[Federal Register Volume 65, Number 161 (Friday, August 18, 2000)]
[Notices]
[Pages 50544-50548]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 00-21060]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Health Care Financing Administration


Privacy Act of 1974; Report of New System

AGENCY: Department of Health and Human Services (HHS), Health Care 
Financing 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. The 
proposed system is titled ``Links of Social Security Administration 
(SSA) and Health Care Financing Administration (HCFA) Data (LOD), HHS/
HCFA/OSP, 09-70-0069.'' HCFA proposes to establish a new system of 
records containing benefit information derived from Social Security 
Administration and HCFA records for samples of the United States 
population served by programs administered by both agencies.
    The primary purpose of this system of records is to provide 
information that will be used to conduct research, perform policy 
analysis, and improve program management for populations served by both 
SSA and HCFA. Information in this system will support: research, 
evaluation, or epidemiological projects; special projects and 
activities performed within the agency or by a contractor or 
consultant; constituent requests made to a congressional 
representative; and litigation involving the agency.
    We have provided background information about the proposed system 
in the ``Supplementary Information'' section below. Although the 
Privacy Act requires only that the ``routine use'' portion of the 
system be published for comment, 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

[[Page 50545]]

Senate Committee on Governmental Affairs, and the Administrator, Office 
of Information and Regulatory Affairs, Office of Management and Budget 
(OMB) on August 4, 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 9:00 a.m.-3:00 p.m., 
eastern time zone.

FOR FURTHER INFORMATION CONTACT: Dave Baugh, Office of Strategic 
Planning, HCFA, Room C3-19-07, 7500 Security Boulevard, Baltimore, 
Maryland 21244-1850. The telephone number is 410-786-7716.

SUPPLEMENTARY INFORMATION:

I. Description of the New System of Records

Statutory and Regulatory Basis for System of Records

    Under section 1875(a) of the Social Security Act, (the Act) [42 
U.S.C. 1395ii(a) and section 1110 of the Social Security Act (42 U.S.C. 
1310), HCFA and SSA programs are inextricably linked as they were 
created under Federal law. Eligibility for Medicare is based on meeting 
minimum standards for covered employment for Social Security. In 
particular, Medicare disability coverage is directly linked to SSA 
determinations of eligibility for income payments under the Social 
Security Disability Income program. Likewise, for most States, a 
person's Medicaid eligibility is determined by their eligibility for 
SSA's Supplemental Security Income (SSI) program. Because of the 
interrelationship between these SSA and HCFA programs, information on 
program beneficiaries is housed in both agencies. Some information, 
such as reason for disability (for disabled enrollees) is housed only 
in SSA files. Other information, such as utilization and expenditures 
for health care services, is housed only in HCFA files. Therefore, some 
of the research, evaluation, policy analysis and program management 
activities can only be conducted if data are linked from the two 
agencies. In summary, the purpose of this notice is to allow disclosure 
of the linked data in this system only where these data are required to 
meet the research objectives. Examples of current research objectives 
include:
    (A) Evaluations of the impact of the Federal welfare reform law, 
the Personal Responsibility and Work Opportunity Reconciliation Act of 
1996 (PRWORA) on program enrollment and spending in HCFA and SSA.
    (B) Studies of utilization and spending in Medicare and Medicaid 
for disabled enrollees based on their reason for disability.
    (C) Studies to improve the quality of care delivered to Medicare 
disabled beneficiaries.
    (D) Studies to promote the efficiency and effectiveness of acute 
and long-term care services received by persons eligible for both 
Medicare and Medicaid (the dual eligibles) including the development of 
improved risk-adjusted payment methods for dual eligibles.

II. Collection and Maintenance of Data in the System

A. Scope of the Data Collected

    The system includes samples of the United States population served 
by HCFA and SSA programs and the following information for each: name, 
social security number, Medicaid identification number, health 
insurance claim number, eligibility for SSA and HCFA programs, and 
benefit record information.

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 LOD 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. Identifiable 
data includes individual records with LOD information and identifiers. 
Non-identifiable data includes individual records with LOD information 
and masked identifiers or LOD information with identifiers stripped out 
of the file.
    Data may only be used under these routine uses for those projects 
approved in writing by both SSA and HCFA. We will only disclose the 
minimum personal data necessary to achieve the purpose of LOD. 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 for the minimum information necessary to accomplish the purpose of 
the disclosure after HCFA:
    (a) Determines that the use or disclosure is consistent with the 
reason that the data is being collected, e.g., used to conduct 
research, perform policy analysis, and improve program management for 
populations served by SSA and HCFA.
    (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;
    (2) Remove or destroy at the earliest time all individually-
identifiable information; and
    (3) Agree to not use or disclose the information for any purpose 
other than the stated purpose under which the information was 
disclosed.
    (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

    The routine use disclosures in this system may occur only to the 
following four (4) categories of entities (i.e., the entities, which 
can get identifiable data only if we apply the policies and procedures 
in Section II. B. above). In addition, our policy will be to prohibit 
release even of non-identifiable data, beyond the four listed 
categories, if there is a possibility that an individual can be 
identified through implicit deduction based on small cell sizes 
(instances where the population is so small that individuals who are 
familiar with the population could, because of the small size, use this 
information to deduce the identity). Disclosures may be made:
    1. To an individual or organization for research, evaluation, or 
epidemiological

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projects related to the prevention of disease or disability, or the 
restoration or maintenance of health, and for payment related projects.
    We contemplate disclosing information under this routine use only 
in situations in which HCFA may enter into a contract, grant or 
cooperative agreement with project directors, contractors, grantees, or 
awardees of cooperative agreements to assist in accomplishing 
activities relating to purposes for this system of records.
    2. 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 contract or similar 
agreement with a contractor or consultant to assist in accomplishing 
activities 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 and/or consultant whatever information is 
necessary for the contractor and/or consultant to fulfill its duties. 
In these situations, safeguards are provided in the contract 
prohibiting the contractor and/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.
    3. 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.
    4. 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. A determination would be made in each instance that, 
under the circumstances involved, the purposes served by the use of the 
information in the particular litigation is compatible with a purpose 
for which HCFA collects the information.

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 sufficient to protect 
the confidentiality of the data and to prevent unauthorized access to 
the data. Records are used in a designated work area or work station 
and the system location is attended at all times during working hours.
    To ensure security of the data, the proper level of class user is 
assigned for each individual user. 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 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.
    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 LOD data:
    Access to different areas on the Windows NT server is 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; HHS, 
Information Resource Management (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. Effect 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 monitor the collection and reporting of LOD data. LOD 
information on all projects is completed and submitted to HCFA through 
standard systems located at the HCFA Data Center. HCFA will utilize a 
variety of onsite and offsite edits and audits to increase the accuracy 
of LOD data.
    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. 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

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privacy as a result of the disclosure of information relating to 
individuals.

    Dated: August 4, 2000.
Nancy-Ann Min DeParle,
Administrator, Health Care Financing Administration.
09-70-0069

SYSTEM NAME:
    ``Links of Social Security Administration (SSA) and Health Care 
Financing Administration (HCFA) Data (LOD), HHS/HCFA/OSP, 09-70-0069.''

SECURITY CLASSIFICATION:
    Level 3, Privacy Act Sensitive Data

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

CATEGORIES OF INDIVIDUALS COVERED BY THE SYSTEM:
    Samples of the United States population served by programs 
administered by HCFA and SSA.

CATEGORIES OF RECORDS IN THE SYSTEM:
    The system includes the following information for each: name, 
social security number, Medicaid identification number, health 
insurance claim number, eligibility for SSA and HCFA programs, and 
benefit record information.

AUTHORITY FOR MAINTENANCE OF THE SYSTEM:
    Section 1875(a) of the Social Security Act [42 U.S.C. 1395ii(a)] 
and section 1110 of the Social Security Act [42 U.S.C. 1310].

PURPOSE (S) OF THE SYSTEM:
    The primary purpose of this system of records is to provide 
information that will be used to conduct research, perform policy 
analysis, and improve program management for populations served by both 
SSA and HCFA. Information in this system will support research, 
evaluation, or epidemiological projects; special projects and 
activities performed within the agency or by a contractor or 
consultant; support constituent requests made to a congressional 
representative; and support litigation involving the agency.

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 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.
    2. 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.
    3. 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.
    4. 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
    (d) Agreed to represent the employee, or 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.

POLICIES AND PRACTICES FOR STORING, RETRIEVING, ACCESSING, RETAINING, 
AND DISPOSING OF RECORDS IN THE SYSTEM:
STORAGE:
    Computer diskette and on magnetic storage media.

RETRIEVABILITY:
    Information can be retrieved by the social security number, 
Medicaid identification number, health insurance claim number and by 
name.

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 LOD 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:
    Records are maintained in a secure storage area with identifiers. 
Records will be retained for 15 years.

SYSTEM MANAGER AND ADDRESS:
    Director, Office of Strategic Planning, HCFA, Room C3-20-11, 7500 
Security Boulevard, Baltimore, Maryland 21244-1850. The telephone 
number is 410-786-7932.

NOTIFICATION PROCEDURE:
    For purpose of access, the subject individual should write to the 
system manager who will require the system name, Medicaid 
identification number, 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).

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RECORD SOURCE CATEGORIES:
    Sources of information contained in this records system include 
data collected from SSA systems of records, e.g., Supplemental Security 
Record (09-60-0103), Master Beneficiary Record (09-60-0090), Disability 
Determination Files (09-60-0044), and Social Security Account Number 
Identification File (09-60-0058) and HCFA systems of records, e.g., 
Medicaid Statistical Information System (09-70-6001), Current 
Beneficiary Survey (09-70-6002), Common Working Files (09-70-0526), 
National Claims History Files (09-70-0005) and Enrollment Data Base 
(09-70-0502).

SYSTEMS EXEMPTED FROM CERTAIN PROVISIONS OF THE ACT:
    None.

[FR Doc. 00-21060 Filed 8-17-00; 8:45 am]
BILLING CODE 4120-03-P