[Federal Register Volume 66, Number 53 (Monday, March 19, 2001)]
[Notices]
[Pages 15496-15500]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 01-6538]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Health Care Financing Administration


Privacy Act of 1974; Report of Modified or Altered System

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

ACTION: Notice of modified or altered system of records (SOR).

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SUMMARY: In accordance with the requirements of the Privacy Act of 
1974, we are proposing to modify or alter a system of records, ``A 
Current Beneficiary Survey (CBS), HHS/HCFA/OACT, System No. 09-70-
6002.'' We propose to delete published routine use number 2 authorizing 
disclosure to the Bureau of the Census, and an unnumbered routine use 
authorizing disclosure to the Social Security Administration. Routine 
use number 2 unnecessarily duplicated Exception 4 of the Privacy Act 
allowing release of data to the Bureau of the Census. We propose to add 
a new routine use for release of information to another federal agency 
to broaden the scope of release for activities related to this system 
of records. We will modify the name of this system to read, ``Medicare 
Current Beneficiary Survey (MCBS).'' The security classification 
previously reported as ``None'' will be modified to reflect that the 
data in this system is considered to be ``Level Three Privacy Act 
Sensitive.'' We are modifying the language in the remaining routine 
uses to provide clarity to HCFA's intention to disclose individual-
specific information contained in this system. The routine uses will 
then be prioritized and reordered according to their usage. We will 
also take the opportunity to update any sections of the system that 
were affected by the recent reorganization and to update language in 
the administrative sections to correspond with language used in other 
HCFA (SOR).
    The primary purpose of the system of records is to maintain a 
research database for HCFA and other researchers that is capable of 
producing data sets suitable for both longitudinal and cross-sectional 
analysis to be used to: (1) Produce projections for current programs 
and proposed program changes, (2) produce national level estimates of 
health care expenditures by the aged and disabled, and (3) provide a 
research database that can be used to provide guidance to program 
management and policies. Information in this system will also be used 
to: support research of policy issues, quality and effectiveness of 
care, and of epidemiological projects, support regulatory and policy 
functions performed within the agency or by a contractor or consultant, 
another federal agency, support constituent requests made to a 
congressional representative, and support litigation involving the 
agency related to this system of records. 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 modified or altered 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 March 12, 2001. To ensure that all 
parties have adequate time in which to comment, the modified or altered 
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, 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: Sydney P. Galloway, Privacy Act 
Coordinator, Systems, Technical, and Analytic Resources Group, Office 
of Strategic Planning (OSP), HCFA, Mailstop C3-24-07, 7500 Security 
Boulevard, Baltimore, Maryland 21244-1850. The telephone number is 410-
786-6645. The e-mail address is [email protected].

[[Page 15497]]


SUPPLEMENTARY INFORMATION:

I. Description of the Modified (SOR)

Statutory and Regulatory Basis for (SOR)

    In 1990, HCFA established a (SOR) under the authority of section 
1875 of the Social Security Act (42 United States Code (U.S.C.) 
139511), entitled ``Studies and Recommendations.'' Notice of this 
system, ``A Current Beneficiary Survey (CBS), HHS/HCFA/OACT, System No. 
09-70-6002,'' was published in the Federal Register on Tuesday, 
September 4, 1990 (55 Fed. Reg. 35957).

II. Collection and Maintenance of Data in the System

A. Scope of the Data Collected

    The system contains a random sampling of individuals enrolled for 
hospital insurance (Part A) and/or supplemental medical benefits (Part 
B) under the Medicare program. Information contained in this system 
include the name of beneficiary, health insurance claim (HIC) number, 
age, sex, race, education, military service history, income data, 
marital status, medical utilization and cost data, prescription drug 
usage and cost data, health and functional status, health insurance 
coverage, medical condition status, household composition data, and 
medical provider names.

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 CBS information that can be associated 
with an individual as provided for under ``Section III. Proposed 
Routine Use Disclosures of Data in the System.'' 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 CBS. 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 only after HCFA:
    (a) Determines that the use or disclosure is consistent with the 
reason that the data is being collected, e.g., to maintain a research 
database that is capable of producing data sets suitable for both 
longitudinal and cross-sectional analysis to: (1) Produce projections 
for current programs and proposed program changes, (2) produce national 
level estimates of health care expenditures by the aged and disabled, 
and (3), provide a research database that can be used to provide 
guidance to program management and policies.
    (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

    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 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 collected data will provide the research, evaluation and 
epidemiological projects a broader, longitudinal, national perspective 
of the 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 data for research and evaluation purposes may involve aggregate data 
rather than individual-specific data.
    2. To agency contractors, or consultants who have been engaged by 
the agency to assist in accomplishment of a HCFA function relating to 
the purposes for this system of records and who need to have access to 
the records in order to assist HCFA.
    We contemplate disclosing information under this routine use only 
in situations in which HCFA may enter into an award 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.
    3. To another federal agency 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 agencies in their administration of a federal health 
program may require MCBS information in order to support evaluations 
and monitoring of reimbursement for services provided.
    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 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.
    5. To the Department of Justice (DOJ), court or adjudicatory body 
when:

[[Page 15498]]

    (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 is deemed 
by the agency to be for a purpose that is compatible with the purposes 
for which the agency collected the records.
    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.

IV. Safeguards

    The MCBS system will conform with applicable law and policy 
governing the privacy and security of federal automated information 
systems. These include but are not limited to: the Privacy Act of 1974, 
Computer Security Act of 1987, the Paperwork Reduction Act (PRA) of 
1995, the Clinger-Cohen Act of 1996, and OMB Circular A-130, Appendix 
III, ``Security of Federal Automated Information Resources.'' HCFA has 
prepared a comprehensive system security plan as required by the Office 
and Management and Budget (OMB) Circular A-130, Appendix III. This plan 
conforms fully to guidance issued by the National Institute for 
Standards and Technology (NIST) in NIST Special Publication 800-18, 
``Guide for Developing Security Plans for Information Technology 
Systems.'' Paragraphs A-C of this section highlight some of the 
specific methods that HCFA is using to ensure the security of this 
system and the information within it.
    A. Authorized users: Personnel having access to the system have 
been trained in Privacy Act and systems security requirements. 
Employees and contractors 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 
is monitoring the authorized users to ensure against excessive or 
unauthorized use. Records are used in a designated work area or work 
station and the 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 as determined at the agency 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 individual 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 MCBS 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 System (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 MCBS 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 transmission connections to 
the system. As a result, Netscape controls all 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 
as stated previously in this section. 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.

[[Page 15499]]

V. Effect of the Modified System of Records on Individual Rights

    HCFA proposes to modify 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 MCBS data. MCBS 
information on individuals is completed by agency personnel and 
submitted to HCFA through standard systems located at different 
locations. HCFA will utilize a variety of onsite and offsite edits and 
audits to increase the accuracy of MCBS 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 including not collecting individually identifiable data for non-
HCFA individuals. HCFA will collect only that information necessary to 
perform the system's functions. In addition, HCFA will make disclosure 
of identifiable data from the modified 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: February 9, 2001.
Michael McMullan,
Acting Deputy Administrator, Health Care Financing Administration.
09-70-6002

SYSTEM NAME:
    Medicare Current Beneficiary Survey (MCBS) System, HHS/HCFA/OSP.

SECURITY CLASSIFICATION:
    Level Three Privacy Act Sensitive.

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 contains a random sampling of individuals enrolled for 
hospital insurance (Part A) and/or supplemental medical benefits (Part 
B) under the Medicare program.

CATEGORIES OF RECORDS IN THE SYSTEM:
    Information contained in this system include the name of the 
beneficiary, health insurance claim number (HIC) number, age, sex, 
race, education, military service history, income, marital status, 
medical utilization and cost, prescription drug usage and cost data, 
health and functional status, health insurance coverage, medical 
condition status, household composition and medical provider names.

AUTHORITY FOR MAINTENANCE OF THE SYSTEM:
    Authority for the maintenance of this system of records is given 
under of section 1875 of the Social Security Act (42 United States Code 
(USC) 1395ll), entitled, ``Studies and Recommendations.''

PURPOSE(S):
    The primary purpose of the system of records is to maintain a 
research database for HCFA and other researchers that is capable of 
producing data sets suitable for both longitudinal and cross-sectional 
analysis to be used to: (1) Produce projections for current programs 
and proposed program changes, (2) produce national level estimates of 
health care expenditures by the aged and disabled, and (3) provide a 
research database that can be used to provide guidance to program 
management and policies. Information in this system will also be used 
to: Support research of policy issues, quality and effectiveness of 
care, and of epidemiological projects, support regulatory and policy 
functions performed within the agency or by a contractor or consultant, 
other federal agencies, support constituent requests made to a 
congressional representative, and support litigation involving the 
agency related to this system of records.

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 modify 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 accomplishment of a HCFA function relating to 
the purposes for this system of records and who need to have access to 
the records in order to assist HCFA.
    3. To another federal agency 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 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 and 
that the use of such records is deemed by the agency to be for a 
purpose that is compatible with the purposes for which the agency 
collected the records.

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 name, and HIC 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.

[[Page 15500]]

    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 MCBS system. For computerized records, 
safeguards have been established in accordance with the Department of 
Health and Human Services (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. 
Disposal occurs ten years after the final action of the research 
project is completed.

SYSTEM MANAGERS AND ADDRESS:
    Director, Systems, Office of Strategic Planning, HCFA, 7500 
Security Boulevard, 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, HIC, date of birth, 
and sex, and for verification purposes, the subject individual's name 
(woman's maiden name, if applicable), and 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 obtains the identifying information contained in this records 
system from Medicare enrollment records, Medicare bill records, 
Medicare provider records, Medicare beneficiaries and or their 
representatives, and Medicare carriers and intermediaries.

SYSTEMS EXEMPTED FROM CERTAIN PROVISIONS OF THE ACT:
    None.

[FR Doc. 01-6538 Filed 3-16-01; 8:45 am]
BILLING CODE 4120-03-P