83 FR 51960 - Privacy Act of 1974; Matching Program

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

Federal Register Volume 83, Issue 199 (October 15, 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 re-established matching program between CMS and each State Based Administering Entity (AE), titled ``Determining Eligibility for Enrollment in Applicable State Health Subsidy Programs Under the Patient Protection and Affordable Care Act.''

[Federal Register Volume 83, Number 199 (Monday, October 15, 2018)]
[Notices]
[Pages 51960-51961]
From the Federal Register Online  [www.thefederalregister.org]
[FR Doc No: 2018-22405]


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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 (CMS), Department of 
Health and Human Services (HHS).

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 
re-established matching program between CMS and each State Based 
Administering Entity (AE), titled ``Determining Eligibility for 
Enrollment in Applicable State Health Subsidy Programs Under the 
Patient Protection and Affordable Care Act.''

DATES: The deadline for comments on this notice is November 14, 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 changes to the 
matching program and certify that the program has been conducted in 
compliance with the matching agreement.

ADDRESSES: Written comments can be sent 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.

Walter Stone,
CMS Privacy Act Officer, Information Security and Privacy Group, and 
Office of Information Technology, Centers for Medicare & Medicaid 
Service.

Participating Agencies

    Department of Health and Human Services (HHS), Centers for Medicare 
& Medicaid Services (CMS), and the AE in each state. Each is both a 
source and a recipient agency as explained in the Purpose(s) section 
below.
    AEs administer insurance affordability programs, and include 
Medicaid/Children's Health Insurance Program (CHIP) agencies, state-
based exchanges (SBEs), and basic health programs (BHPs). In states 
that operate a SBE, the AE would include the Medicaid/CHIP agency. 
Additionally, there are two states--Minnesota and New York--where the 
AE operates both a SBE and BHP. In states that have elected to utilize 
the federally-facilitated exchange (FFE), the AE would include only the 
Medicaid/CHIP agency.

Authority for Conducting the Matching Program

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

Purpose(s)

    The matching program will enable CMS to provide information 
(including information CMS receives from other federal agencies under 
related matching agreements) to AEs, to assist AEs in verifying 
applicant information as required by the Affordable Care Act to 
determine applicants' eligibility for enrollment in applicable state 
health subsidy programs, including exemption from the requirement to 
maintain minimum essential coverage (MEC) or from the individual 
responsibility payment. In addition, to avoid dual enrollment, 
information will be shared between CMS and AEs, and among AEs, for the 
purpose of verifying whether applicants and enrollees are currently 
eligible for or enrolled in a Medicaid/CHIP program. All information 
will be shared through a data services hub (Hub) established by CMS to 
support the federally-facilitated health insurance exchange (which CMS 
operates) and state-based exchanges.

Categories of Individuals

    The individuals whose information will be used in the matching 
program are consumers who apply for eligibility to enroll in applicable 
state health subsidy programs through an exchange established under ACA 
and other relevant individuals (such as, applicants' household 
members).

Categories of Records

    The categories of records that will be used in the matching program 
are identifying records; minimum essential coverage period records; 
return information (household income and family size information); 
citizenship status records; birth and death information; disability 
coverage and income information; and imprisonment status records.
    The data elements CMS will receive from AEs may include:
    1. Social security number (if applicable).
    2. last name.

[[Page 51961]]

    3. first name.
    4. date of birth.
    The data elements the AEs will receive from CMS may include:
    1. Validation of SSN.
    2. verification of citizenship or immigration status.
    3. incarceration status.
    4. eligibility and/or enrollment in certain types of minimum 
essential coverage.
    5. income, based on federal tax information (FTI), Title II 
benefits, and current income sources.
    6. quarters of coverage.
    7. death indicator.

System(s) of Records

    The records that CMS will disclose to AEs will be disclosed from 
the following systems of records, as authorized by routine use 3 
published in the System of Records Notices (SORNs ) cited below:
     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).

[FR Doc. 2018-22405 Filed 10-12-18; 8:45 am]
BILLING CODE 4120-03-P