83 FR 54755 - Privacy Act of 1974; Matching Program

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Federal Register Volume 83, Issue 211 (October 31, 2018)

Page Range		54755-54756
FR Document		2018-23780

In accordance with 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 Defense (DoD), ``Verification of Eligibility for Minimum Essential Coverage Under the Patient Protection and Affordable Care Act Through a Department of Defense Health Benefits Plan.''

Federal Register, Volume 83 Issue 211 (Wednesday, October 31, 2018)

[Federal Register Volume 83, Number 211 (Wednesday, October 31, 2018)]
[Notices]
[Pages 54755-54756]
From the Federal Register Online  [www.thefederalregister.org]
[FR Doc No: 2018-23780]


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DEPARTMENT OF HEALTH AND HUMAN 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 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 Defense (DoD), ``Verification of 
Eligibility for Minimum Essential Coverage Under the Patient Protection 
and Affordable Care Act Through a Department of Defense Health Benefits 
Plan.''

DATES: The deadline for comments on this notice is November 30, 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 
December 2018 to June 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 on this 
notice, by mail or email, to the CMS Privacy Officer, Division of 
Security, Privacy Policy & Governance, Information Security & Privacy 
Group, Office of Information Technology, Centers for Medicare & 
Medicaid Services, Location: N1-14-56, 7500 Security Blvd., Baltimore, 
MD 21244-1850, [email protected].

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

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

    Department of Health and Human Services (HHS), Centers for Medicare 
& Medicaid Services (CMS) is the recipient agency, and the Department 
of Defense (DoD), Defense Manpower Data Center (DMDC) is the source 
agency.

Authority for Conducting the Matching Program

    The matching program is authorized under 42 U.S.C. 18001, et seq.

Purpose(s)

    The purpose of the matching program is to provide CMS with DoD data 
verifying individuals' eligibility for coverage under a DoD health 
benefits plan (i.e., TRICARE), when requested by CMS and state-based 
administering entities (AE) for the purpose of determining the 
individuals' eligibility for insurance affordability programs under the 
Affordable Care Act (ACA). CMS and the requesting AE will use the DoD 
data to determine whether an enrollee in private health coverage under 
a qualified health plan through a federally-facilitated or state-based 
health insurance exchange is eligible for coverage under TRICARE, and 
the dates the individual was eligible for TRICARE coverage. DoD health 
benefit plans provide minimum essential coverage (MEC), and eligibility 
for such plans

[[Page 54756]]

usually precludes eligibility for financial assistance in paying for 
private coverage. CMS and AE will use the DoD data to authenticate 
identity, determine eligibility for financial assistance (including an 
advance tax credit and cost-sharing reduction, which are types of 
insurance affordability programs), and determine the amount of the 
financial assistance.

Categories of Individuals

    The categories of individuals whose information is involved in the 
matching program are active duty service members and their family 
members and retirees and their family members whose TRICARE eligibility 
records at DoD match data provided to DoD by CMS (submitted by AEs) 
about individual consumers who are applying for or are enrolled in 
private health insurance coverage under a qualified health plan through 
a federally-facilitated or state-based health insurance exchange.

Categories of Records

    The categories of records used in the matching program are identity 
records and minimum essential coverage period records. The data 
elements are as follows:

A. From CMS to DoD

    For each applicant or enrollee seeking an eligibility 
determination, CMS will submit a request file to DoD that may contain, 
but is not limited to, the following specified data elements in a fixed 
record format: Transaction ID, social security number (SSN), first 
name, middle name, surname, date of birth, gender, requested qualified 
health plan (QHP) coverage effective date, requested QHP coverage end 
date.

B. From DoD to CMS

    For each applicant or enrollee seeking an eligibility 
determination, DoD will provide CMS with data indicating whether or not 
the individual is eligible for MEC through TRICARE during the 
applicable QHP coverage period. The data may contain, but is not 
limited to, the following specified data elements in a fixed record 
format: Insurance end date, person SSN identification, response code, 
response code text.

System(s) of Records

    The records used in this matching program are disclosed from the 
following systems of records, as authorized by routine uses published 
in the System of Records Notices (SORNs) cited below:

A. CMS System of Records

    [square] MCMS 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).

B. DoD Systems of Records

    [square] SDMDC 02 DoD, Defense Enrollment Eligibility Reporting 
Systems (DEERS), 80 FR 68304 (Nov. 4, 2015), as amended at 81 FR 49210 
(July 27, 2016).

[FR Doc. 2018-23780 Filed 10-30-18; 8:45 am]
 BILLING CODE 4120-03-P

Federal Register / Vol. 83, No. 211 / Wednesday, October 31, 2018 / Notices 54755

Docket Number. All relevant comments SUMMARY: In accordance with the recipient federal agency, provided to
received will be posted without change Privacy Act of 1974, as amended, the Congress and the Office of Management
to www.regulations.gov, including any Department of Health and Human and Budget (OMB), and made available
personal information provided. For Services (HHS), Centers for Medicare & to the public, as required by 5 U.S.C.
access to the docket to read background Medicaid Services (CMS) is providing 552a(o), (u)(3)(A), and (u)(4).
documents or comments received, go to notice of a new matching program 2. Notify the individuals whose
www.regulations.gov. between CMS and the Department of information will be used in the
FOR FURTHER INFORMATION CONTACT: Defense (DoD), ‘‘Verification of matching program that the information
Commander Aimee Treffiletti, Vessel Eligibility for Minimum Essential they provide is subject to verification
Sanitation Program, National Center for Coverage Under the Patient Protection through matching, as required by 5
Environmental Health, Centers for and Affordable Care Act Through a U.S.C. 552a(o)(1)(D).
Disease Control and Prevention, 4770 Department of Defense Health Benefits 3. Verify match findings before
Buford Highway NE, MS F–58, Atlanta, Plan.’’ suspending, terminating, reducing, or
Georgia 30341; phone: 954–356–6650 or DATES: The deadline for comments on making a final denial of an individual’s
770–488–3141; email: vsp@cdc.gov. this notice is November 30, 2018. The benefits or payments or taking other
re-established matching program will adverse action against the individual, as
SUPPLEMENTARY INFORMATION: The
commence not sooner than 30 days after required by 5 U.S.C. 552a(p).
purpose of the meeting is to present 4. Report the matching program to
VSP’s clarifications to the 2018 publication of this notice, provided no
comments are received that warrant a Congress and the OMB, in advance and
Operations Manual and Construction annually, as required by 5 U.S.C.
Guidelines and the proposed fee change to this notice. The matching
program will be conducted for an initial 552a(o) (2)(A)(i), (r), and (u)(3)(D).
schedule for fiscal year 2020. 5. Publish advance notice of the
The 2018 Operations Manual and term of 18 months (from approximately
December 2018 to June 2020) and matching program in the Federal
Construction Guidelines went into effect Register as required by 5 U.S.C.
on June 1, 2018. Since that time, small within 3 months of expiration may be
renewed for one additional year if the 552a(e)(12).
errors and the need for clarifications to This matching program meets these
some sections have been identified. parties make no change to the matching
requirements.
VSP issues a fee schedule annually program and certify that the program
has been conducted in compliance with Barbara Demopulos,
and will propose changing the current
the matching agreement. CMS Privacy Advisor, Division of Security,
fee schedule to include an additional
ADDRESSES: Interested parties may Privacy Policy and Governance Information
size category for the largest cruise ships.
submit written comments on this notice, Security and Privacy Group, Office of
Changes to the fee schedule are Information Technology, Centers for Medicare
expected to take effect in fiscal year by mail or email, to the CMS Privacy
Officer, Division of Security, Privacy & Medicaid Services.
2020.
Matters to be Discussed: Policy & Governance, Information Participating Agencies
• Clarifications to the VSP 2018 Security & Privacy Group, Office of
Department of Health and Human
Operations Manual and Construction Information Technology, Centers for
Services (HHS), Centers for Medicare &
Medicare & Medicaid Services,
Guidelines. Medicaid Services (CMS) is the
Location: N1–14–56, 7500 Security
• Proposed fee schedule for fiscal recipient agency, and the Department of
Blvd., Baltimore, MD 21244–1850,
year 2020. Defense (DoD), Defense Manpower Data
Walter.Stone@cms.hhs.gov.
Meeting Accessibility: The meeting is Center (DMDC) is the source agency.
FOR FURTHER INFORMATION CONTACT: If
open to the public, but space is limited
you have questions about the matching Authority for Conducting the Matching
to approximately 70 people. Advanced
program, you may contact Jack Lavelle, Program
registration is required. Information
regarding logistics is available on the Senior Advisor, Marketplace Eligibility The matching program is authorized
VSP website (www.cdc.gov/nceh/vsp). and Enrollment Group, Centers for under 42 U.S.C. 18001, et seq.
Attendees at the annual meeting Consumer Information and Insurance
Oversight, CMS, at (410) 786–0639, or Purpose(s)
normally include cruise ship industry
officials, private sanitation consultants, by email at Jack.Lavelle1@cms.hhs.gov, The purpose of the matching program
and other interested parties. or by mail at 7501 Wisconsin Ave., is to provide CMS with DoD data
Bethesda, MD 20814. verifying individuals’ eligibility for
Dated: October 17, 2018. SUPPLEMENTARY INFORMATION: The coverage under a DoD health benefits
Sandra Cashman, Privacy Act of 1974, as amended (5 plan (i.e., TRICARE), when requested by
Executive Secretary, Centers for Disease U.S.C. 552a) provides certain CMS and state-based administering
Control and Prevention. protections for individuals applying for entities (AE) for the purpose of
[FR Doc. 2018–23715 Filed 10–30–18; 8:45 am] and receiving federal benefits. The law determining the individuals’ eligibility
BILLING CODE 4163–18–P governs the use of computer matching for insurance affordability programs
by federal agencies when records in a under the Affordable Care Act (ACA).
system of records (meaning, federal CMS and the requesting AE will use the
DEPARTMENT OF HEALTH AND agency records about individuals DoD data to determine whether an
HUMAN SERVICES retrieved by name or other personal enrollee in private health coverage
identifier) are matched with records of under a qualified health plan through a
amozie on DSK3GDR082PROD with NOTICES1

Privacy Act of 1974; Matching Program other federal or non-federal agencies. federally-facilitated or state-based
AGENCY: Centers for Medicare & The Privacy Act requires agencies health insurance exchange is eligible for
Medicaid Services (CMS), Department involved in a matching program to: coverage under TRICARE, and the dates
of Health and Human Services (HHS). 1. Enter into a written agreement, the individual was eligible for TRICARE
which must be prepared in accordance coverage. DoD health benefit plans
ACTION: Notice of a new matching
with the Privacy Act, approved by the provide minimum essential coverage
program.
Data Integrity Board of each source and (MEC), and eligibility for such plans

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Document Created: 2018-10-31 00:33:04
Document Modified: 2018-10-31 00:33:04

Category		Regulatory Information
Collection		Federal Register
sudoc Class		AE 2.7: GS 4.107: AE 2.106:
Publisher		Office of the Federal Register, National Archives and Records Administration
Section		Notices
Action		Notice of a new matching program.
Dates		The deadline for comments on this notice is November 30, 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 December 2018 to June 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.
Contact		If you have questions about the matching program, you may contact Jack Lavelle, Senior Advisor, Marketplace Eligibility and Enrollment Group, Centers for Consumer Information and Insurance Oversight, CMS, at (410) 786-0639, or by email at [email protected], or by mail at 7501 Wisconsin Ave., Bethesda, MD 20814.
FR Citation		83 FR 54755