83 FR 49930 - Privacy Act of 1974; Matching Program

DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services

Federal Register Volume 83, Issue 192 (October 3, 2018)

In accordance with subsection (e)(12) of the Privacy Act of 1974, as amended, the Department of Health and Human Services (HHS), Centers for Medicare & Medicaid Services (CMS) is providing notice of a new matching program between CMS and the Department of Veterans Affairs (VA), Veterans Health Administration (VHA), ``Verification of Eligibility for Minimum Essential Coverage Under the Patient Protection and Affordable Care Act Through a Veterans Health Administration Plan.''

[Federal Register Volume 83, Number 192 (Wednesday, October 3, 2018)]
[Notices]
[Pages 49930-49931]
From the Federal Register Online  [www.thefederalregister.org]
[FR Doc No: 2018-21506]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services


Privacy Act of 1974; Matching Program

AGENCY: Centers for Medicare & Medicaid Services, Department of Health 
and Human Services.

ACTION: Notice of a new matching program.

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SUMMARY: In accordance with subsection (e)(12) of the Privacy Act of 
1974, as amended, the Department of Health and Human Services (HHS), 
Centers for Medicare & Medicaid Services (CMS) is providing notice of a 
new matching program between CMS and the Department of Veterans Affairs 
(VA), Veterans Health Administration (VHA), ``Verification of 
Eligibility for Minimum Essential Coverage Under the Patient Protection 
and Affordable Care Act Through a Veterans Health Administration 
Plan.''

DATES: The deadline for comments on this notice is November 2, 2018. 
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 
October 2018 to April 2020) and within 3 months of expiration may be 
renewed for one additional year if the parties make no change to the 
matching program and certify that the program has been conducted in 
compliance with the matching agreement.

ADDRESSES: Interested parties may submit written comments to: CMS 
Privacy Act Officer, Division of Security, Privacy Policy & Governance, 
Information Security & Privacy Group, Office of Information Technology, 
CMS, 7500 Security Blvd., Baltimore, MD 21244-1870, Mailstop: N3-15-25, 
or by email to: [email protected]. Comments received will be 
available for review at this location, by appointment, during regular 
business hours, Monday through Friday from 9:00 a.m. to 3:00 p.m.

FOR FURTHER INFORMATION CONTACT: If you have questions about the 
matching program, you may contact Jack Lavelle, Senior Advisor, 
Marketplace Eligibility and Enrollment Group, Center for Consumer 
Information and Insurance Oversight, CMS, 7501 Wisconsin Ave., 
Bethesda, MD 20814, (410) 786-0639, or by email at 
[email protected].

SUPPLEMENTARY INFORMATION: The Privacy Act of 1974, as amended (5 
U.S.C. 552a) provides certain protections for individuals applying for 
and receiving federal benefits. The law governs the use of computer 
matching by federal agencies when records in a system of records 
(meaning, federal agency records about individuals retrieved by name or 
other personal identifier) are matched with records of other federal or 
non-federal agencies. The Privacy Act requires agencies involved in a 
matching program to:
    1. Enter into a written agreement, which must be prepared in 
accordance with the Privacy Act, approved by the Data Integrity Board 
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,
CMS Privacy Advisor, Division of Security, Privacy Policy and 
Governance, Information Security and Privacy Group, Office of 
Information Technology, Centers for Medicare & Medicaid Services.

Participating Agencies

    The Department of Health and Human Services (HHS), Centers for 
Medicare & Medicaid Services (CMS) is the recipient agency, and the 
Department of Veterans Affairs (VA), Veterans Health Administration 
(VHA) is the source agency.

Authority for Conducting the Matching Program

    The statutory authority for the matching program is 42 U.S.C. 
18001.

Purpose(s)

    The purpose of the matching program is to assist CMS in determining 
individuals' eligibility for financial assistance in paying for private 
health

[[Page 49931]]

insurance coverage. In this matching program, VHA provides CMS with 
data when a state administering entity (AE) requests it and VHA is 
authorized to release it, verifying whether an individual who is 
applying for or is enrolled in private health insurance coverage under 
a qualified health plan through a federally-facilitated health 
insurance exchange is eligible for coverage under a VHA health plan. 
CMS makes the data provided by VHA available to the requesting AE 
through a data services hub to use in determining the applicant's or 
enrollee's eligibility for financial assistance (including an advance 
tax credit and cost-sharing reduction, which are types of insurance 
affordability programs) in paying for private health insurance 
coverage. VHA health plans provide minimum essential coverage, and 
eligibility for such plans usually precludes eligibility for financial 
assistance in paying for private coverage. The data provided by VHA 
under this matching program will be used by CMS and AEs to authenticate 
identity, determine eligibility for financial assistance, and determine 
the amount of the financial assistance.

Categories of Individuals

    The categories of individuals whose information is involved in the 
matching program are:
     Veterans whose records at VHA match data provided to VHA 
by CMS (submitted by AEs) about individuals who are applying for or are 
enrolled in private insurance coverage under a qualified health plan 
through a federally-facilitated health insurance exchange.

Categories of Records

    The categories of records used in this matching program are 
identity records and minimum essential coverage period records, 
consisting of the following data elements:
    Data provided by CMS to VHA:

a. First name (required)
b. middle name/initial (if provided by applicant)
c. surname (applicant's last name) (required)
d. date of birth (required)
e. gender (optional)
f. SSN (required)
g. requested qualified health plan (QHP) coverage effective date 
(required)
h. requested QHP coverage end date (required)
i. transaction ID (required)

    Data provided by VHA to CMS:

a. SSN (required)
b. start/end date(s) of enrollment period(s) (when match occurs)
c. a blank date response when a non-match occurs
d. if CMS transmits request and a match is made, but VA's record 
contains a date of death, VA will respond in the same manner as a non-
match response, with a blank date
e. enrollment period(s) is/are defined as the timeframe during which 
the individual was enrolled in a VHA health care program

Systems(s) of Records

    The records used in this matching program will be disclosed from 
the following systems of records, as authorized by routine uses 
published in the system of records notices (SORNs) cited below:

A. System of Records Maintained by CMS

     CMS Health Insurance Exchanges System (HIX), CMS System 
No. 09-70-0560, last published in full at 78 FR 63211 (Oct. 23, 2013), 
as amended at 83 FR. 6591 (Feb. 14, 2018). Routine use 3 authorizes 
CMS' disclosures to VHA.

B. Systems of Records Maintained by VHA

     147VA10NF1 Enrollment and Eligibility Records--VA, 
published at 81 FR 45597 (July 14, 2016). Routine use 14 authorizes 
VHA's disclosures to CMS.
     54VA10NB3 Veterans and Beneficiaries Purchased Care 
Community Health Care Claims, Correspondence, Eligibility, Inquiry and 
Payment Files--VA, published at 80 FR 11527 (March 3, 2015). Routine 
use 25 authorizes VHA's disclosures to CMS.

[FR Doc. 2018-21506 Filed 10-2-18; 8:45 am]
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