[Federal Register Volume 65, Number 161 (Friday, August 18, 2000)]
[Notices]
[Pages 50548-50552]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 00-21095]


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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, ``Medicare 
Provider Analysis and Review (MEDPAR), HHS/HCFA/OIS, 09-70-0009.'' The 
MEDPAR will contain a summary of all services rendered to a Medicare 
beneficiary, from the time of admission through discharge, for a stay 
in an inpatient hospital and/or skilled nursing facility (SNF), 
Supplemental Security Income (SSI) eligibility information which HCFA 
receives from the Social Security Administration on Medicare 
beneficiaries who have had stays at inpatient hospitals and SNF, and 
enrollment data on Medicare beneficiaries.
    The primary purpose of the system of records is to collect and 
maintain information for all services rendered during a stay at an 
inpatient hospital and/or SNF of Medicare beneficiaries, so as to 
enable HCFA and its contractors to facilitate research on the quality 
and effectiveness of care provided, update annual hospital Prospective 
Payment System (PPS) rates, and to recalculate Supplemental Security 
Income (SSI) ratios for hospitals that are paid under the PPS and serve 
a disproportionate share of low-income patients may be entitled to 
increased reimbursement under Part A of the Medicare program. 
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, provide 
system data to a hospital that has an appeal properly pending before 
the Provider Reimbursement Review Board (PRRB), or before an 
intermediary, assist another federal or state agency with information 
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 constituent requests made to a 
congressional representative, support litigation involving the agency, 
facilitate research on the quality and effectiveness of care provided, 
and, combat fraud and abuse in certain health benefits programs. We 
have provided background information about the modified 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 August 14, 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: Anne Rudolph, Division of Acute Care, 
Plan and Providers Purchasing Policy Group (PPPPG), Center for Health 
Plans and Providers (CHPP), HCFA, Room C4-07-07, 7500 Security 
Boulevard, Baltimore, Maryland 21244-1850. The telephone number is 
(410) 786-4546.

SUPPLEMENTARY INFORMATION:

I. Description of the Proposed System of Records

A. Statutory and Regulatory Basis For System of Records

    Authority for maintainance of this system is given under sections 
1102(a), 1871, and 1886(d)(5)(F) of the Social Security Act, (Title 42 
United States Code (USC) sections 1302(a), 1395hh, and 
1395ww(d)(5)(F)). Under section 1886 (d)(5)(F)(vi)(I) of the Social 
Security Act (the Act), 42 USC 1395ww (d)(5)(F)(vi)(I), hospitals that 
are paid under the PPS and serve a disproportionate share of low-income 
patients may be entitled to increased reimbursement under Part A of the 
Medicare program. Such disproportionate share hospital payments, which 
became effective for discharges occurring on or after May 1, 1986, 
depend in part on a hospital's ``SSI ratio.'' HCFA determines a 
hospital's SSI ratio by comparing, for the same period, (1) the 
hospital's total number of its Medicare inpatient days to (2) the 
hospital's ``Medicare/SSI days,'' i.e., inpatient days attributable to 
Medicare patients who for such days were eligible for SSI payments 
under Title XVI of the Act. In determining a hospital's SSI ratio, HCFA 
uses information from the National Claims History (NCH), (HHS/HCFA/OIS 
09-70-0005), in conjunction with SSI eligibility information that HCFA 
receives from the Social Security Administration. HCFA notifies each 
hospital of the total number of its Medicare/SSI days for a given 
federal fiscal year, or cost reporting period, but does not identify 
which of the hospital's Medicare patients had Medicare/SSI days.

II. Collection and Maintenance of Data in the System

A. Scope of the Data Collected

    The MEDPAR contains information necessary for appropriate Medicare 
claim processing. It contains the Medicare health insurance claim (HIC) 
number, sex, race, age (no date of birth), zip code, state and county 
for Medicare beneficiaries who have received inpatient hospital and SNF 
services.

[[Page 50549]]

B. Agency Policies, Procedures, and Restrictions on the Routine Use

    We are establishing the following policies, procedures and 
restrictions on routine use disclosures of information that will be 
maintained in the system. In general, routine uses of this system (or a 
subset thereof) will be approved for the minimum set of data elements 
in the record needed to accomplish the purpose of the disclosure 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 refining 
payment systems and monitoring the quality of care provided to 
patients.
    (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 potential 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

    The Privacy Act allows us to disclose information without an 
individual's consent if the information is to be used for a purpose 
that 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 uses in this system meet the compatibility 
requirement of the Privacy Act. 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 doing 
so 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 requires 
the contractor or consultant to return or destroy all information at 
the completion of the contract.
    2. To a hospital that has an appeal properly pending before the 
Provider Reimbursement Review Board (PRRB), or before an intermediary, 
on the issue of whether it is entitled to disproportionate share 
hospital payments, or the amount of such payments. As a condition of 
disclosure under this routine use, HCFA will require the recipient of 
the information to:
    (a) Establish reasonable administrative, technical, and physical 
safeguards to prevent unauthorized access, use or disclosure of the 
record or any part thereof. The physical safeguards must provide a 
level of security that is at least the equivalent to the level of 
security contemplated in OMB Circular A-130 (Revised), Appendix III, 
Security of Federal Automated Information Systems, which sets forth 
guidelines for security plans for automated information systems in 
Federal agencies.
    (b) Remove or destroy the information that allows the subject 
individual(s) to be identified at the earliest time at which removal or 
destruction can be accomplished consistent with the purpose of the 
request;
    (c) Refrain from using or disclosing the information for any 
purpose other than the stated purpose under which the information was 
disclosed; and
    (d) Attest in writing that it understands the foregoing provisions, 
and is willing to abide by the foregoing provisions and any additional 
provisions that HCFA deems appropriate in the particular circumstances.
    Disclosure under this routine use shall be for the purpose of 
assisting the hospital to verify or challenge HCFA's determination of 
the hospital's SSI ratio (i.e., the total number of Medicare days 
compared to the number of Medicare/SSI days), and shall be limited to 
data concerning the SSI eligibility status of individuals who had stays 
at the inpatient hospital's facility during the period that is relevant 
to the appeal. The proposed routine use would permit disclosure only to 
a hospital that has a proper appeal pending before the PRRB or before 
an intermediary.
    3. To another federal or state agency:
    (a) To contribute to the accuracy of HCFA's proper payment of 
Medicare benefits, and/or
    (b) 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 MEDPAR information in order to 
support evaluations and monitoring of Medicare claims information of 
beneficiaries who have had stays at inpatient hospitals and SNF, 
including proper reimbursement for services provided.
    4. 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 MEDPAR data will provide the research, evaluation and 
epidemiological projects a broader, longitudinal, national perspective 
of the MEDPAR and inpatient data. 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. Disclosure of MEDPAR data for research and evaluation 
purposes will usually involve aggregate data rather than individual-
specific data.
    5. 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 an 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.
    6. To the Department of Justice (DOJ), court or adjudicatory body 
when:
    (a) the agency or any component thereof, or

[[Page 50550]]

    (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 and 
that the use of such records by the DOJ, court or adjudicatory body is 
compatible with the purpose for which the agency collected the records.
    Whenever HCFA is involved in litigation, and 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.
    7. To a HCFA contractor (including, but not necessarily limited to 
fiscal intermediaries and carriers) that assists in the administration 
of a HCFA-administered health benefits program, or to a grantee of a 
HCFA-administered grant program, when disclosure is deemed reasonably 
necessary by HCFA to prevent, deter, discover, detect, investigate, 
examine, prosecute, sue with respect to, defend against, correct, 
remedy, or otherwise combat fraud or abuse in such program.
    We contemplate disclosing information under this routine use only 
in situations in which HCFA may enter into a contractual relationship 
or grant with a third party to assist in accomplishing HCFA functions 
relating to the purpose of combating fraud and abuse.
    HCFA occasionally contracts out certain of its functions and makes 
grants when doing so would contribute to effective and efficient 
operations. HCFA must be able to give a contractor or grantee whatever 
information is necessary for the contractor or grantee to fulfill its 
duties. In these situations, safeguards are provided in the contract 
prohibiting the contractor or grantee from using or disclosing the 
information for any purpose other than that described in the contract 
and requiring the contractor or grantee to return or destroy all 
information.
    8. 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 governmental agency), that 
administers, or that has the authority to investigate potential fraud 
or abuse in, a health benefits program funded in whole or in part by 
federal funds, when disclosure is deemed reasonably necessary by HCFA 
to prevent, deter, discover, detect, investigate, examine, prosecute, 
sue with respect to, defend against, correct, remedy, or otherwise 
combat fraud or abuse in such programs.
    Other agencies may require MEDPAR information for the purpose of 
combating fraud and abuse in such Federally funded 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 sufficient to protect the confidentiality of the 
data and to prevent unauthorized access to the data. Records are used 
in a designated work area and 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 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 Report Generator class has read-only 
access to all fields and tables;
     Policy Research class has query access to tables, but is 
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 
MEDPAR 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 Automated 
Information Systems (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 MEDPAR 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 MEDPAR transmission 
connections to the system. As a result, Netscape controls all MEDPAR 
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 is maintained 
through the use of file, directory and

[[Page 50551]]

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, 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. 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 are 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.

    Dated: August 10, 2000.
Nancy-Ann Min DeParle,
Administrator, Health Care Financing Administration.
09-70-0009

SYSTEM NAME:
    ``Medicare Provider Analysis and Review (MEDPAR) HHS/HCFA/OIS.''

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 categories of individuals covered by this system are Medicare 
beneficiaries who have had stays in inpatient hospitals and skilled 
nursing facilities (SNF).

CATEGORIES OF RECORDS IN THE SYSTEM:
    The MEDPAR will contain claims and demographic information on 
Medicare beneficiaries who have had stays in inpatient hospitals and 
SNF, Supplemental Security Income (SSI) eligibility information which 
HCFA receives from the Social Security Administration on Medicare 
beneficiaries who have had stays at inpatient hospitals and SNF, and 
enrollment data on Medicare beneficiaries.

AUTHORITY FOR MAINTENANCE OF THE SYSTEM:
    Sections 1102(a), 1871, and 1886(d)(5)(F) of the Social Security 
Act, (42 U.S.C. Secs. 1302(a), 1395hh, and 1395ww(d)(5)(F)).

PURPOSE(S) OF THE SYSTEM:
    The primary purpose of the system of records is to collect and 
maintain information for all services rendered during a stay at an 
inpatient hospital and/or SNF of Medicare beneficiaries, so as to 
enable HCFA and its contractors to facilitate research on the quality 
and effectiveness of care provided, update annual hospital Prospective 
Payment System (PPS) rates, and to recalculate SSI ratios for hospitals 
that are paid under the PPS and serve a disproportionate share of low-
income patients may be entitled to increased reimbursement under Part A 
of the Medicare program. 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, provide system data to a hospital that has an appeal 
properly pending before the Provider Reimbursement Review Board (PRRB), 
or before an intermediary, assist another federal or state agency with 
information 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 
constituent requests made to a congressional representative, support 
litigation involving the agency, facilitate research on the quality and 
effectiveness of care provided, 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 
that is compatible with the purpose(s) for which the information was 
collected. Any such compatible use of data is known as a ``routine 
use.'' 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.
    2. To a hospital that has an appeal properly pending before the 
Provider Reimbursement Review Board (PRRB), or before an intermediary, 
on the issue of whether it is entitled to disproportionate share 
hospital payments, or the amount of such payments. As a condition of 
disclosure under this routine use, HCFA will require the recipient of 
the information to:
    (a) Establish reasonable administrative, technical, and physical 
safeguards to prevent unauthorized access, use or disclosure of the 
record or any part thereof. The physical safeguards must provide a 
level of security that is at least the equivalent to the level of 
security contemplated in OMB Circular A-130 (Revised), Appendix III, 
Security of Federal Automated Information Systems, which sets forth 
guidelines for security plans for automated information systems in 
federal agencies.
    (b) Remove or destroy the information that allows the subject 
individual(s) to be identified at the earliest time at which removal or 
destruction can be

[[Page 50552]]

accomplished consistent with the purpose of the request;
    (c) Refrain from using or disclosing the information for any 
purpose other than the stated purpose under which the information was 
disclosed; and
    (d) Attest in writing that it understands the foregoing provisions, 
and is willing to abide by the foregoing provisions and any additional 
provisions that HCFA deems appropriate in the particular circumstances.
    3. To another federal or state agency:
    (a) To contribute to the accuracy of HCFA's proper payment of 
Medicare benefits, and/or
    (b) 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.
    4. 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.
    5. 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.
    6. 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 and 
that the use of such records by the DOJ, court or adjudicatory body is 
compatible with the purpose for which the agency collected the records.
    7. To a HCFA contractor (including, but not necessarily limited to 
fiscal intermediaries and carriers) that assists in the administration 
of a HCFA-administered health benefits program, or to a grantee of a 
HCFA-administered grant program, when disclosure is deemed reasonably 
necessary by HCFA to prevent, deter, discover, detect, investigate, 
examine, prosecute, sue with respect to, defend against, correct, 
remedy, or otherwise combat fraud or abuse in such program.
    8. 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 governmental agency), that 
administers, or that has the authority to investigate potential fraud 
or abuse in, a health benefits program funded in whole or in part by 
federal funds, when disclosure is deemed reasonably necessary by HCFA 
to prevent, deter, discover, detect, investigate, examine, prosecute, 
sue with respect to, defend against, correct, remedy, or otherwise 
combat fraud or abuse in such programs.

POLICIES AND PRACTICES FOR STORING, RETRIEVING, ACCESSING, RETAINING, 
AND DISPOSING OF RECORDS IN THE SYSTEM:
STORAGE:
    All records are stored on magnetic media.

RETRIEVABILITY:
    The Medicare records are retrieved by health insurance claim (HIC) 
number of the beneficiary.

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 MEDPAR 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 and the repository of the National Archive and Records 
Administration will retain identifiable MEDPAR data for a total period 
not to exceed 25 years.

SYSTEM MANAGER AND ADDRESS:
    Director, Division of Enrollment, Utilization, and Data 
Development, Enterprise Databases Group, Office of Information 
Services, HCFA, Room N3-16-28, 7500 Security Boulevard, Baltimore, 
Maryland, 21244-1850. The telephone number is (410)-786-6759.

NOTIFICATION PROCEDURE:
    For purpose of access, the subject individual should write to the 
system manager who will require the system name, HIC, address, age, 
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:
    HCFA's National Claims History system of records, enrollment data 
on Medicare beneficiaries, and SSI eligibility information from the 
Social Security Administration.

SYSTEMS EXEMPTED FROM CERTAIN PROVISIONS OF THE ACT:
    None.

[FR Doc. 00-21095 Filed 8-17-00; 8:45 am]
BILLING CODE 4120-03-P