 71 FR 67143 (November 

20, 2006). 

6. HHA Outcome and Assessment 

Information Set (OASIS), System No. 

09–70–0522, published at 72 FR 63906 

(November 13, 2007). 

7. Unique Physician/Practitioner 

Identification Number System (UPIN), 

System No. 09–70–0525, published at 

71 FR 66535 (November 15, 2006). 

8. Common Working File (CWF), 

System No, 09–70–0526, published at 

71 FR 64955 (November 6, 2006). 

9. Fraud Investigation Database (FID), 

System No. 09–70–0527, published at 

71 FR 77759 (December 27, 2006). 

10. Long Term Care MDS (LTC MDS), 

System No. 09–70–0528, published at 

72 FR 12801 (March 19, 2007). 

11. Medicare Supplier Identification 

File (MSIF), System No. 09–70–0530, 

published at 71 FR 70404 (December 4, 

2006). 

12. Provider Enrollment, Chain and 

Ownership System (PECOS), System 

No. 09–70–0532, published at 71 FR 

60536 (October 13, 2006). 

13. Medicare Exclusion Database 

(MED), System No. 09–70–0534, 

published at 71 FR 70967 (December 7, 

2006). 

14. Medicare Beneficiary Database 

(MBD), System No. 09–70–0536, 

published at 71 FR 70396 (December 4, 

2006). 

15. Medicaid Statistical Information 

System (MSIS), System No. 09–70–0541, 

published at 71 FR 65527 (November 8, 

2006). 

16. Medicare Retiree Drug Subsidy 

Program (RDSP), System No. 09–70– 

0550, published at 70 FR 41035 (July 15, 

2005). 

17. Medicare Drug Data Processing 

System (DDPS), System No. 09–70– 

0553, published at 73 FR 30943 (May 

29, 2008). 

18. National Plan and Provider 

Enumeration System (NPPES), System 

No. 09–70–0555, published at 75 FR 

30411 (June 1, 2010). 

19. National Claims History (NCH), 

System No. 09–70–0558, published at 

71 FR 67137 (November 20, 2006). 

20. Integrated Data Repository (IDR) 

System No. 09–70–0571, published at 

71 FR 74915 (December 13, 2006). 

21. Chronic Condition Data 

Repository (CCDR), System No. 09–70– 

0573, published at 71 FR 74915 

(December 13, 2006). 

22. Medicaid Integrity Program 

System (MIPS), System No. 09–70–0599, 

published at 73 FR 11639 (March 4, 

2008). 

23. Medicare Advantage Prescription 

Drug System (MARx), System No. 09– 

70–0588, published at 70 FR 60530 

(October 18, 2005). 

Michelle Snyder, 

Deputy Chief Operating Officer, Centers for 

Medicare & Medicaid Services. 

[FR Doc. 2013–12690 Filed 5–28–13; 8:45 am] 

BILLING CODE 4120–03–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Administration for Children and 

Families 

Proposed Information Collection 

Activity; Comment Request 

Proposed Projects 

Title: Federally Assisted State 

Transmitted Levy (FAST Levy). 

OMB No.: New Collection. 

Description: State IV–D child support 

enforcement agencies are required to 

secure assets in cases where there is a 

support arrearage to satisfy any current 

support obligation and the arrearage by 

attaching and seizing assets of the 

obligor held in financial institutions. To 

assist states in fulfilling this statutory 

requirement the federal Office of Child 

Support Enforcement (OCSE) is 

proposing a new information collection 

using the Federally Assisted State 

Transmitted Levy (FAST Levy), a new 


tkelley on DSK3SPTVN1PROD with NOTICES