69766 Federal Register / Vol. 70, No. 221 / Thursday, November 17, 2005 / Notices 

before posting a final version on its Web 

site. 

FOR FURTHER INFORMATION CONTACT: 

David N. Weissman, MD, CDC/NIOSH, 

Division of Respiratory Disease Studies, 

Mailstop H–2900, 1095 Willowdale 

Road, Morgantown, WV 26505, 304–

285–5749. 

Information requests can also be 

submitted by e-mail to 

CWHSP@cdc.gov. 

Dated: November 10, 2005. 

John Howard, 

Director, National Institute for Occupational 

Safety and Health, Centers for Disease Control 

and Prevention. 

[FR Doc. 05–22762 Filed 11–16–05; 8:45 am] 

BILLING CODE 4163–19–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

Privacy Act of 1974; Report of New 

System of Records 

AGENCY: Department of Health and 

Human Services (HHS) Centers for 

Medicare & Medicaid Services (CMS). 

ACTION: Notice of New System of 

Records (SOR). 

SUMMARY: In accordance with the 

requirements of the Privacy Act of 1974, 

we are proposing a new SOR titled, 

‘‘Medicare Premium Withhold System 

(PWS), No. 09–70–0552.’’ On December 

8, 2003, Congress passed the Medicare 

Prescription Drug, Improvement, and 

Modernization Act of 2003 (MMA) 

(Public Law (Pub. L.) 108–173). Among 

other provisions, MMA allows Medicare 

payment to health plans for coverage of 

outpatient prescription drugs under the 

Medicare Part D benefit. The Social 

Security Act (the Act) provides for four 

summary payment mechanisms: Risk 

adjusted, federal reinsurance subsidies, 

risk corridor payments, and subsidized 

coverage for qualified low-income 

individuals. In addition, there is a 

premium payable by each beneficiary 

for Part D coverage, as well as the preexisting premium for Part C (now 

known as Medicare Advantage (MA)), 

created under Title II legislation. 

Beginning January 2006, MMA will 

provide enrollees in MA, and Medicare 

Advantage Prescription Drug (MAPD) 

plans an option to have Part C and Part 

D premiums withheld from their 

monthly retirement annuities provided 

by the Social Security Administration 

(SSA), Railroad Retirement Board (RRB), 

or Office of Personnel Management 

(OPM). The Medicare Premium 

Withhold System is the system of record 

(SOR) for maintaining and managing 

Part C and Part D beneficiary premium 

payment amounts. For 2006, two 

external agencies, the SSA and the RRB, 

provide this monthly premium 

withholding through the PWS. The 

Medicare Advantage Prescription Drug 

System (MARx) notifies SSA and RRB of 

premium amounts to be withheld and 

applicable periods on a daily basis. PWS 

uses interfaces from MARx to track 

these premium withholding amounts as 

‘‘expected.’’ PWS also uses interfaces 

with SSA and RRB to record the 

withheld premium amounts and periods 

they apply to as ‘‘actual.’’ The PWS 

notifies the appropriate MA and MAPD 

of all beneficiary withholdings and 

facilitates the payment of withheld 

premiums via the automated plan 

payment system (APPS) and the 

Financial Accounting System (FACS) 

for ultimate payment by the United 

States Treasury. 

The primary purpose of the SOR is to 

process a monthly premium withhold 

file from SSA and RRB, capture 

expected premium withholding 

amounts from MARx and compare them 

to actual withholding amounts, produce 

a reconciliation of the reported 

withholding amounts with amounts 

transferred via Governmental Payment 

and Collection (IPAC) files from SSA 

and RRB, and generate plan payment 

requests to APPS. Information in this 

system will also be disclosed to: (1) 

Support regulatory, reimbursement, and 

policy functions performed by a 

contractor or consultant contracted by 

the Agency; (2) support Medicare 

Prescription Drug Plans (PDP) and 

Medicare Advantage Prescription Drug 

Plans (MAPD) directly or through a 

CMS contractor for the administration of 

Title XVIII of the Act; (3) support 

another Federal or State agency, agency 

of a state government, an agency 

established by state law, or its fiscal 

agent; (4) support constituent requests 

made to a congressional representative; 

(5) support litigation involving the 

Agency, and (6) combat fraud and abuse 

in certain health benefits programs. We 

have provided background information 

about the modified system in the 

SUPPLEMENTARY INFORMATION section 

below. Although the Privacy Act 

requires only that CMS provide an 

opportunity for interested persons to 

comment on the proposed routine uses, 

CMS invites comments on all portions 

of this notice. See EFFECTIVE DATES

section for comment period. 

DATES: Effective Dates: CMS filed a new 

system report with the Chair of the 

House Committee on Government 

Reform and Oversight, the Chair of the 

Senate Committee on Governmental 

Affairs, and the Administrator, Office of 

Information and Regulatory Affairs, 

Office of Management and Budget 

(OMB) on November 3, 2005. To ensure 

that all parties have adequate time in 

which to comment, the SOR, including 

routine uses, will become effective 40 

days from the publication of the notice, 

or from the date it was submitted to 

OMB and the Congress, whichever is 

later, unless CMS receives comments 

that require alterations to this notice. 

ADDRESSES: The public should address 

comments to: CMS Privacy Officer, 

Division of Privacy Compliance Data 

Development (DPCDD), CMS, Room N2–

04–27, 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 a.m.–3 p.m., 

Eastern daylight time. 

FOR FURTHER INFORMATION CONTACT: 

Linda Bosque, Computer Technology 

Information Specialist, Division of 

Medicare Advantage Payment Systems, 

Information Services Modernization 

Group, Office of Information Services, 

CMS, Room N3–13–10, 7500 Security 

Boulevard, Baltimore, Maryland 21244–

1850. The telephone number is 410–

786–0164. 

SUPPLEMENTARY INFORMATION: CMS has 

long realized that the Medicare program 

is in the middle of a rapidly changing 

health insurance industry characterized 

by an expansion of service delivery 

models and payment options. The 

managed care provisions of the Balance 

Budget Act (BBA) of 1997 (Public Law 

105–33) combined with the MMA have 

made managing beneficiary health 

choices one of the most critical 

challenges facing CMS and the health 

industry at large. To be of maximum 

use, the data must be organized and 

categorized into comprehensive 

interrelated systems. 

The Medicare Premium Withhold 

System (PWS) is a new system that 

helps remove barriers to beneficiary 

enrollment in Medicare’s new 

prescription drug benefits, which will 

be offered by MAPDs and PDPs effective 

January 1, 2006. Through the PWS, CMS 

has extended to both Part C and Part D 

enrollees the option of withholding 

their monthly premium amounts from 

retirement annuities provided by 

external agencies, including SSA and 

RRB (and OPM in future releases of the 

system). The PWS builds upon the 

Enterprise Data Exchange with these 

three agencies, adding data stores and 

reporting capabilities in order to 

Federal Register / Vol. 70, No. 221 / Thursday, November 17, 2005 / Notices 69767 

facilitate beneficiary cost-sharing. By 

forwarding withheld premium amounts 

to MAs, MAPDs and PDPs, PWS 

retrospectively supplements the 

monthly, prospective payment to plans 

of capitated amounts and low-income 

subsidies calculated in MARx. In 

addition to these components of the 

plan payment transaction, APPS 

receives from PWS all the premiumrelated information required to facilitate 

the execution of plan payments. 

Beginning January 2006, MMA will 

provide enrollees in MA, and Medicare 

Advantage Prescription Drug (MAPD) 

plans an option to have Part C and Part 

D premiums withheld from their 

monthly retirement annuities provided 

by the Social Security Administration 

(SSA), Railroad Retirement Board (RRB) 

or Office of Personnel Management 

(OPM). The Medicare Premium 

Withhold System is the system of record 

(SOR) for maintaining and managing 

Part C and Part D beneficiary premium 

payment amounts. For 2006, two 

external agencies, the SSA and RRB, 

provide this monthly premium 

withholding through the PWS. 

The Medicare Advantage Prescription 

Drug System (MARx) notifies SSA and 

RRB of premium amounts to be 

withheld and applicable periods on a 

daily basis. PWS uses interfaces from 

MARx to track these premium 

withholding amounts as ‘‘expected.’’

PWS also uses interfaces with SSA and 

RRB to record the withheld premium 

amounts and periods they apply to as 

‘‘actual.’’ The PWS notifies the 

appropriate MA and MAPDs of all 

beneficiary withholdings and facilitates 

the payment of withheld premiums via 

the automated plan payment system 

(APPS), and the Financial Accounting 

System (FACS) for ultimate payment by 

the U.S. Treasury. The PWS carries out 

these responsibilities through key 

monthly functions including: 

• Receiving monthly premium 

withhold files from SSA and RRB that 

identify premium amounts withheld 

and the periods they apply to. These are 

used as ‘‘actual’’ amounts. 

• Receiving a monthly premium 

withhold extract from MARx that 

identifies beneficiaries electing 

Premium Withhold and the premium 

amounts and the periods they apply to. 

These are used by PWS as ‘‘expected’’

amounts. 

• PWS performs monthly 

reconciliation of the MARx expected 

amounts and the SSA or RRB actual 

amounts, identifying discrepancies and, 

if necessary, directing MARx to convert 

a beneficiary whose withholding is 

incorrect to direct bill status. The results 

of the reconciliation are reported to 

MARx for distribution to the plans. 

• PWS also performs a reconciliation 

of the report of funds transferred by SSA 

and RRB to the actual transfer 

accomplished via the Intergovernmental 

Payment and Collection (IPAC) files 

from SSA and RRB. 

• PWS 1 produces a file that is sent 

to the Automated Plan Payment System 

(APPS) that indicates the proper 

payment of withheld funds to the MA 

and MAPD plans. 

An independent technical evaluation 

of CMS’ managed care systems found 

that the new premium withhold 

functionality required by MMA could 

not be supported by existing Medicare 

systems. The comprehensive review of 

existing systems was necessary in order 

to proceed with a development effort 

that would ensure the new MMA 

provisions and future customer service 

and program management objectives 

were met. 

I. Description of System of Records 

A. Statutory and Regulatory Basis for 

the System 

Authority for maintenance of the 

system is given under Section 101 of 

MMA (Pub. L. 108–173) amended the 

Title XVIII of the Social Security Act. 

Authority for maintenance of the system 

is also given under the provisions of 

§§ 1833(a)(1)(A), 1860, 1866, and 1876 

of Title XVIII of the Act (42 U.S.C. 

1395(A)(1)(a), 1395cc, and 1395mm). 

B. Collection and Maintenance of Data 

in the System 

The Medicare Premium Withhold 

System creates a PWS Data Mart to store 

data needed for processing and record 

keeping. The PWS Data Mart stores, at 

the beneficiary level, the expected 

withholding data and the actual 

withholding data as reported by the 

withholding agencies. 

II. Agency Policies, Procedures, and 

Restrictions on Routine Uses 

A. Agency Policies, Procedures, and 

Restrictions on the Routine Use 

The Privacy Act permits us to disclose 

information without an individual’s 

consent if the information is to be used 

for a purpose that is compatible with the 

purpose(s) for which the information 

was collected. Any such disclosure of 

data is known as a ‘‘routine use.’’ The 

Government will only release PWS 

information that can be associated with 

an individual as provided for under 

‘‘Section III. Proposed Routine Use 

Disclosures of Data in the System.’’ Both 

identifiable and non-identifiable data 

may be disclosed under a routine use. 

We will only collect the minimum 

personal data necessary to achieve the 

purpose of PWS. 

CMS has the following policies and 

procedures concerning disclosures of 

information that will be maintained in 

the system. Disclosure of information 

from the system will be approved only 

to the extent necessary to accomplish 

the purpose of the disclosure and only 

after CMS: 

1. Determines that the use or 

disclosure is consistent with the reason 

that the data is being collected; e.g., to 

process a monthly premium withhold 

file from SSA and RRB, capture 

expected premium withholding 

amounts from MARx and comparing 

them to actual withholding amounts, 

produce a reconciliation of the reported 

withholding amounts with amounts 

transferred via IPAC files from SSA and 

RRB, and generate plan payment 

requests to APPS. 

2. Determines that: 

a. The purpose for which the 

disclosure is to be made can only be 

accomplished if the record is provided 

in individually identifiable form; 

b. The purpose for which the 

disclosure is to be made is of sufficient 

importance to warrant the effect and/or 

risk on the privacy of the individual that 

additional exposure of the record might 

bring; and 

c. There is a strong probability that 

the proposed use of the data would in 

fact accomplish the stated purpose(s). 

3. Requires the information recipient 

to: 

a. Establish administrative, technical, 

and physical safeguards to prevent 

unauthorized use of disclosure of the 

record; 

b. Remove or destroy, at the earliest 

time, all patient-identifiable 

information; and 

c. Agree to not use or disclose the 

information for any purpose other than 

the stated purpose under which the 

information was disclosed. 

4. Determines that the data are valid 

and reliable. 

III. Proposed Routine Use Disclosures 

of Data in the System 

A. Entities Who May Receive 

Disclosures Under Routine Use 

These routine uses specify 

circumstances, in addition to those 

provided by statute in the Privacy Act 

of 1974, under which CMS may release 

information from the PWS facilitator 

without the consent of the individual to 

whom such information pertains. Each 

proposed disclosure of information 

under these routine uses will be 

evaluated to ensure that the disclosure 

69768 Federal Register / Vol. 70, No. 221 / Thursday, November 17, 2005 / Notices 

is legally permissible, including but not 

limited to ensuring that the purpose of 

the disclosure is compatible with the 

purpose for which the information was 

collected. We propose to establish or 

modify the following routine use 

disclosures of information maintained 

in the system: 

1. To Agency contractors or 

consultants who have been contracted 

by the Agency to assist in 

accomplishment of a CMS function 

relating to the purposes for this SOR 

and who need to have access to the 

records in order to assist CMS. 

We contemplate disclosing 

information under this routine use only 

in situations in which CMS may enter 

into a contractual or similar agreement 

with a third party to assist in 

accomplishing a CMS function relating 

to purposes for this SOR. 

CMS occasionally contracts out 

certain of its functions when doing so 

would contribute to effective and 

efficient operations. CMS must be able 

to give a contractor or consultant 

whatever information is necessary for 

the contractor or consultant to fulfill its 

duties. In these situations, safeguards 

are provided in the contract prohibiting 

the contractor or consultant from using 

or disclosing the information for any 

purpose other than that described in the 

contract and requires the contractor or 

consultant to return or destroy all 

information at the completion of the 

contract. 

2. To Medicare Prescription Drug 

Plans (PDP) and Medicare Advantage 

Prescription Drug Plans (MAPD) 

directly or through a CMS contractor for 

the administration of Title XVIII of the 

Act. 

PDPs and MAPDs require PWS 

information in order to establish the 

validity of evidence or to verify the 

accuracy of information presented by 

the individual, as it concerns the 

individual’s entitlement to Part D 

benefits under the Medicare 

Prescription Drug Benefit Program. 

3. To another Federal or state agency, 

agency of a state government, an agency 

established by state law, or its fiscal 

agent pursuant to agreements with CMS 

to: 

a. Contribute to the accuracy of CMS’s 

proper payment of Medicare benefits; 

b. Enable such agency to administer a 

Federal health benefits program, or as 

necessary to enable such agency to 

fulfill a requirement of a Federal statute 

or regulation that implements a health 

benefits program funded in whole or in 

part with Federal funds; and/or 

c. Assist Federal/state Medicaid 

programs within the state. 

Other Federal or state agencies in 

their administration of a Federal health 

program may require PWS information 

in order to support evaluations and 

monitoring of Medicare claims 

information of beneficiaries, including 

proper reimbursement for services 

provided. 

In addition, state agencies in their 

administration of a Federal health 

program may require PWS information 

for the purposes of determining, 

evaluating and/or assessing cost, 

effectiveness, and/or the quality of 

health care services provided in the 

state. 

Disclosure under this routine use 

shall be used by state Medicaid agencies 

pursuant to agreements with the HHS 

for determining Medicaid and Medicare 

eligibility, for quality control studies, 

for determining eligibility of recipients 

of assistance under Titles IV, XVIII, and 

XIX of the Act, and for the 

administration of the Medicaid program. 

Data will be released to the state only on 

those individuals who are patients 

under the services of a Medicaid 

program within the state or who are 

residents of that state. 

We also contemplate disclosing 

information under this routine use in 

situations in which state auditing 

agencies require PWS information for 

auditing state Medicaid eligibility 

considerations. CMS may enter into an 

agreement with state auditing agencies 

to assist in accomplishing functions 

relating to purposes for this SOR. 

4. To a Member of Congress or 

congressional staff member in response 

to an inquiry of the congressional office 

made at the written request of the 

constituent about whom the record is 

maintained. 

Beneficiaries often request the help of 

a Member of Congress in resolving an 

issue relating to a matter before CMS. 

The Member of Congress then writes 

CMS, and CMS must be able to give 

sufficient information to be responsive 

to the inquiry. 

5. To the Department of Justice (DOJ), 

court, or adjudicatory body when: 

a. The Agency or any component 

thereof, or 

b. Any employee of the Agency in his 

or her official capacity, or 

c. Any employee of the Agency in his 

or her individual capacity where the 

DOJ has agreed to represent the 

employee, or 

d. The United States Government, 

is a party to litigation or has an interest 

in such litigation, and, by careful 

review, CMS determines that the 

records are both relevant and necessary 

to the litigation and that the use of such 

records by the DOJ, court or 

adjudicatory body is compatible with 

the purpose for which the agency 

collected the records. 

Whenever CMS is involved in 

litigation, or occasionally when another 

party is involved in litigation and CMS’s 

policies or operations could be affected 

by the outcome of the litigation, CMS 

would be able to disclose information to 

the DOJ, court, or adjudicatory body 

involved. 

6. To a CMS contractor (including, but 

not limited to fiscal intermediaries and 

carriers) that assists in the 

administration of a CMS-administered 

health benefits program, or to a grantee 

of a CMS-administered grant program, 

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 or abuse in such program. 

We contemplate disclosing 

information under this routine use only 

in situations in which CMS may enter 

into a contract or grant with a third 

party to assist in accomplishing CMS 

functions relating to the purpose of 

combating fraud and abuse. 

CMS occasionally contracts out 

certain of its functions when doing so 

would contribute to effective and 

efficient operations. CMS must be able 

to give a contractor or grantee whatever 

information is necessary for the 

contractor or grantee to fulfill its duties. 

In these situations, safeguards are 

provided in the contract prohibiting the 

contractor or grantee from using or 

disclosing the information for any 

purpose other than that described in the 

contract and requiring the contractor or 

grantee to return or destroy all 

information. 

7. To another Federal agency or to an 

instrumentality of any governmental 

jurisdiction within or under the control 

of the United States (including any state 

or local governmental agency), that 

administers, or that has the authority to 

investigate potential fraud or abuse in, 

a health benefits program funded in 

whole or in part by Federal funds, 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 or abuse in such programs. 

Other agencies may require PWS 

information for the purpose of 

combating fraud and abuse in such 

Federally-funded programs. 

Federal Register / Vol. 70, No. 221 / Thursday, November 17, 2005 / Notices 69769 

B. Additional Circumstances Affecting 

Routine Use Disclosures 

To the extent this system contains 

Protected Health Information as defined 

by HHS regulation ‘‘Standards for 

Privacy of Individually Identifiable 

Health Information’’ (45 CFR parts 160 

and 164, 65 FR 82462 (12–28–00), 

subparts A and E. Disclosures of 

Protected Health Information that are 

otherwise authorized by these routine 

uses may only be made if, and as, 

permitted or required by the ‘‘Standards 

for Privacy of Individually Identifiable 

Health Information.’’

In addition, our policy will be to 

prohibit release even of data not directly 

identifiable, except pursuant to one of 

the routine uses or if required by law, 

if we determine there is a possibility 

that an individual can be identified 

through implicit deduction based on 

small cell sizes (instances where the 

patient population is so small that 

individuals who are familiar with the 

enrollees could, because of the small 

size, use this information to deduce the 

identity of the beneficiary). 

IV. Safeguards 

CMS has safeguards in place for 

authorized users and monitors such 

users to ensure against excessive or 

unauthorized use. Personnel having 

access to the system have been trained 

in the Privacy Act and information 

security requirements. Employees who 

maintain records in this system are 

instructed not to release data until the 

intended recipient agrees to implement 

appropriate management, operational 

and technical safeguards sufficient to 

protect the confidentiality, integrity and 

availability of the information and 

information systems and to prevent 

unauthorized access. 

This system will conform to all 

applicable Federal laws and regulations 

and Federal, HHS, and CMS policies 

and standards as they relate to 

information security and data privacy. 

These laws and regulations may apply 

but are not limited to: The Privacy Act 

of 1974; the Federal Information 

Security Management Act of 2002; the 

Computer Fraud and Abuse Act of 1986; 

the Health Insurance Portability and 

Accountability Act of 1996; the EGovernment Act of 2002, the ClingerCohen Act of 1996; MMA, and the 

corresponding implementing 

regulations. OMB Circular A–130, 

Management of Federal Resources, 

Appendix III, Security of Federal 

Automated Information Resources also 

applies. Federal, HHS, and CMS 

policies and standards include but are 

not limited to: All pertinent National 

Institute of Standards and Technology 

publications; the HHS Information 

Systems Program Handbook and the 

CMS Information Security Handbook. 

V. Effect of the Proposed System on 

Individual Rights 

CMS proposes to establish this system 

in accordance with the principles and 

requirements of the Privacy Act and will 

collect, use, and disseminate 

information only as prescribed therein. 

We will only disclose the minimum 

personal data necessary to achieve the 

purpose of PWS. Disclosure of 

information from the system will be 

approved only to the extent necessary to 

accomplish the purpose of the 

disclosure. CMS has assigned a higher 

level of security clearance for the 

information maintained in this system 

in an effort to provide added security 

and protection of data in this system. 

CMS will take precautionary 

measures to minimize the risks of 

unauthorized access to the records and 

the potential harm to individual privacy 

or other personal or property rights. 

CMS will collect only that information 

necessary to perform the system’s 

functions. In addition, CMS will make 

disclosure from the proposed system 

only with consent of the subject 

individual, or his/her legal 

representative, or in accordance with an 

applicable exception provision of the 

Privacy Act. 

CMS, therefore, does not anticipate an 

unfavorable effect on individual privacy 

as a result of the disclosure of 

information relating to individuals. 

Dated: November 3, 2005. 

Charlene Frizzera, 

Acting Chief Operating Officer, Centers for 

Medicare & Medicaid Services. 

System No.: 09–70–0552 

SYSTEM NAME

‘‘Medicare Premium Withhold 

System’’ (PWS) HHS/CMS/OIS. 

SECURITY CLASSIFICATION

Level Three Privacy Act Sensitive. 

SYSTEM LOCATION

CMS Data Center, 7500 Security 

Boulevard, North Building, First Floor, 

Baltimore, Maryland 21244–1850. 

CATEGORIES OF INDIVIDUALS COVERED BY THE

SYSTEM

The system will include information 

on recipients of Medicare hospital 

insurance (Part A) and Medicare 

medical insurance (Part B) and 

recipients of the Prescription Drug 

Benefits Program (Part D) enrolled in the 

Medicare Advantage (MA) Program. 

CATEGORIES OF RECORDS IN THE SYSTEM

The system will also include 

information about a beneficiary’s 

entitlement to Medicare benefits and 

enrollment in Medicare Programs, 

prescription drug coverage and 

supplementary medical claims 

information. The system will contain 

identifying information such as 

beneficiary name, health insurance 

claim number, social security number, 

and other demographic information. 

AUTHORITY FOR MAINTENANCE OF THE SYSTEM

Authority for maintenance of the 

system is given under section 101 of the 

MMA (Pub. L. 108–173) amended the 

Title XVIII of the Social Security Act. 

Authority for maintenance of the system 

is also given under the provisions of 

§§ 1833(a) (1) (A), 1860, 1866, and 1876 

of Title XVIII of the Act (42 CFR parts 

417 and 422). 

PURPOSE (S) OF THE SYSTEM

The primary purpose of the SOR is to 

process a monthly premium withhold 

file from SSA and RRB, capture 

expected premium withholding 

amounts from MARx and compare them 

to actual withholding amounts, produce 

a reconciliation of the reported 

withholding amounts with amounts 

transferred via Governmental Payment 

and Collection (IPAC) files from SSA 

and RRB, and generate plan payment 

requests to APPS. Information in this 

system will also be disclosed to: (1) 

Support regulatory, reimbursement, and 

policy functions performed by a 

contractor or consultant contracted by 

the Agency; (2) support Medicare 

Prescription Drug Plans (PDP) and 

Medicare Advantage Prescription Drug 

Plans (MAPD) directly or through a 

CMS contractor for the administration of 

Title XVIII of the Act; (3) support 

another Federal or State agency, agency 

of a state government, an agency 

established by state law, or its fiscal 

agent; (4) support constituent requests 

made to a congressional representative; 

(5) support litigation involving the 

Agency, and (6) combat fraud and abuse 

in certain health benefits programs. 

ROUTINE USES OF RECORDS MAINTAINED IN THE

SYSTEM, INCLUDING CATEGORIES OR USERS AND

THE PURPOSES OF SUCH USES

A. ENTITIES WHO MAY RECEIVE DISCLOSURES

UNDER ROUTINE USE

These routine uses specify 

circumstances, in addition to those 

provided by statute in the Privacy Act 

of 1974, under which CMS may release 

information from the PWS facilitator 

without the consent of the individual to 

whom such information pertains. Each 

proposed disclosure of information 

69770 Federal Register / Vol. 70, No. 221 / Thursday, November 17, 2005 / Notices 

under these routine uses will be 

evaluated to ensure that the disclosure 

is legally permissible, including but not 

limited to ensuring that the purpose of 

the disclosure is compatible with the 

purpose for which the information was 

collected. We propose to establish or 

modify the following routine use 

disclosures of information maintained 

in the system: 

1. To Agency contractors or 

consultants who have been contracted 

by the Agency to assist in 

accomplishment of a CMS function 

relating to the purposes for this SOR 

and who need to have access to the 

records in order to assist CMS. 

2. To Medicare Prescription Drug 

Plans (PDP) and Medicare Advantage 

Prescription Drug Plans (MAPD) 

directly or through a CMS contractor for 

the administration of Title XVIII of the 

Act. 

3. To another Federal or state agency, 

agency of a state government, an agency 

established by state law, or its fiscal 

agent pursuant to agreements with CMS 

to: 

a. Contribute to the accuracy of CMS’s 

proper payment of Medicare benefits; 

b. Enable such agency to administer a 

Federal health benefits program, or as 

necessary to enable such agency to 

fulfill a requirement of a Federal statute 

or regulation that implements a health 

benefits program funded in whole or in 

part with Federal funds; and/or 

c. Assist Federal/state Medicaid 

programs within the state. 

4. To a Member of Congress or 

congressional staff member in response 

to an inquiry of the congressional office 

made at the written request of the 

constituent about whom the record is 

maintained. 

5. To the Department of Justice (DOJ), 

court, or adjudicatory body when: 

a. The Agency or any component 

thereof, or 

b. Any employee of the Agency in his 

or her official capacity, or 

c. Any employee of the Agency in his 

or her individual capacity where the 

DOJ has agreed to represent the 

employee, or 

d. The United States Government, is 

a party to litigation or has an interest in 

such litigation, and, by careful review, 

CMS determines that the records are 

both relevant and necessary to the 

litigation and that the use of such 

records by the DOJ, court or 

adjudicatory body is compatible with 

the purpose for which the agency 

collected the records. 

6. To a CMS contractor (including, but 

not limited to fiscal intermediaries and 

carriers) that assists in the 

administration of a CMS-administered 

health benefits program, or to a grantee 

of a CMS-administered grant program, 

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 or abuse in such program. 

7. To another Federal agency or to an 

instrumentality of any governmental 

jurisdiction within or under the control 

of the United States (including any state 

or local governmental agency), that 

administers, or that has the authority to 

investigate potential fraud or abuse in, 

a health benefits program funded in 

whole or in part by Federal funds, 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 or abuse in such programs. 

B. Additional Circumstances Affecting 

Routine Use Disclosures 

To the extent this system contains 

Protected Health Information as defined 

by HHS regulation ‘‘Standards for 

Privacy of Individually Identifiable 

Health Information’’ (45 CFR parts 160 

and 164, 65 FR 82462 (12–28–00), 

subparts A and E. Disclosures of 

Protected Health Information that are 

otherwise authorized by these routine 

uses may only be made if, and as, 

permitted or required by the ‘‘Standards 

for Privacy of Individually Identifiable 

Health Information.’’

In addition, our policy will be to 

prohibit release even of data not directly 

identifiable, except pursuant to one of 

the routine uses or if required by law, 

if we determine there is a possibility 

that an individual can be identified 

through implicit deduction based on 

small cell sizes (instances where the 

patient population is so small that 

individuals who are familiar with the 

enrollees could, because of the small 

size, use this information to deduce the 

identity of the beneficiary). 

POLICIES AND PRACTICES FOR STORING, 

RETRIEVING, ACCESSING, RETAINING, AND

DISPOSING OF RECORDS IN THE SYSTEM

STORAGE

Computer diskette and on magnetic 

storage media. 

RETRIEVABILITY

Information can be retrieved by name 

and health insurance claim number of 

the beneficiary. 

SAFEGUARDS

CMS has safeguards in place for 

authorized users and monitors such 

users to ensure against excessive or 

unauthorized use. Personnel having 

access to the system have been trained 

in the Privacy Act and information 

security requirements. Employees who 

maintain records in this system are 

instructed not to release data until the 

intended recipient agrees to implement 

appropriate management, operational 

and technical safeguards sufficient to 

protect the confidentiality, integrity and 

availability of the information and 

information systems and to prevent 

unauthorized access. 

This system will conform to all 

applicable Federal laws and regulations 

and Federal, HHS, and CMS policies 

and standards as they relate to 

information security and data privacy. 

These laws and regulations may apply 

but are not limited to: The Privacy Act 

of 1974; the Federal Information 

Security Management Act of 2002; the 

Computer Fraud and Abuse Act of 1986; 

the Health Insurance Portability and 

Accountability Act of 1996; the EGovernment Act of 2002, the ClingerCohen Act of 1996; MMA, and the 

corresponding implementing 

regulations. OMB Circular A–130, 

Management of Federal Resources, 

Appendix III, Security of Federal 

Automated Information Resources also 

applies. Federal, HHS, and CMS 

policies and standards include but are 

not limited to: All pertinent National 

Institute of Standards and Technology 

publications; the HHS Information 

Systems Program Handbook and the 

CMS Information Security Handbook. 

RETENTION AND DISPOSAL: 

Records are maintained with 

identifiers for all transactions after they 

are entered into the system for a period 

of 6 years and 3 months. Records are 

housed in both active and archival files. 

All claims-related records are 

encompassed by the document 

preservation order and will be retained 

until notification is received from the 

Department of Justice. 

SYSTEM MANAGER AND ADDRESS: 

Director, Division of Medicare 

Advantage Appeals and Payment 

Systems, Information Services 

Modernization Group, Office of 

Information Services, CMS, Room N3–

16–24, 7500 Security Boulevard, 

Baltimore, Maryland 21244–1850. 

NOTIFICATION PROCEDURE: 

For purpose of access, the subject 

individual should write to the systems 

manager who will require the system 

name, SSN, address, date of birth, sex, 

and for verification purposes, the 

subject individual’s name (woman’s 

maiden name, if applicable). Furnishing 

Federal Register / Vol. 70, No. 221 / Thursday, November 17, 2005 / Notices 69771 

the SSN is voluntary, but it may make 

searching for a record easier and prevent 

delay. 

RECORD ACCESS PROCEDURE: 

For purpose of access, use the same 

procedures outlined in Notification 

Procedures above. Requestors should 

also reasonably specify the record 

contents being sought. (These 

procedures are in accordance with 

Department regulation 45 CFR 5b.5 (a) 

(2)). 

CONTESTING RECORD PROCEDURES: 

The subject individual should contact 

the system manager named above, and 

reasonably identify the record and 

specify the information to be contested. 

State the corrective action sought and 

the reasons for the correction with 

supporting justification. (These 

procedures are in accordance with 

Department regulation 45 CFR 5b.7). 

RECORD SOURCE CATEGORIES: 

Data for this system is collected from 

the Medicare Advantage Prescription 

Drug System (MARx) system, the 

Medicare Beneficiary Database (MBD), 

as well as two external providers of 

monthly retirement annuities, SSA, and 

RRB, with potentially OPM as the third 

external partner in a future release of 

the PWS. 

SYSTEMS EXEMPTED FROM CERTAIN PROVISIONS

OF THE ACT: 

None. 

[FR Doc. 05–22763 Filed 11–16–05; 8:45 am] 

BILLING CODE 4120–03–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Administration for Children and 

Families 

Office of Community Services; 

Program Announcement for Assets for 

Independence Demonstration Program 

Grants 

Notice of amendment to the standing 

announcement for Assets for 

Independence Demonstration Program 

Grants, HHS–2005–ACF–OCS–EI–0053, 

CFDA #93.602, published on February 

9, 2005. 

AGENCY: Office of Community Services 

(OCS), Administration for Children and 

Families, U.S. Department of Health and 

Human Services. 

ACTION: Notice of Amendment. 

The program announcement 

concerning the application procedures 

for the Assets for Independence 

Demonstration Program grants 

published on February 9, 2005 in 

Volume 70, Federal Register, pages 

6879—6888 is hereby modified. The 

amendment modifies the application 

receipt requirements. 

SUMMARY: On February 9, 2005, the 

Office of Community Services, 

Administration for Children and 

Families, U.S. Department of Health and 

Human Services published an 

announcement seeking applications for 

the Assets for Independence 

Demonstration Program. The 

announcement appeared in Volume 70, 

pages 6879–6888 of the Federal 

Register. This document announces a 

change in the application receipt 

requirements. To be considered timely 

for all application due dates, 

applications now must be received at 

the OCS Operations Center no later than 

the due dates. 

The Program Announcement for 

Assets for Independence Demonstration 

Program is a standing announcement. It 

is effective until canceled or changed by 

the Office of Community Services 

(OCS). Applicants may submit 

applications at any time throughout the 

year. OCS will review and make funding 

decisions about applications submitted 

by any of three due dates: March 15, 

June 15, and November 1. (If a date falls 

on a weekend, the due date will be the 

following Monday.) For example, 

starting in mid-March annually, OCS 

will review all applications submitted 

November 2 through March 15. Starting 

in early June, OCS will review all 

applications submitted March 16 

through June 15. And, starting in early 

November, OCS will review all 

applications submitted June 16 through 

November 1. Unsuccessful applicants 

may submit a new application in any 

succeeding application period. 

(1) Under Section IV.3. Submission 

Dates and Times 

Please Delete the following: 

Explanation of Due Dates 

The closing time and date for receipt 

of applications is referenced above. 

Mailed applications postmarked after 

the closing date will be classified as 

late. 

Deadline: Mailed applications shall be 

considered as meeting an announced 

deadline if they are either received on 

or before the deadline date or sent on or 

before the deadline date and received by 

ACF in time for the independent review 

referenced in Section IV.6. 

Applicants must ensure that a legibly 

dated U.S. Postal Service postmark or a 

legibly dated, machine produced 

postmark of a commercial service is 

affixed to the envelope/package 

containing the application(s). To be 

acceptable of proof of timely mailing, a 

postmark from a commercial mail 

service must include the logo/emblem 

of the commercial mail service company 

from the applicant. Private Metered 

postmarks shall not be acceptable as 

proof of timely mailing. 

(Applicants are cautioned that 

express/overnight mail services do not 

always deliver as agreed.) 

Please Replace the deleted paragraphs 

under Section IV.3. Submission Dates 

and Times with the following: 

Explanation of Due Dates 

The closing time and date for receipt 

of applications is referenced above. 

Applications received after 4:30 p.m., 

eastern time, on the closing date will be 

classified as late and will not be 

considered in the current competition. 

Applicants are responsible for 

ensuring that applications are mailed or 

submitted electronically well in 

advance of the application due date. 

(Applicants are cautioned that 

express/overnight mail services do not 

always deliver as agreed.) 

All information in this Notice of 

amendment is accurate and replaces 

information specified in the February 9, 

2005 Notice. 

Announcement Availability: The 

Assets for Independence Demonstration 

Program announcement and all 

application materials are available at 

http://www.Grants.gov. Standard forms 

and certifications may also be found at 

http://www.acf.hhs.gov/programs/ofs/ 

forms.htm. Finally, the OCS Asset 

Building Web site at http:// 

www.acf.hhs.gov/assetbuilding provides 

much information about the Assets for 

Independence Demonstration Program 

and the application process. The page 

includes links to all required forms as 

well as to a guidebook for developing an 

AFI Project and applying for an AFI 

grant. 

FOR FURTHER INFORMATION CONTACT: 

James Gatz, Manager, Assets for 

Independence Program, Telephone: 

(202) 401–4626 or E-mail: 

AFIProgram@acf.hhs.gov. An array of 

helpful information is posted on the 

OCS Asset Building Web site at http:// 

www.acf.hhs.gov/assetbuilding. 

Dated: November 10, 2005. 

Josephine B. Robinson, 

Director, Office of Community Services. 

[FR Doc. 05–22799 Filed 11–16–05; 8:45 am] 

BILLING CODE 4184–01–P