[Federal Register Volume 65, Number 151 (Friday, August 4, 2000)]
[Notices]
[Pages 47995-48000]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 00-18548]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Health Care Financing Administration


Privacy Act of 1974; Report of New System

AGENCY: Health Care Financing, Department of Health and Human Services 
(HHS), Administration (HCFA).

ACTION: Notice of new system of records.

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SUMMARY: In accordance with the requirements of the Privacy Act of 
1974, we are proposing to establish a new system of records, ``National 
Emphysema Treatment Trial (NETT) System, HHS/HCFA/CHPP, 09-70-0531.'' 
HCFA and the National Heart, Lung and Blood Institute, which is part of 
the National Institutes of Health, are collaborating on an effort to 
study the effectiveness of lung volume reduction surgery. The study is 
called ``National Emphysema Treatment Trial.'' The purpose of this 
multi-center randomized study is to evaluate the long-term outcomes of 
lung volume reduction surgery on function, morbidity and mortality, and 
to define appropriate patient selection criteria in order to determine 
which patients will likely benefit from lung volume reduction surgery.
    The primary purpose of the system of records is to maintain data 
that will allow HCFA to collect and provide secure data on participants 
in the randomized phase of the study, pay claims, and to monitor and 
evaluate the clinical trial. Information retrieved from this system of 
records will also be disclosed to: support regulatory, reimbursement 
and policy functions performed within the agency or by a contractor or 
consultant, another federal or state agency to enable such agency to 
administer a federal health benefits program, or to enable such agency 
to fulfill a requirement of a Federal statute or regulation that 
implements a health

[[Page 47996]]

benefits program funded in whole or in part with federal funds, support 
research, evaluation, or epidemiological projects related to the 
prevention of disease or disability, or the restoration or maintenance 
of health, and for payment related projects, support constituent 
requests made to a congressional representative, support litigation 
involving the agency, and, combat fraud and abuse in certain health 
benefits programs. We have provided background information about the 
proposed system in the ``Supplementary Information'' section below. 
Although the Privacy Act requires only that HCFA provide an opportunity 
for interested persons to comment on the proposed routine uses, HCFA 
invites comments on all portions of this notice. See ``Effective 
Dates'' section for comment period.

EFFECTIVE DATES: HCFA 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 July 18, 2000. To ensure that all parties have adequate time 
in which to comment, the new system of records, 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 HCFA receives comments that require alterations to this 
notice.

ADDRESSES: The public should address comments to: Director, Division of 
Data Liaison and Distribution (DDLD), HCFA, 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 time zone.

FOR FURTHER INFORMATION CONTACT: Steven Sheingold, Ph.D., HCFA, Center 
for Health Plans and Providers, 7500 Security Boulevard, C4-10-07, 
Baltimore, Maryland 21244-1850. His telephone number is (410) 786-5896.

SUPPLEMENTARY INFORMATION:

I. Description of the Modified System of Records

A. Background

    HCFA and the National Heart, Lung and Blood Institute, which is 
part of the National Institutes of Health, are collaborating on an 
effort to study the effectiveness of lung volume reduction surgery. The 
purpose of this multi-center randomized study is to evaluate the long-
term outcomes of lung volume reduction surgery on function, morbidity 
and mortality, and to define appropriate patient selection criteria. 
Data related to health care services furnished to Medicare 
beneficiaries participating in the NETT will be collected and used to 
monitor and evaluate the trial and its interventions. The trial is 
designed to:
     Establish a multi-center randomized clinical trial in 
association with a prospective registry to evaluate the long-term 
efficacy, morbidity and mortality associated with intensive medical 
therapy with lung volume reduction surgery as compared with intensive 
medical therapy alone.
     Define patient selection criteria in order to determine 
which patients will likely benefit from lung volume reduction surgery.
    The NETT contains information on beneficiaries participating in the 
study. HCFA and its evaluation contractor will use this information to 
monitor and evaluate the trial and its interventions. Individual 
patient data will be collected on the HCFA claim forms for fee-for-
services and Medicare managed-care beneficiaries. The trial was 
scheduled to began in 1997 and will continue for 7 years from its 
actual start date or until the recruitment goal of 2600 patients is 
attained, whichever comes first.

B. Statutory and Regulatory Basis for System of Records

    Authority for maintenance of the system is given under Section 
1862(a)(1)(A) of the Social Security Act, and 42 U.S.C. 1395, which 
states that Medicare must provide coverage for items and services that 
are ``reasonable and necessary for the diagnosis or treatment of 
illness or injury or to improve the functioning of a malformed body 
member.''

II. Collection and Maintenance of Data in the System.

A. Scope of the Data Collected

    The system of records will contain information about Medicare 
beneficiaries with emphysema, as well as referring and servicing 
physicians. Utilization and frequency of specific health care services, 
the provider, and the sites of services are provided as part of the 
trial. The system will also contain the beneficiary's name, address, 
date of birth, sex, health insurance claim number (HIC), telephone 
number, marital status, clinical outcomes, and morbidity and mortality 
rates.

B. 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 
which 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 NETT information that can be 
associated with an individual as provided for under ``Section III. 
Entities Who May Receive Disclosures Under Routine Use.'' Both 
identifiable and non-identifiable data may be disclosed under a routine 
use.
    We will only disclose the minimum personal data necessary to 
achieve the purpose of NETT. HCFA has the following policies and 
procedures concerning disclosures of information which will be 
maintained in the system. In general, disclosure of information from 
the system of records will be approved only to the extent necessary to 
accomplish the purpose of the disclosure and only after HCFA:
    (a) Determines that the use or disclosure is consistent with the 
reason that the data is being collected, e.g., developing and 
monitoring the quality of care provided to patients in the study, to 
monitor and evaluate the trial and its interventions.
    (b) Determines:
    (1) That the purpose for which the disclosure is to be made can 
only be accomplished if the record is provided in individually 
identifiable form;
    (2) That 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
    (3) That there is a strong probability that the proposed use of the 
data would in fact accomplish the stated purpose(s).
    (c) Requires the information recipient to:
    (1) Establish administrative, technical, and physical safeguards to 
prevent unauthorized use of disclosure of the record; and
    (2) Remove or destroy at the earliest time all patient-identifiable 
information.
    (d) Determines that the data are valid and reliable.

III. Proposed Routine Use Disclosures of Data in the System

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 HCFA may 
release

[[Page 47997]]

information from the NETT 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 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. In addition, our 
policy will be to prohibit release even of non-identifiable data, 
except pursuant to one of the routine uses, if 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). We are proposing to establish the following routine use 
disclosures of information maintained in the system:
    1. To agency contractors, or consultants who have been engaged by 
the agency to assist in the performance of a service related to this 
system of records and who need to have access to the records in order 
to perform the activity.
    We contemplate disclosing information under this routine use only 
in situations in which HCFA may enter into a contractual or similar 
agreement with a third party to assist in accomplishing HCFA function 
relating to purposes for this system of records.
    HCFA occasionally contracts out certain of its functions when this 
would contribute to effective and efficient operations. HCFA 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 to return 
or destroy all information at the completion of the contract.
    2. To another federal or state agency:
    (1) To contribute to the accuracy of HCFA's proper payment of 
Medicare benefits, and/or
    (2) To 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.
    Other federal or state agencies in their administration of a 
federal health program may require NETT information in order to support 
evaluations and monitoring of Medicare claims information of 
beneficiaries who are participating in the study, including proper 
reimbursement for services provided.
    3. To an individual or organization for research, evaluation, or 
epidemiological projects related to the prevention of disease or 
disability, or the restoration or maintenance of health, and for 
payment related projects.
    The NETT data will provide the research, evaluations and 
epidemiological projects a broader, longitudinal, national perspective 
of the status of patients participating in the study. HCFA anticipates 
that many researchers will have legitimate requests to use these data 
in projects that could ultimately improve the care provided to Medicare 
patients and the policy that governs the care. HCFA understands the 
concerns about the privacy and confidentiality of the release of data 
for a research use.
    4. To a member of congress or to a 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 sometimes request the help of a member of congress in 
resolving some issue relating to a matter before HCFA. The member of 
congress then writes HCFA, and HCFA 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, HCFA determines that the records are both relevant and 
necessary to the litigation.
    Whenever HCFA is involved in litigation, or occasionally when 
another party is involved in litigation and HCFA's policies or 
operations could be affected by the outcome of the litigation, HCFA 
would be able to disclose information to the DOJ, court or adjudicatory 
body involved.
    6. To HCFA contractors, including but not necessarily limited to 
fiscal intermediaries and carriers under Title XVIII of the Social 
Security Act; to administer some aspect of a HCFA-administered health 
benefits program, or to a grantee of a HCFA-administered grant program, 
which program is or could be affected by fraud and abuse, for the 
purpose of preventing, deterring, discovering, detecting, 
investigating, examining, prosecuting, suing with respect to, defending 
against, correcting, remedying, or otherwise combating such fraud and 
abuse in such programs.
    We contemplate disclosing information under this routine use only 
in situations in which HCFA may enter into a contractual or similar 
agreement with a third party to assist in accomplishing HCFA functions 
relating to purposes for this system of records.
    HCFA occasionally contracts out certain of its functions when this 
would contribute to effective and efficient operations. HCFA must be 
able to give a contractor whatever information is necessary for the 
contractor to fulfill its duties. In these situations, safeguards (like 
ensuring that 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 those stated in II.B above), are provided in the contract 
prohibiting the contractor from using or disclosing the information for 
any purpose other than that described in the contract and 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 government agency, for the purpose 
of preventing, deterring, discovering, detecting, investigating, 
examining, prosecuting, suing with respect to, defending against, 
correcting, remedying, or otherwise combating such fraud and abuse in 
health benefits program funded in whole or in part by federal funds.
    Other state agencies in their administration of a Federal health 
program may require NETT information for the purpose of preventing, 
deterring, discovering, detecting, investigating, examining, 
prosecuting, suing with respect to, defending against, correcting, 
remedying, or otherwise combating such fraud and abuse in such 
programs.

IV. Safeguards

A. Authorized Users

     Personnel having access to the system have been trained in Privacy 
Act requirements. Employees who maintain records in the system are 
instructed not to release any data until the intended recipient agrees 
to implement appropriate administrative, technical, procedural, and 
physical safeguards

[[Page 47998]]

sufficient to protect the confidentiality of the data and to prevent 
authorized access to the data. Records are used in a designated work 
area and system location is attended at all times during working hours.
    To assure security of the data, the proper level of class user is 
assigned for each individual user level. This prevents unauthorized 
users from accessing and modifying critical data. The system database 
configuration includes five classes of database users:
     Database Administrator class owns the database objects 
(e.g., tables, triggers, indexes, stored procedures, packages) and has 
database administration privileges to these objects.
     Quality Control Administrator class has read and write 
access to key fields in the database;
     Quality Indicator (QI) Report Generator class has read-
only access to all fields and tables;
     Policy Research class has query access to tables, but are 
not allowed to access confidential patient identification information; 
and
     Submitter class has read and write access to database 
objects, but no database administration privileges. This class is used 
by the NETT data submission applications to receive and validate file 
uploads.

B. Physical Safeguards

    All server sites have implemented the following minimum 
requirements to assist in reducing the exposure of computer equipment 
and thus achieve an optimum level of protection and security for the 
NETT system.
    Access to all servers is controlled, with access limited to only 
those support personnel with a demonstrated need for access. Servers 
are to be kept in a locked room accessible only by specified management 
and system support personnel. Each server requires a specific log on 
process. All entrance doors are identified and marked. A log is kept of 
all personnel who were issued a security card, key and/or combination 
which grants access to the room housing the server, and all visitors 
are escorted while in this room. All servers are housed in an area 
where appropriate environmental security controls are implemented, 
which include measures implemented to mitigate damage to AIS resources 
caused by fire, electricity, water and inadequate climate controls.
    Protection applied to the workstations, servers and databases 
include:
     User Log-ons--Authentication is performed by the Primary 
Domain Controller/Backup Domain Controller of the log-on domain.
     Workstation Names--Workstation naming conventions may be 
defined and implemented at the agency level.
     Hours of Operation--May be restricted by Windows NT. When 
activated all applicable processes will automatically shut down at a 
specific time and not be permitted to resume until the predetermined 
time. The appropriate hours of operation are determined and implemented 
at the agency level.
     Inactivity Log-out--Access to the NT workstation is 
automatically logged out after a specified period of inactivity.
     Warnings--Legal notices and security warnings display on 
all servers and workstations.
     Remote Access Services (RAS)--Windows NT RAS security 
handles resource access control. Access to NT resources is controlled 
for remote users in the same manner as local users, by utilizing 
Windows NT file and sharing permissions. Dial-in access can be granted 
or restricted on a user-by-user basis through the Windows NT RAS 
administration tool.
    There are several levels of security found in the NETT system. 
Windows NT provides much of the overall system security. The Windows NT 
security model is designed to meet the C2-level criteria as defined by 
the U.S. Department of Defense's Trusted Computer System Evaluation 
Criteria document (DoD 5200.28-STD, December 1985). Netscape Enterprise 
Server is the security mechanism for all NETT transmission connections 
to the system. As a result, Netscape controls all NETT information 
access requests. Anti-virus software is applied at both the workstation 
and NT server levels.
    Access to different areas on the Windows NT server are maintained 
through the use of file, directory and share level permissions. These 
different levels of access control provide security that is managed at 
the user and group level within the NT domain. The file and directory 
level access controls rely on the presence of an NT File System (NTFS) 
hard drive partition. This provides the most robust security and is 
tied directly to the file system. Windows NT security is applied at 
both the workstation and NT server levels.

C. Procedural Safeguards

     All automated systems must comply with federal laws, guidance, and 
policies for information systems security. These include, but are not 
limited to: the Privacy Act of 1974, the Computer Security Act of 1987, 
OMB Circular A-130, revised, IRM Circular #10, HHS Automated 
Information Systems Security Program, the HCFA Information Systems 
Security Policy and Program Handbook, and other HCFA systems security 
policies. Each automated information system should ensure a level of 
security commensurate with the level of sensitivity of the data, risk, 
and magnitude of the harm that may result from the loss, misuse, 
disclosure, or modification of the information contained in the system.

V. Effects of the Proposed System of Records on Individual Rights

    HCFA 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. Data in this 
system will be subject to the authorized releases in accordance with 
the routine uses identified in this system of records.
    HCFA will take precautionary measures (see item IV. above) to 
minimize the risks of unauthorized access to the records and the 
potential harm to individual privacy or other personal or property 
rights of patients whose data is maintained in the system. HCFA will 
collect only that information necessary to perform the system's 
functions. In addition, HCFA 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.
    HCFA, therefore, does not anticipate an unfavorable effect on 
individual privacy as a result of the disclosure of information 
relating to individuals.

      
Nancy-Ann Min DeParle,
Administrator, Health Care Financing Administration.
09-70-0531

SYSTEM NAME:
    ``National Emphysema Treatment Trial (NETT) System, HHS/HCFA/
CHPP''.

SECURITY CLASSIFICATION:
    Level Three Privacy Act Sensitive Data.

SYSTEM LOCATION:
    HCFA Data Center, 7500 Security Boulevard, North Building, First 
Floor, Baltimore, Maryland 21244-1850.

CATEGORIES OF INDIVIDUALS COVERED BY THE SYSTEM:
    The system of records will contain information about Medicare 
beneficiaries with emphysema enrolled

[[Page 47999]]

in the randomized phase of the trial, as well as referring and 
servicing physicians.

CATEGORIES OF RECORDS IN THE SYSTEM:
    This system of records will contain information about Medicare 
utilization and frequency of specific health care services, the 
provider and provider's speciality, provider's location or sites of 
services, cost of surgery, medical or pulmonary rehabilitation, extra-
site therapy, medical services necessary for treatment, and self-
administered drug therapy. The system will also contain the 
beneficiary's name, address, date of birth, sex, health insurance claim 
number (HIC), telephone number, marital status, clinical outcomes, and 
morbidity and mortality rates.

AUTHORITY FOR MAINTENANCE OF THE SYSTEM:
    Authority for maintenance of the system is given under section 1862 
(a)(1)(A) of the Social Security Act (the Act), and 42 U.S.C. 1395.

PURPOSE(S):
    The primary purpose of the system of records is to maintain data 
that will allow HCFA to collect and provide secure data on participants 
in the randomized phase of the study, pay claims, and to monitor and 
evaluate the clinical trial. Information retrieved from this system of 
records will also be disclosed to: support regulatory, reimbursement 
and policy functions performed within the agency or by a contractor or 
consultant, another federal or state agency to enable such agency to 
administer a Federal health benefits program, or 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, support research, evaluation, or epidemiological 
projects related to the prevention of disease or disability, or the 
restoration or maintenance of health, and for payment related projects, 
support constituent requests made to a congressional representative, 
support litigation involving the agency, and, 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:
    The Privacy Act allows us to disclose information without an 
individual's consent if the information is to be used for a purpose 
which is compatible with the purpose(s) for which the information was 
collected. Any such compatible use of data is known as a ``routine 
use.'' The proposed routine use in this system meets the compatibility 
requirement of the Privacy Act. We are proposing to establish the 
following routine use disclosures of information which will be 
maintained in the system:
    1. To agency contractors, or consultants who have been engaged by 
the agency to assist in the performance of a service related to this 
system of records and who need to have access to the records in order 
to perform the activity.
    2. To another federal or state agency:
    (1) To contribute to the accuracy of HCFA's proper payment of 
Medicare benefits, and/or
    (2) To 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.
    3. To an individual or organization for research, evaluation, or 
epidemiological projects related to the prevention of disease or 
disability, or the restoration or maintenance of health, and for 
payment related projects.
    4. To a member of congress or to a 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, HCFA determines that the records are both relevant 
and necessary to the litigation.
    6. To HCFA contractors, including but not necessarily limited to 
fiscal intermediaries and carriers under title XVIII of the Social 
Security Act; to administer some aspect of a HCFA-administered health 
benefits program, or to a grantee of a HCFA-administered grant program, 
which program is or could be affected by fraud and abuse, for the 
purpose of preventing, deterring, discovering, detecting, 
investigating, examining, prosecuting, suing with respect to, defending 
against, correcting, remedying, or otherwise combating such fraud and 
abuse in such programs.
    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 government agency, for the purpose 
of preventing, deterring, discovering, detecting, investigating, 
examining, prosecuting, suing with respect to, defending against, 
correcting, remedying, or otherwise combating such fraud and abuse in 
health benefits program funded in whole or in part by Federal funds.

POLICIES AND PRACTICES FOR STORING, RETRIEVING, ACCESSING, RETAINING, 
AND DISPOSING OF RECORDS IN THE SYSTEM:
STORAGE:
    The records are stored in file folders, magnetic tapes and computer 
disks.

RETRIEVABILITY:
    The Medicare and Medicaid records are retrieved by health insurance 
claim number.

SAFEGUARDS:
    HCFA has safeguards 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 systems security 
requirements. Employees who maintain records in the system are 
instructed not to release any data until the intended recipient agrees 
to implement appropriate administrative, technical, procedural, and 
physical safeguards sufficient to protect the confidentiality of the 
data and to prevent unauthorized access to the data.
    In addition, HCFA has physical safeguards in place to reduce the 
exposure of computer equipment and thus achieve an optimum level of 
protection and security for the NETT system. For computerized records, 
safeguards have been established in accordance with HHS standards and 
National Institute of Standards and Technology guidelines, e.g., 
security codes will be used, limiting access to authorized personnel. 
System securities are established in accordance with HHS, Information 
Resource Management (IRM) Circular #10, Automated Information Systems 
Security Program, HCFA Automated Information Systems (AIS) Guide, 
Systems Securities Policies, and OMB Circular No. A-130 (revised), 
Appendix III.

RETENTION AND DISPOSAL:
    HCFA will retain identifiable data for a total period of fifteen 
(15) years from the date the information was last updated.

SYSTEM MANAGER AND ADDRESS:
    HCFA, Director, Center for Health Plans and Providers, Program 
Analysis

[[Page 48000]]

and Performance Measurement Group, 7500 Security Blvd., Baltimore, 
Maryland 21244-1850.

NOTIFICATION PROCEDURE:
    For purpose of access, the subject individual should write to the 
system manager who will require the system name, health insurance claim 
number, address, date of birth, sex, and for verification purposes, the 
subject individual's name (woman's maiden name, if applicable), and 
social security number (SSN). Furnishing 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:
    The NETT will use Medicare enrollment records, Medicare 
beneficiaries or proxies, and medical providers (such as physicians, 
medical facilities, home health care providers) for a sample of 
enrollees.

SYSTEMS EXEMPTED FROM CERTAIN PROVISIONS OF THE ACT:
    None.
[FR Doc. 00-18548 Filed 8-3-00; 8:45 am]
BILLING CODE 4120-03-P