Privacy Act of 1974; Matching Program
| Published date | 14 November 2019 |
| Citation | 84 FR 61960 |
| Record Number | 2019-24724 |
| Section | Notices |
| Court | Social Security Administration |
Federal Register, Volume 84 Issue 220 (Thursday, November 14, 2019)
[Federal Register Volume 84, Number 220 (Thursday, November 14, 2019)]
[Notices]
[Pages 61960-61961]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2019-24724]
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SOCIAL SECURITY ADMINISTRATION
[Docket No. SSA-2019-0016]
Privacy Act of 1974; Matching Program
AGENCY: Social Security Administration (SSA).
ACTION: Notice of a New Matching Program.
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SUMMARY: In accordance with the provisions of the Privacy Act, as
amended, this notice announces a new matching program with the Center
for Medicare & Medicaid Services (CMS). This matching agreement
establishes the terms, conditions, and safeguards under which CMS will
disclose to SSA Medicare non-utilization information for Social
Security Title II beneficiaries aged 90 and above. CMS will identify
Medicare enrollees whose records have been inactive for three or more
years. SSA will use this data as an indicator to select and prioritize
cases for review to determine continued eligibility for benefits under
Title II of the Social Security Act (Act). SSA will contact these
individuals to verify ongoing eligibility. SSA will use this data for
the purposes of fraud discovery and the analysis of fraud program
operations; this agreement allows for SSA's Office of Anti-Fraud
Programs (OAFP) to evaluate the data for the purposes of fraud
detection. SSA will refer individual cases of suspected fraud, waste,
or abuse to the Office of the Inspector General (OIG) for
investigation.
DATES: The deadline to submit comments on the proposed matching program
is 30 days from the date of publication of this notice in the Federal
Register. The matching program will be applicable on January 1, 2020,
or once a minimum of 30 days after publication of this notice has
elapsed, whichever is later. The matching program will be in effect for
a period of 18 months.
ADDRESSES: Interested parties may comment on this notice by either
telefaxing to (410) 966-0869, writing to Matthew Ramsey, Executive
Director, Office of Privacy and Disclosure, Office of the General
Counsel, Social Security
[[Page 61961]]
Administration, G-401 WHR, 6401 Security Boulevard, Baltimore MD 21235-
6401, or emailing [email protected]. All comments received will be
available for public inspection by contacting Mr. Ramsey at this street
address.
FOR FURTHER INFORMATION CONTACT: Norma Followell, Supervisory Team
Lead, Office of Privacy and Disclosure, Office of the General Counsel,
Social Security Administration, G-401 WHR, 6401 Security Boulevard,
Baltimore, MD 21235-6401, at telephone: (410) 966-5855, or send an
email to [email protected].
SUPPLEMENTARY INFORMATION: None.
Matthew Ramsey,
Executive Director, Office of Privacy and Disclosure, Office of the
General Counsel.
PARTICIPATING AGENCIES:
SSA and CMS.
AUTHORITY FOR CONDUCTING THE MATCHING PROGRAM:
The legal authority for this agreement is executed in compliance
with the Privacy Act of 1974 (5 U.S.C. 552a), as amended by the
Computer Matching and Privacy Protection Act (CMPPA) of 1988 (Public
Law (Pub. L.) 100-503), including 5 U.S.C. 552a(b)(3); section 1106 of
the Act (42 U.S.C. 1306); and Office of Management and Budget
guidelines pertaining to computer matching at 54 FR 25818 (June 19,
1989).
Section 202 of the Act (42 U.S.C. 402) outlines the requirements
for eligibility to receive Old-Age, Survivors, and Disability Insurance
Benefits under Title II of the Act. Section 205(c) of the Act (42
U.S.C. 405) directs the Commissioner of Social Security to verify the
eligibility of a beneficiary.
This matching program employs CMS systems containing Protected
Health Information (PHI) as defined by Health and Human Services (HHS)
regulation ``Standards for Privacy of Individually Identifiable Health
Information'' (45 CFR 160 and 164 (78 FR 5566, Parts A and E, published
January 25, 2013)). PHI authorized by the routine uses may only be
disclosed by CMS if, and as permitted or required by the ``Standard for
Privacy in Individually Identifiable Health Information,'' (45 CFR
164.512d).
PURPOSE(S):
This matching program establishes the terms, conditions, and
safeguards under which CMS will disclose to SSA Medicare non-
utilization information for Social Security Title II beneficiaries aged
90 and above.
CMS will identify Medicare enrollees whose records have been
inactive for three or more years. SSA will use this data as an
indicator to select and prioritize cases for review to determine
continued eligibility for benefits under Title II of the Act. SSA will
contact these individuals to verify ongoing eligibility. In addition,
SSA will use this data for the purposes of fraud discovery and the
analysis of fraud program operations; this agreement allows for SSA's
OAFP to evaluate the data for purposes of fraud detection. SSA will
refer individual cases of suspected fraud, waste, or abuse to OIG for
investigation.
CATEGORIES OF INDIVIDUALS:
The individuals whose information is involved in this matching
program are Social Security Title II beneficiaries aged 90 and above.
CATEGORIES OF RECORDS:
SSA will provide CMS with a finder file containing the following
information for each individual: (a) Title II Claim Account Number; (b)
Title II Beneficiary Identification Code; (c) First Name; (d) Last
Name; and (e) Date of birth.
CMS will provide SSA with a response file containing the following
information for each individual: (a) CMS File Number (identified as a
Health Insurance Claim Number (HICN) or Medicare Beneficiary Identifier
(MBI)); (b) Whether CMS matched beneficiary or individual is a Medicare
beneficiary; (c) Whether individual is a Medicaid recipient; (d)
Whether Medicare was used in the last 3 years; (e) Whether the
beneficiary is a part of an HMO; (f) Whether the beneficiary lives in a
nursing home; (g) Whether the beneficiary has private health insurance;
(h) Whether the beneficiary has veteran's health insurance; or (i)
Whether the beneficiary has Tricare insurance.
SYSTEM(S) OF RECORDS:
SSA will disclose to CMS information from the Master Beneficiary
Record (MBR) (60-0090), last fully published January 11, 2006 (71 FR
1826), amended on December 10, 2007 (72 FR 69723), July 5, 2013 (78 FR
40542), July 3, 2018 (83 FR 31250-31251), and November 1, 2018 (83 FR
54969).
SSA will retain any information from the CMS response file in the
Anti-Fraud Enterprise Solution System of Records for OAFP fraud-related
analytics, or data that leads to OAFP to initiate a fraud investigation
(60-0388) published May 3, 2018 (83 FR 19588).
CMS will disclose to SSA information from the following Systems of
Record (SORs): (a) National Claims History (NCH) (09-70-0558),
published November 20, 2006 (71 FR 67137); (b) Enrollment Data Base
(EDB) (09-70-0502), published February 26, 2008 at 73 FR 10249; and (c)
The Long Term Care--Minimum Data Set (MDS) (90-70-0528), published
March 19, 2007 at 72 FR 12801.
SSA's and CMS's SORs have routine uses permitting the disclosures
needed to conduct this match.
[FR Doc. 2019-24724 Filed 11-13-19; 8:45 am]
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