[Federal Register Volume 80, Number 41 (Tuesday, March 3, 2015)]
[Notices]
[Pages 11527-11531]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2015-04312]


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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.

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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 ``Health 
Administration Center Civilian Health and Medical Program Records-VA'' 
(54VA16) as set forth in the Federal Register 74 FR 34398. VA is 
amending the system of records by revising the System Name, System 
Number, System Location, Categories of Individuals Covered by the 
System, Categories of Records in the System, Authority for Maintenance 
of the System, Purpose, Routine Uses of Records Maintained in the 
System, Including Categories of Users and the Purposes of Such Uses; 
Retrievability, Safeguards, Retention and Disposal, System Manager(s) 
and Address, Record Access Procedure, and Notification Procedure. VA is 
republishing the system notice in its entirety.

ADDRESSES: Written comments concerning the proposed new system of 
records 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. All 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 for 
an appointment. (This is not a toll free number.) In addition, during 
the comment period, comments may be viewed online through the Federal 
Docket Management System 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 
Health Administration Center Civilian Health and Medical Program 
Records-VA to Veterans and Beneficiaries Purchased Care Community 
Health Care Claims, Correspondence, Eligibility, Inquiry and Payment 
Files-VA.
    The system number is changed from 54VA16 to 54VA10NB3 to reflect 
the current organizational alignment.
    The System Location, Safeguards, Notification Procedure, and Record 
Access Procedure have been amended to reflect a name change from the 
Health Administration Center to the VA Chief Business Office Purchased 
Care.
    Categories of Individuals Covered by the System has been amended to 
include family members and caregivers of Veterans who are authorized 
and receive community non-VA medical care health care benefits and/or 
stipends, and to reflect that records are maintained on all health care 
providers who provide care under the programs administered by CBOPC. 38 
U.S.C. 1720G, 1787, 1812, 1821 and Public Law 111-163 section 101 are 
being added to section 1 and 4. A new section 5 has been added to 
include caregivers of Veterans providing personal care services and in 
receipt of a stipend under 38 U.S.C. 1720G and Public Law 111-163 
section 101.
    The Category of Records in the System is amended to reflect that 
information regarding family members and caregivers will be included, 
including information regarding eligibility or entitlement to other 
federal medical programs; and those who have applied for benefits in 
these programs, claims (billing) for medical care and services; 
information related to claims processing; documents pertaining to 
stipend calculation and payment; and documents pertaining to appeals.
    The Authority for Maintenance of the System is amended to include 
1720G, 1787, 1812, 1821, and Public Law 111-163 section 101.
    The Purpose is being amended to include processing claims for 
medical care and services, and processing stipends.
    Routine use 1 is being amended to add interactive voice recognition 
and portal. Routine use 28 is added to allow the disclosure of any 
relevant information to the Centers for Medicare and Medicaid, the 
Social Security Administration, Veterans Benefit Administration, or any 
other federal or state agency.
    The Retrievability section is being amended to include caregivers. 
The Retention and Disposal section is amended to reflect the Record 
Control Schedule (RCS) 10-1 item XXXVIII Civilian Health and Medical 
care (CHMC) Records, NARA job number N1-015-3-1Item 1-8b, (Master file) 
item 3, destroy 6 years after all individuals in the record become 
ineligible for program benefits.
    The System Manager and Address and Record Access Procedure are 
being amended to change the official maintaining the System from the 
Director, Health Administration Center to the Deputy Chief Business 
Officer Purchased Care.
    The Privacy Act permits VA to disclose information about 
individuals without their consent for a routine use when the 
information will be used for a purpose that is compatible with the 
purpose for which VA collected the information. In all of the routine 
use disclosures described above, the recipient of the information will 
use the information in connection with a matter relating to one of VA's 
programs, or to provide a benefit to VA, or disclosure is required by 
law.
    The Report of Intent to Amend a System of Records Notice and an 
advance copy of the system notice have been sent to the appropriate 
Congressional committees and to the

[[Page 11528]]

Director of the Office of Management 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. Jose D. Riojas, Chief of Staff, approved this 
document on February 10, 2015, for publication.

    Dated: February 25, 2015.
Jeffrey M. Martin,
Program Manager, Regulation Policy and Management, Office of the 
General Counsel, Department of Veterans Affairs.
54VA10NB3

SYSTEM NAME:
    ``Veterans and Beneficiaries Purchased Care Community Health Care 
Claims, Correspondence, Eligibility, Inquiry and Payment Files--VA''

SYSTEM LOCATION:
    Records are maintained at the Chief Business Office Purchased Care 
(CBOPC), 3773 Cherry Creek North Drive, Denver, Colorado 80209.

CATEGORIES OF INDIVIDUALS COVERED BY THE SYSTEM:
    Categories of individuals covered by the system include the 
following:
    1. Family members of Veterans who seek health care under 38 U.S.C. 
1720G, 1781, 1787, 1802, 1803, 1812, 1813, 1821, Public Law 103-446, 
section 107 and Public Law 111-163 section 101.
    2. Veterans seeking health care services in a foreign country under 
38 U.S.C. 1724.
    3. Veterans receiving community fee-for-service benefits at VA 
expense under Title 38 U.S.C. 1703, 1725 and 1728.
    4. Health care providers treating individuals who receive care 
under 38 U.S.C. 1703, 1720G, 1724, 1725, 1728, 1781, 1787, 1803, 1812, 
1813, 1821, Public Law 103-446 section 107 and Public Law 111-163 
section 101.
    5. Caregivers of Veterans providing personal care services and in 
receipt of a stipend under 38 U.S.C. 1720G and Public Law 111-163 
section 101.

CATEGORIES OF RECORDS IN THE SYSTEM:
    Records maintained in the system include program applications, 
eligibility information concerning the Veteran, family members, 
caregivers: Other health insurance information to include information 
regarding eligibility or entitlement to other federal medical programs: 
Correspondence concerning individuals who have applied for benefits in 
these programs; claims (billing) for medical care and services; 
documents pertaining to claims for medical services; information 
related to claims processing; documents pertaining to stipend 
calculation and payment; documents pertaining to appeals; and third 
party liability information and recovery actions taken by VA and/or 
TRICARE. The record may include the name, address and other identifying 
information concerning health care providers, services provided, 
amounts claimed and paid for health care services, amounts calculated 
and paid for stipends, medical records, and treatment and payment 
dates.
    Additional information may include Veterans, who have applied for 
benefits in these programs; claims (billing) for medical care and 
services; documents pertaining to claims for medical services; 
information related to claims processing; documents pertaining to 
stipend calculation and payment; documents pertaining to appeals; and 
third party liability information and recovery actions. family member, 
and caregiver identifying information (e.g., name, address, social 
security number, VA claim file number, date of birth), and military 
service information concerning the Veteran and spouse or other family 
member (when applicable--e.g., dates, branch and character of service, 
medical information).

AUTHORITY FOR MAINTENANCE OF THE SYSTEM:
    Title 38, United States Code, sections 501(a), 501(b), 1703, 1720G, 
1724, 1725, 1728, 1781, 1787, 1802, 1803, 1812, 1813, 1821, Public Law 
103-446 section 107 and Public Law 111-163 section 101.

PURPOSE(S):
    Records may be used for purposes of establishing and monitoring 
eligibility to receive VA benefits, processing claims for medical care 
and services, and processing stipends.

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. Eligibility and claim information from this system of records 
may be disclosed verbally or in writing. For example, disclosure may be 
made via correspondence, call service center, interactive voice 
recognition, portal or interactive Web page, in response to an inquiry 
made by the claimant, claimant's guardian, claimant's next of kin, 
health care provider, trading partner, other federal agency or 
contractor. Purposes of these disclosures are to assist the provider or 
claimant in obtaining reimbursement for claimed medical services, to 
facilitate billing processes, to verify beneficiary eligibility and to 
provide payment information regarding claimed services. Eligibility or 
entitlement information disclosed may include the name, authorization 
number (social security number), effective dates of eligibility, 
reasons for any period of ineligibility, and other health insurance 
information of the named individual. Claim or stipend information 
disclosed may include payment information such as payment 
identification number, date of payment, date of service, amount billed, 
amount paid, name of payee, or reasons for non-payment.
    2. Statistical and other data to Federal, State, and local 
government agencies and national health organizations to assist in the 
development of programs that will be beneficial to health care 
recipients, to protect their rights under the law, and to ensure that 
they are receiving all health benefits to which they are entitled.
    3. VA may disclose on its own initiative any information in this 
system, except the names and home addresses of Veterans and their 
family members or caregivers 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, Tribal, or foreign agency charged with the responsibility 
of investigating or prosecuting such violation, or charged with 
enforcing or implementing the statute, regulation, rule or order. On 
its own initiative, VA may also disclose the names and addresses of 
Veterans, their family members or caregivers 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,

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regulation, rule or order issued pursuant thereto.
    4. A record from this system of records may be disclosed to a 
Federal agency upon its request for use in the issuance of a security 
clearance, the investigation of an employee, the letting of a contract, 
or 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 on the matter.
    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 and to General Services Administration in records 
management inspections conducted under authority of 44 U.S.C.
    7. Any relevant information in this system of records may be 
disclosed to attorneys, insurance companies, employers, and to courts, 
boards, or commissions; such disclosures may be made only to the extent 
necessary to aid the VA in preparation, presentation, and prosecution 
of claims authorized under Federal, State, or local laws, and 
regulations promulgated thereunder.
    8. Any information in this system of records may be disclosed to 
the United States Department of Justice or United States Attorneys in 
order to prosecute or defend litigation involving or pertaining to the 
United States, or in which the United States has an interest.
    9. Any information in this system of records may be disclosed to a 
Federal agency or party to an administrative proceeding being conducted 
by a Federal agency, in order for VA to respond to and comply with the 
issuance of an order by that Federal agency requiring production of the 
information.
    10. Any information in this system of records may be disclosed to a 
State or municipal grand jury, a State or municipal court or a party in 
litigation, or to a State or municipal administrative agency 
functioning in a quasi-judicial capacity or a party to a proceeding 
being conducted by such agency, provided that any disclosure of 
claimant information made under this routine use must comply with the 
provisions of 38 CFR 1.511.
    11. Any information concerning the claimant's indebtedness to the 
United States by virtue of a person's participation in a benefits 
program administered by VA, including personal information obtained 
from other Federal agencies through computer matching programs, may be 
disclosed to any third party, except consumer reporting agencies, in 
connection with any proceeding for the collection of any amount owed to 
the United States. Purposes of these disclosures may be to assist VA in 
collection of costs of services provided individuals not entitled to 
such services and to initiate legal actions for prosecuting individuals 
who willfully or fraudulently obtain Title 38 benefits without 
entitlement. This disclosure is consistent with 38 U.S.C. 5701(b)(6).
    12. Any relevant information from this system of records may be 
disclosed to TRICARE, the Department of Defense (DoD) and the Defense 
Eligibility Enrollment Reporting System (DEERS) to the extent necessary 
to determine eligibility for the Civilian Health and Medical Program of 
the Department of Veterans Affairs (CHAMPVA) or TRICARE benefits, to 
develop and process CHAMPVA or TRICARE claims, and to develop cost-
recovery actions for claims involving individuals not eligible for the 
services or claims involving potential third party liability.
    13. The name and address of a Veteran, family member or caregiver, 
and other information as is reasonably necessary to identify such 
individual, may be disclosed to a consumer reporting agency for the 
purpose of locating the individual or obtaining a consumer report to 
determine the ability of the individual to repay an indebtedness to the 
United States by virtue of the individual's participation in a benefits 
program administered by VA, provided that the requirements of 38 U.S.C. 
5701(g)(2) have been met.
    14. The name and address of a Veteran, family member or caregiver 
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 purposes of 
assisting in the collection of such indebtedness, provided that the 
requirements of 38 U.S.C. 5701(g)(4) have been met.
    15. In response to an inquiry about a named individual from a 
member of the general public, disclosure of information may be made 
from this system of records 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).
    16. The name and address of a Veteran, family member or caregiver 
may be disclosed to another Federal agency or to a contractor of that 
agency, at the written request of the head of that agency or designee 
of the head of that agency, for the purpose of conducting government 
research necessary to accomplish a statutory purpose of that agency.
    17. Any information in this system of records relevant to a claim 
of a Veteran, family member or caregiver 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 at the request of the claimant 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 the accredited service organization, claims agent or 
an attorney.
    18. Any information in this system, including medical information, 
the basis and nature of claim, the amount of benefits and 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 only to 
the extent necessary to fulfill the duties of the VA Federal fiduciary 
or the guardian ad litem.
    19. 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 Treasury Department, 
Internal Revenue Service, as a report of income under 26 U.S.C. 
61(a)(12).
    20. The name of a Veteran, family member or caregiver, or 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 benefit program administered by 
VA, may be disclosed to the Treasury Department, Internal Revenue 
Service, for the collection of Title 38, U.S.C. 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.

[[Page 11530]]

    21. The name, date of birth and social security number of a 
Veteran, family member or caregiver, and other identifying information 
as is reasonably necessary may be disclosed to Social Security 
Administration and Centers for Medicare & Medicaid Services, Department 
of Health and Human Services, for the purpose of validating social 
security numbers and Medicare information.
    22. The name and address of any health care provider in this system 
of records who has received payment for claimed services on behalf of a 
Veteran, family member or caregiver may be disclosed in response to an 
inquiry from a member of the general public who requests assistance in 
locating medical providers who accept VA payment for health care 
services.
    23. Relevant information from this system of records may be 
disclosed to individuals, organizations, private or public agencies, 
etc., 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.
    24. Relevant information from this system of records may be 
disclosed to an accrediting Quality Review and Peer Review Organization 
in connection with the review of claims or other review activities 
associated with CBOPC accreditation to professionally accepted claims 
processing standards.
    25. Identifying information, including social security number, of 
Veterans, spouse(s) of veterans, and dependents of Veterans, family 
members and caregivers, 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.
    26. 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.
    27. 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 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.
    28. Any relevant information from this system of records may be 
disclosed to the Centers for Medicare and Medicaid, the Social Security 
Administration, Veterans Benefit Administration, or any other federal 
or state agency.

POLICIES AND PRACTICES FOR STORING, RETRIEVING, ACCESSING, RETAINING, 
AND DISPOSING OF RECORDS IN THE SYSTEM:
STORAGE:
    Records are stored electronically, in paper folders, magnetic 
discs, and magnetic tape. Paper documents may be scanned/digitized and 
stored for viewing electronically.

RETRIEVABILITY:
    Paper records are retrieved by name or VA claims file number or 
social security number of the Veteran, family member or caregiver. 
Computer records are retrieved by name or social security number of the 
Veteran family member, caregiver, or VA claims file number of the 
Veteran.

SAFEGUARDS:
    Working spaces and record storage areas at CBOPC are secured during 
all business and non-business hours. All entrance doors require an 
electronic pass card for entry. The CBOPC Logistics Department issues 
electronic pass cards. CBOPC staff control visitor entry by door 
release and escort. The building is equipped with an intrusion alarm 
system monitored by CBOPC security staff during business hours and by a 
security service vendor during non-business hours. Electronic/Digital 
records are stored in an electronic controlled storage filing area. 
Paper records in work areas are stored in locked file cabinets or 
locked rooms. Access to record storage areas is restricted to VA 
employees on a ``need-to-know'' basis. Access to the computer room is 
limited by appropriate locking devices and restricted to authorized VA 
employees and vendor personnel. Automated Data Processing (ADP) 
peripheral devices are generally placed in secure areas or are 
otherwise protected. Authorized VA employees may access information in 
the computer system by a series of individually unique passwords/codes.

RETENTION AND DISPOSAL:
    Record Control Schedule (RCS) 10-1 item XXXVIII Civilian Health and 
Medical care (CHMC) Records. NARA job number N1-015-3-1Item 1-8b. 
(Master file) item 3, Destroy 6 years after all individuals in the 
record become ineligible for program benefits.

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: Deputy Chief Business 
Officer Purchased Care, Department of Veterans Affairs, P.O. Box 
469060, Denver, CO 80246-9060.

NOTIFICATION PROCEDURE:
    Any individual who wishes to determine whether a record is being 
maintained in this system under his or her name or other personal 
identifier, or wants to determine the contents of such record, should 
submit a written request to Chief Business Office Purchased Care, P.O. 
Box 469060, Denver, Colorado 80246-9060, or apply in person to the VHA 
Chief Business Office Purchased Care, 3773 Cherry Creek North Drive, 
Denver, Colorado 80209. All inquiries (Veteran and beneficiary) should 
include the Veteran's full name and social security and VA claims file 
numbers, and the spouse's family member or caregiver's name, social 
security number and return address.

RECORD ACCESS PROCEDURE:
    An individual who seeks access to records maintained under his or 
her name in this system may write or visit the Deputy Chief Business 
Officer, VHA CBO Purchased Care.

CONTESTING RECORD PROCEDURES:
    (See Record Access Procedures above.)

RECORD SOURCE CATEGORIES:
    The Veteran sponsor, family member, caregiver, military service 
departments, private medical facilities and health care professionals, 
electronic trading partners, contractors, DoD, TRICARE,

[[Page 11531]]

DEERS, other Federal agencies, VA Regional Offices, Veterans Benefits 
Administration (VBA) automated record systems, and VA Medical Centers.

[FR Doc. 2015-04312 Filed 3-2-15; 8:45 am]
BILLING CODE 8320-01-P