[Federal Register Volume 67, Number 163 (Thursday, August 22, 2002)]
[Notices]
[Pages 54428-54436]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 02-21374]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
Privacy Act of 1974; Report of Modified or Altered System
AGENCY: Department of Health and Human Services (HHS), Centers for
Medicare & Medicaid Services (CMS) (Formerly the Health Care Financing
Administration).
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 SOR, ``Carrier Medicare
Claims Record (CMCR) System'', System No. 09-70-0501. We propose to
delete published routine uses numbered 1, 3, 4, 5, 6, 7, 9, 12, 14, 16,
17, 18, 19, 21, 22, 23, 24, and an unnumbered routine use authorizing
disclosure to the Social Security Administration (SSA). We propose to
delete published routine uses number 1 authorizing disclosure to
claimants and their authorized representatives, number 3 authorizing
disclosure to third party contacts to establish or verify information,
number 4 authorizing disclosure to the Treasury Department for
investigating alleged theft, number 5 authorizing disclosure to the
United States Postal Service (USPS), number 6 authorizing disclosure to
the Department of Justice (DOJ) to combat fraud and abuse, number 7
authorizing disclosure to the Railroad Retirement Board (RRB), number 9
authorizing disclosure to State Licensing Boards for review of
unethical practices, number 12 authorizing disclosure to state welfare
departments, number 14 authorizing disclosure to state audit agencies,
number 16 authorizing disclosure to senior citizen volunteers to assist
beneficiaries, number 17 authorizing disclosure to a contractor to
recover erroneous Medicare payments, number 18 authorizing disclosure
to state and other governmental Workers' Compensation Agencies, number
19 authorizing disclosure to insurance companies providing protection
to enrollees, number 21 authorizing disclosure to an agency of a state
government or established by law, number 22 authorizing disclosure to
insurers who are primary payers to Medicare, number 23 authorizing
disclosure to the Internal Revenue Service, number 24 authorizing
disclosure to servicing fiscal intermediaries/carriers banks to
transfer remittance advice to Medicare, and an unnumbered routine use
authorizing disclosure to the Social Security Administration (SSA).
A disclosure permitted under routine uses number 4, 5, 7, 9, 12,
14, 18, 21, 23, and to the SSA will be made a part of proposed routine
use number 2. Proposed routine use number 2 will allow for release of
information to ``another Federal and/or state agency, agency of a state
government, an agency established by state law, or its fiscal agent''.
Disclosures permitted under published routine uses number 1, 3, 16, and
24 will be combined with published routine use number 2, which permits
release to ``third party contacts,'' and covered by proposed routine
use number 3. Disclosure authorized to ``insurance companies providing
protection to enrollees'' under routine use 19 and to ``insurers who
are primary payers to Medicare'' under routine use number 22 will be
combined and listed as proposed routine use number 6. Disclosures
permitted under published routine use number 17 will be covered by
proposed routine use number 10, which will permit the release of data
to contractors and grantees for the purposes of combating fraud and
abuse. Disclosures permitted under published routine use number 6 will
be covered by proposed routine use number 11, which will permit the
release of data to other Federal agencies for the purposes of combating
fraud and abuse. We propose to renumber published routine use number 20
as proposed routine use number 1 and modify the language to clarify the
circumstances for disclosure to contractors and consultants.
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
[[Page 54429]]
language in the remaining routine uses to provide clarity to CMS'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 CMS SORs.
The primary purpose of the SOR is to properly pay medical insurance
benefits to or on behalf of entitled beneficiaries. Information in this
system will also be released to: support regulatory and policy
functions performed within the Agency or by a contractor or consultant,
another Federal or state agency, agency of a state government, an
agency established by state law, or its fiscal agent, third party
contacts, providers and suppliers of services dealing through fiscal
intermediaries or carriers, Peer Review Organizations (PRO), insurance
companies and other groups providing protection for their enrollees,
insurers and other groups providing protection against medical expenses
who are primary payers to Medicare in accordance with 42 U.S.C
Sec. 1395y (b), an individual or organization for a research,
evaluation, or epidemiological project, support constituent requests
made to a congressional representative, support litigation involving
the Agency related to this SOR, and combat fraud and abuse in certain
Federally funded health care programs. We have provided background
information about the modified system in the Supplementary Information
section below. Although the Privacy Act requires only that CMS provide
an opportunity for interested persons to comment on the proposed
routine uses, CMS invites comments on all portions of this notice. See
Effective Dates section for comment period.
EFFECTIVE DATES: CMS 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 August 8, 2002. To ensure that all
parties have adequate time in which to comment, the modified or altered
SOR, 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 CMS receives comments that
require alterations to this notice.
ADDRESSES: The public should address comments to: Director, Division of
Data Liaison and Distribution, CMS, 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
daylight time.
FOR FURTHER INFORMATION CONTACT: Anita Denion, Health Insurance
Specialist, Business Solutions Operating Group, Division of Carrier
Systems, Office of Information Services, CMS, Room N2-07-27, 7500
Security Boulevard, Baltimore, Maryland 21244-1850. The telephone
number is 410-786-7022.
SUPPLEMENTARY INFORMATION:
I. Description of the Modified System
A. Statutory and Regulatory Basis for SOR
In 1994, CMS modified a SOR under the authority of sections 1842,
1862 (b) and 1874 of Title XVIII of the Social Security Act (42 United
States Code (U.S.C.)) 1395u, 1395y (b), and 1395kk). Notice of the
modification to this system, ``Carrier Medicare Claims Records, System
No. 09-70-0501'' was published in the Federal Register (FR) 59 FR 37244
(July 21, 1994), an unnumbered routine use was added for the SSA at 61
FR 6645 (Feb. 21, 1996), three new fraud and abuse routine uses were
added at 63 FR 38414 (July 16, 1998), and then at 65 FR 60552 (Aug. 18,
2000), two of the fraud and abuse routine uses were revised and a third
deleted.
II. Collection and Maintenance of Data in the System
A. Scope of the Data Collected
The system contains information on Medicare beneficiaries who have
submitted claims for Supplemental Medical Insurance (SMI) benefit
(Medicare Part B), or individuals whose enrollment in an employer group
health benefits plan covers the beneficiary. Information contained in
this system consist of request(s) for payment, provider billing for
patient services, prepayment plan for group Medicare practice dealing
through a carrier, health insurance claim form, request(s) for medical
payment, explanation of benefits, request for claim number
verification, payment record transmittal, statement of person regarding
Medicare payment for medical services furnished deceased patient,
report of prior period of entitlement, itemized bills and other similar
documents required to support payments to beneficiaries and to
physicians and other suppliers of Part B services, and Medicare
secondary payer records containing other party liability insurance
information necessary for appropriate Medicare claims payment.
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
that 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 CMCR 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 CMCR. CMS has the following policies and
procedures concerning disclosures of information that will be
maintained in the system. In general, disclosure of information from
the SOR will be approved only for the minimum information necessary to
accomplish the purpose of the disclosure only after CMS:
1. Determines that the use or disclosure is consistent with the
reason that the data is being collected, e.g., to properly pay medical
insurance benefits to or on behalf of entitled beneficiaries.
2. Determines that:
a. The purpose for which the disclosure is to be made can only be
accomplished if the record is provided in individually identifiable
form;
b. 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
c. There is a strong probability that the proposed use of the data
would in fact accomplish the stated purpose(s).
3. Requires the information recipient to:
a. Establish administrative, technical, and physical safeguards to
prevent unauthorized use of disclosure of the record;
b. Remove or destroy at the earliest time all individually-
identifiable information; and
c. Agree to not use or disclose the information for any purpose
other than the stated purpose under which the information was
disclosed.
4. Determines that the data are valid and reliable.
[[Page 54430]]
III. Proposed Routine Use Disclosures of Data in the System
A. 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 CMS may
release information from the CMCR 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. We are proposing to
establish or modify the following routine use disclosures of
information maintained in the system:
5. To Agency contractors or consultants who have been engaged by
the Agency to assist in accomplishment of a CMS function relating to
the purposes for this SOR and who need to have access to the records in
order to assist CMS.
We contemplate disclosing information under this routine use only
in situations in which CMS may enter into a contractual or similar
agreement with a third party to assist in accomplishing a CMS function
relating to purposes for this SOR.
CMS occasionally contracts out certain of its functions when doing
so would contribute to effective and efficient operations. CMS 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.
Carriers and intermediaries occasionally work with contractors to
identify and recover erroneous Medicare payments for which workers'
compensation programs are liable.
2. To another Federal or state agency, agency of a state
government, an agency established by state law, or its fiscal agent
pursuant to agreements with CMS to:
a. Contribute to the accuracy of CMS's proper payment of Medicare
benefits,
b. 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, and/or
c. Assist Federal/state Medicaid programs within the state.
Other Federal or state agencies in their administration of a
Federal health program may require CMCR information for the purposes of
determining, evaluating, and/or assessing cost, effectiveness, and/or
the quality of health care services provided in the state, to support
evaluations and monitoring of Medicare claims information of
beneficiaries, including proper reimbursement for services provided.
The Treasury Department may require CMCR data for investigating
alleged theft, forgery, or unlawful negotiation of Medicare
reimbursement checks.
The USPS may require CMCR data for investigating alleged forgery or
theft of reimbursement checks.
The RRB requires CMCR information to enable them to assist in the
implementation and maintenance of the Medicare program.
The SSA requires CMCR data to enable them to assist in the
implementation and maintenance of the Medicare program.
The IRS may require CMCR data for the application of tax penalties
against employers and employee organizations that contribute to
Employer Group Health Plan or Large Group Health Plans that are not in
compliance with 42 U.S.C. 1395y (b).
Disclosure under this routine use shall be used by state Medicaid
agencies pursuant to agreements with the HHS for administration of
state supplementation payments for determinations of eligibility for
Medicaid, for enrollment of welfare recipients for medical insurance
under section 1843 of the Social Security Act (the Act), for quality
control studies, for determining eligibility of recipients of
assistance under Titles IV, and XIX of the Act, and for the complete
administration of the Medicaid program. CMCR data will be released to
the state only on those individuals who are patients under the services
of a Medicaid program within the state or who are residents of that
state.
Occasionally state licensing boards require access to the CMCR data
for review of unethical practices or non-professional conduct.
We also contemplate disclosing information under this routine use
in situations in which state auditing agencies require CMCR information
for auditing of Medicare eligibility considerations. Disclosure of
physicians' customary charge data are made to state audit agencies in
order to ascertain the corrections of Title XIX charges and payments.
CMS may enter into an agreement with state auditing agencies to assist
in accomplishing functions relating to purposes for this SOR.
State and other governmental worker's compensation agencies working
with CMS to assure that workers' compensation payments are made where
Medicare has erroneously paid and workers' compensation programs are
liable.
3. To third party contacts (without the consent of the individuals
to whom the information pertains) in situations where the party to be
contacted has, or is expected to have information relating to the
individual's capacity to manage his or her affairs or to his or her
eligibility for, or an entitlement to, benefits under the Medicare
program and,
a. The individual is unable to provide the information being sought
(an individual is considered to be unable to provide certain types of
information when any of the following conditions exists: the individual
is confined to a mental institution, a court of competent jurisdiction
has appointed a guardian to manage the affairs of that individual, a
court of competent jurisdiction has declared the individual to be
mentally incompetent, or the individual's attending physician has
certified that the individual is not sufficiently mentally competent to
manage his or her own affairs or to provide the information being
sought, the individual cannot read or write, cannot afford the cost of
obtaining the information, a language barrier exist, or the custodian
of the information will not, as a matter of policy, provide it to the
individual), or
b. The data are needed to establish the validity of evidence or to
verify the accuracy of information presented by the individual, and it
concerns one or more of the following: the individual's entitlement to
benefits under the Medicare program; and the amount of reimbursement;
any case in which the evidence is being reviewed as a result of
suspected fraud and abuse, program integrity, quality appraisal, or
evaluation and measurement of program activities.
Third parties contacts require CMCR information in order to provide
support for the individual's entitlement to benefits under the Medicare
program; to establish the validity of evidence or to verify the
accuracy of information presented by the individual or the
representative of the applicant, and assist in the monitoring of
Medicare
[[Page 54431]]
claims information of beneficiaries, including proper reimbursement of
services provided.
Senior citizen volunteers working in the carriers and
intermediaries' offices to assist Medicare beneficiaries request for
assistance may require access to CMCR information.
Occasionally fiscal intermediary/carrier banks, automated clearing
houses, value added networks (VAN), and provider banks, to the extent
necessary transfer to providers electronic remittance advice of
Medicare payments, and with respect to provider banks, to the extent
necessary to provide account management services to providers using
this information.
4. To providers and suppliers of services dealing through fiscal
intermediaries or carriers for the administration of Title XVIII of the
Social Security Act.
Providers and suppliers of services require CMCR information in
order to establish the validity of evidence, or to verify the accuracy
of information presented by the individual as it concerns the
individual's entitlement to benefits under the Medicare program,
including proper reimbursement for services provided.
Providers and suppliers of services who are attempting to validate
items on which the amounts included in the annual Physician/Supplier
Payment List, or other similar publications are based.
5. To Peer Review Organizations (PRO) in connection with review of
claims, or in connection with studies or other review activities,
conducted pursuant to Part B of Title XI of the Act and in performing
affirmative outreach activities to individuals for the purpose of
establishing and maintaining their entitlement to Medicare benefits or
health insurance plans.
PROs will work to implement quality improvement programs, provide
consultation to CMS, its contractors, and to state agencies. PROs will
assist the state agencies in related monitoring and enforcement
efforts, assist CMS and intermediaries in program integrity assessment,
and prepare summary information for release to CMS.
6. To insurance companies, third party administrators (TPA),
employers, self-insurers, managed care organizations, other
supplemental insurers, non-coordinating insurers, multiple employer
trusts, group health plans (i.e., health maintenance organizations
(HMOs) or a competitive medical plan (CMP) with a Medicare contract, or
a Medicare-approved health care prepayment plan (HCPP)), directly or
through a contractor, and other groups providing protection for their
enrollees. Information to be disclosed shall be limited to Medicare
entitlement data. In order to receive the information, they must agree
to:
a. Certify that the individual about whom the information is being
provided is one of its insured or employees, or is insured and/or
employed by another entity for whom they serve as a TPA;
b. Utilize the information solely for the purpose of processing the
identified individual's insurance claims; and
c. Safeguard the confidentiality of the data and prevent
unauthorized access.
Other insurers, TPAs, HMOs, and HCPPs may require CMCR information
in order to support evaluations and monitoring of Medicare claims
information of beneficiaries, including proper reimbursement for
services provided.
7. To an individual or organization for a research, evaluation, or
epidemiological project related to the prevention of disease or
disability, the restoration or maintenance of health, or payment-
related projects.
CMCR data will provide for research, evaluation, and
epidemiological projects, a broader, longitudinal, national perspective
of the status of Medicare beneficiaries. CMS anticipates that many
researchers will have legitimate requests to use these data in projects
that could ultimately improve the care provided to Medicare
beneficiaries and the policy that governs the care.
8. 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 CMS. The Member of
Congress then writes CMS, and CMS must be able to give sufficient
information to be responsive to the inquiry.
9. 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, CMS determines that
the records are both relevant and necessary to the litigation.
Whenever CMS is involved in litigation, or occasionally when
another party is involved in litigation and CMS's policies or
operations could be affected by the outcome of the litigation, CMS
would be able to disclose information to the DOJ, court, or
adjudicatory body involved.
10. To a CMS contractor (including, but not limited to FIs and
carriers) that assists in the administration of a CMS-administered
health benefits program, or to a grantee of a CMS-administered grant
program, when disclosure is deemed reasonably necessary by CMS 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.
We contemplate disclosing information under this routine use only
in situations in which CMS may enter into a contract or grant with a
third party to assist in accomplishing CMS functions relating to the
purpose of combating fraud and abuse.
CMS occasionally contracts out certain of its functions when doing
so would contribute to effective and efficient operations. CMS 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.
11. 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 CMS 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 CMCR information for the purpose of
combating fraud and abuse in such Federally funded programs.
B. Additional Circumstances Affecting Routine Use Disclosures
This SOR contains Protected Health Information as defined by HHS
regulation ``Standards for Privacy of Individually Identifiable Health
Information'' (45 CFR parts 160 and 164,
[[Page 54432]]
65 FR 82462 (12-28-00), as amended by 66 FR 12434 (2-26-01)).
Disclosures of Protected Health Information authorized by these routine
uses may only be made if, and as, permitted or required by the
``Standards for Privacy of Individually Identifiable Health
Information''.
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).
IV. Safeguards
A. Administrative Safeguards
The CMCR system will conform to 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''. CMS 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 CMS is using to ensure the security of this
system and the information within it.
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, CMS is monitoring
the authorized users to ensure against excessive or unauthorized use.
Records are used in a designated work area or workstation 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 CMCR 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
that 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 CMCR 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.
V. Effect of the Modified SOR on Individual Rights
CMS 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
[[Page 54433]]
authorized releases in accordance with the routine uses identified in
this SOR.
CMS will monitor the collection and reporting of CMCR data. CMCR
information on individuals is completed by contractor personnel and
submitted to CMS through standard systems located at different
locations. CMS will utilize a variety of onsite and offsite edits and
audits to increase the accuracy of CMCR data.
CMS 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. CMS will collect only that information necessary to perform the
system's functions. In addition, CMS 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.
CMS, therefore, does not anticipate an unfavorable effect on
individual privacy as a result of the disclosure of information
relating to individuals.
Dated: August 15, 2002.
Thomas A. Scully,
Administrator, Centers for Medicare & Medicaid Services.
09-70-0501
SYSTEM NAME:
Carrier Medicare Claims Record (CMCR) System, HHS/CMS/OIS.
SECURITY CLASSIFICATION:
Level Three Privacy Act Sensitive.
SYSTEM LOCATION:
CMS Data Center, 7500 Security Boulevard, North Building, First
Floor, Baltimore, Maryland 21244-1850. See Appendix A for various
remote sites where this system is also maintained.
CATEGORIES OF INDIVIDUALS COVERED BY THE SYSTEM:
The system contains information on Medicare beneficiaries who have
submitted claims for Supplemental Medical Insurance (SMI) benefit
(Medicare Part B), or individuals whose enrollment in an employer group
health benefits plan covers the beneficiary.
CATEGORIES OF RECORDS IN THE SYSTEM:
Information contained in this system consist of request(s) for
payment, provider billing for patient services, prepayment plan for
group Medicare practice dealing through a carrier, health insurance
claim form, request(s) for medical payment, explanation of benefits,
request for claim number verification, payment record transmittal,
statement of person regarding Medicare payment for medical services
furnished deceased patient, report of prior period of entitlement,
itemized bills and other similar documents required to support payments
to beneficiaries and to physicians and other suppliers of Part B
services, and Medicare secondary payer records containing other party
liability insurance information necessary for appropriate Medicare
claims payment.
AUTHORITY FOR MAINTENANCE OF THE SYSTEM:
Authority for the maintenance of this SOR is given under the
authority of sections 1842, 1862 (b) and 1874 of Title XVIII of the
Social Security Act (the Act) (42 United States Code (U.S.C.) sections
1395u, 1395y (b), and 1395kk).
PURPOSE(S):
The primary purpose of the SOR is to properly pay medical insurance
benefits to or on behalf of entitled beneficiaries. Information in this
system will also be released to: support regulatory and policy
functions performed within the Agency or by a contractor or consultant,
another Federal or state agency, agency of a state government, an
agency established by state law, or its fiscal agent, third party
contacts, providers and suppliers of services directly or through
fiscal intermediaries or carriers, Peer Review Organizations (PRO),
insurance companies and other groups providing protection for their
enrollees, insurers and other groups providing protection against
medical expenses who are primary payers to Medicare in accordance with
42 U.S.C. 1395y (b), an individual or organization for a research,
evaluation, or epidemiological project, support constituent requests
made to a congressional representative, support litigation involving
the agency related to this SOR, and combat fraud and abuse in certain
Federally funded health care programs.
ROUTINE USES OF RECORDS MAINTAINED IN THE SYSTEM, INCLUDING CATEGORIES
OR USERS AND THE PURPOSES OF SUCH USES:
These routine uses specify circumstances, in addition to those
provided by statute in the Privacy Act of 1974, under which CMS may
release information from the CMCR 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).
This SOR contains Protected Health Information as defined by HHS
regulation ``Standards for Privacy of Individually Identifiable Health
Information'' (45 CFR parts 160 and 164, 65 FR 82462 (12-28-00), as
amended by 66 FR 12434 (2-26-01)). Disclosures of Protected Health
Information authorized by these routine uses may only be made if, and
as, permitted or required by the ``Standards for Privacy of
Individually Identifiable Health Information''.
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 propose to establish or
modify 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 accomplishment of a CMS function relating to
the purposes for this SOR and who need to have access to the records in
order to assist CMS.
2. To another Federal or state agency, agency of a state
government, an agency established by state law, or its fiscal agent
pursuant to agreements with CMS to:
a. Contribute to the accuracy of CMS's proper payment of Medicare
benefits,
b. 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, and/or
c. Assist Federal/state Medicaid programs within the state.
3. To third party contacts (without the consent of the individuals
to whom the information pertains) in situations where the party to be
contacted has, or is expected to have information relating to the
individual's capacity to manage his or her affairs or to his or her
eligibility for, or an entitlement to,
[[Page 54434]]
benefits under the Medicare program and,
a. The individual is unable to provide the information being sought
(an individual is considered to be unable to provide certain types of
information when any of the following conditions exists: the individual
is confined to a mental institution, a court of competent jurisdiction
has appointed a guardian to manage the affairs of that individual, a
court of competent jurisdiction has declared the individual to be
mentally incompetent, or the individual's attending physician has
certified that the individual is not sufficiently mentally competent to
manage his or her own affairs or to provide the information being
sought, the individual cannot read or write, cannot afford the cost of
obtaining the information, a language barrier exists, or the custodian
of the information will not, as a matter of policy, provide it to the
individual), or
b. The data are needed to establish the validity of evidence or to
verify the accuracy of information presented by the individual, and it
concerns one or more of the following: the individual's entitlement to
benefits under the Medicare program; and the amount of reimbursement;
any case in which the evidence is being reviewed as a result of
suspected fraud and abuse, program integrity, quality appraisal, or
evaluation and measurement of program activities.
4. To providers and suppliers of services dealing through fiscal
intermediaries or carriers for the administration of Title XVIII of the
Act.
5. To Peer Review Organizations (PRO) in connection with review of
claims, or in connection with studies or other review activities,
conducted pursuant to Part B of Title XI of the Act and in performing
affirmative outreach activities to individuals for the purpose of
establishing and maintaining their entitlement to Medicare benefits or
health insurance plans.
6. To insurance companies, third party administrators (TPA),
employers, self-insurers, managed care organizations, other
supplemental insurers, non-coordinating insurers, multiple employer
trusts, group health plans (i.e., health maintenance organizations
(HMOs) or a competitive medical plan (CMP) with a Medicare contract, or
a Medicare-approved health care prepayment plan (HCPP)), directly or
through a contractor, and other groups providing protection for their
enrollees. Information to be disclosed shall be limited to Medicare
entitlement data. In order to receive the information, they must agree
to:
a. Certify that the individual about whom the information is being
provided is one of its insured or employees, or is insured and/or
employed by another entity for whom they serve as a TPA;
b. Utilize the information solely for the purpose of processing the
identified individual's insurance claims; and
c. Safeguard the confidentiality of the data and prevent
unauthorized access.
7. To an individual or organization for research, evaluation, or
epidemiological projects related to the prevention of disease or
disability, the restoration or maintenance of health, or payment
related projects.
8. To a Member of Congress or 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.
9. 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, CMS determines that
the records are both relevant and necessary to the litigation.
10. To a CMS contractor (including, but not limited to fiscal
intermediaries and carriers) that assists in the administration of a
CMS-administered health benefits program, or to a grantee of a CMS-
administered grant program, when disclosure is deemed reasonably
necessary by CMS 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.
11. 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 CMS 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:
Records are maintained on paper, computer diskette and on magnetic
storage media.
RETRIEVABILITY:
Information can be retrieved by the beneficiary's name, HIC, and
assigned unique physician identification number.
SAFEGUARDS:
CMS 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, CMS has physical safeguards in place to reduce the
exposure of computer equipment and thus achieve an optimum level of
protection and security for the CMCR 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
Circular #10, Automated Information Systems Security Program; CMS
Automated Information Systems 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 are closed at the end of the calendar year in which paid, held
2 additional years, transferred to Federal records center and destroyed
after another 2 years.
SYSTEM MANAGER(S) AND ADDRESS:
Director, Business Solutions Operating Group, Division of Carrier
Systems, Office of Information Services, CMS, 7500 Security Boulevard,
Room S1-05-06, Baltimore, Maryland 21244-1850.
[[Page 54435]]
NOTIFICATION PROCEDURE:
For purpose of access, the subject individual should write to the
system manager who will require the system name, HIC, address, date of
birth, and sex, and for verification purposes, the subject individual's
name (woman's maiden name, if applicable), 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:
Sources of information contained in this records system is obtained
from third party agencies, Social Security Administration's Master
Beneficiary Record, and CMS's Enrollment Database.
SYSTEMS EXEMPTED FROM CERTAIN PROVISIONS OF THE ACT:
None.
Appendix A. Health Insurance Claims
Medicare records are maintained at the CMS Central Office (see
section 1 below for the address). Health Insurance Records of the
Medicare program can also be accessed through a representative of
the CMS Regional Office (see section 2 below for addresses).
Medicare claims records are also maintained by private insurance
organizations that share in administering provisions of the health
insurance programs. These private insurance organizations, referred
to as carriers and intermediaries, are under contract to the Health
Care Financing Administration and the Social Security Administration
to perform specific task in the Medicare program (see section three
below for addresses for intermediaries, section four addresses the
carriers, and section five addresses the Payment Safeguard
Contractors.
I. Central Office Address
CMS Data Center, 7500 Security Boulevard, North Building, First
Floor, Baltimore, Maryland 21244-1850.
II. CMS Regional Offices
BOSTON REGION--Connecticut, Maine, Massachusetts, New Hampshire,
Rhode Island, Vermont. John F. Kennedy Federal Building, Room 1211,
Boston, Massachusetts 02203. Office Hours: 8:30 a.m.-5 p.m.
NEW YORK REGION--New Jersey, New York, Puerto Rico, Virgin
Islands. 26 Federal Plaza, Room 715, New York, New York 10007,
Office Hours: 8:30 a.m.-5 p.m.
PHILADELPHIA REGION--Delaware, District of Columbia, Maryland,
Pennsylvania, Virginia, West Virginia. Post Office Box 8460,
Philadelphia, Pennsylvania 19101. Office Hours: 8:30 a.m.-5 p.m.
ATLANTA REGION--Alabama, North Carolina, South Carolina,
Florida, Georgia, Kentucky, Mississippi, Tennessee. 101 Marietta
Street, Suite 702, Atlanta, Georgia 30223, Office Hours: 8:30 a.m.-
4:30 p.m.
CHICAGO REGION--Illinois, Indiana, Michigan, Minnesota, Ohio,
Wisconsin. Suite A-824, Chicago, Illinois 60604. Office Hours: 8
a.m.-4:45 p.m.
DALLAS REGION--Arkansas, Louisiana, New Mexico, Oklahoma, Texas,
1200 Main Tower Building, Dallas, Texas. Office Hours: 8 a.m.-4:30
p.m.
KANSAS CITY REGION--Iowa, Kansas, Missouri, Nebraska. New
Federal Office Building, 601 East 12th Street--Room 436, Kansas
City, Missouri 64106. Office Hours: 8 a.m.-4:45 p.m.
DENVER REGION--Colorado, Montana, North Dakota, South Dakota,
Utah, Wyoming. Federal Office Building, 1961 Stout St--Room 1185,
Denver, Colorado 80294. Office Hours: 8 a.m.-4:30 p.m.
SAN FRANCISCO REGION--American Samoa, Arizona, California, Guam,
Hawaii, Nevada. Federal Office Building, 10 Van Ness Avenue, 20th
Floor, San Francisco, California 94102. Office Hours: 8 a.m.-4:30
p.m.
SEATTLE REGION--Alaska, Idaho, Oregon, Washington. 1321 Second
Avenue, Room 615, Mail Stop 211, Seattle, Washington 98101. Office
Hours 8 a.m.-4:30 p.m.
III. Intermediary Addresses (Hospital Insurance)
Medicare Coordinator, ASSOC. HOSPITAL SERV. MAINE (ME BC), 2
GANNETT DRIVE, SOUTH PORTLAND, ME 04106-6911.
Medicare Coordinator, Anthem New Hampshire, 300 GOFFS FALLS
ROAD, MANCHESTER, NH 03111-0001.
Medicare Coordinator, BC/BS RHODE ISLAND (RI BC), 444
WESTMINSTER STREET, PROVIDENCE, RI 02903-3279.
Medicare Coordinator, EMPIRE MEDICARE SERVICES, 400 S. SALINA
STREET, SYRACUSE, NY 13202.
Medicare Coordinator, COOPERATIVA, P.O. BOX 363428, SAN JUAN, PR
00936-3428.
Medicare Coordinator, MARYLAND B/C, P.O. BOX 4368, 1946
GREENSPRING AVE., TIMONIUM, MD 21093.
Medicare Coordinator, Highmark, P5103, 120 FIFTH AVENUE PLACE,
PITTSBURGH, PA 15222-3099.
Medicare Coordinator, UNITED GOVERNMENT SERVICES, 1515 N.
RIVERCENTER DR., MILWAUKEE, WI 53212.
Medicare Coordinator, ALABAMA B/C, 450 RIVERCHASE PARKWAY EAST,
BIRMINGHAM, AL 35298.
Medicare Coordinator, FLORIDA B/C, 532 RIVERSIDE AVE.,
JACKSONVILLE, FL 32202-4918.
Medicare Coordinator, GEORGIA B/C, P.O. BOX 9048, 2357 WARM
SPRINGS ROAD, COLUMBUS, GA 31908.
Medicare Coordinator, MISSISSIPPI B/C B MS, P.O. BOX 23035, 3545
LAKELAND DRIVE, JACKSON, MI 39225-3035.
Medicare Coordinator, NORTH CAROLINA B/C, P.O. BOX 2291, DURHAM,
NC 27702-2291.
Medicare Coordinator, PALMETTO GBA A/RHHI, 17 TECHNOLOGY CIRCLE,
COLUMBIA, SC 29203-0001.
Medicare Coordinator, TENNESSEE B/C, 801 PINE STREET,
CHATTANOOGA, TN 37402-2555.
Medicare Coordinator, ANTHEM INSURANCE CO. (ANTHEM IN), P.O. BOX
50451, 8115 KNUE ROAD, INDIANAPOLIS, IN 46250-1936.
Medicare Coordinator, ARKANSAS B/C, 601 GAINES STREET, LITTLE
ROCK, AR 72203.
Medicare Coordinator, GROUP HEALTH OF OKLAHOMA, 1215 SOUTH
BOULDER, TULSA, OK 74119-2827.
Medicare Coordinator, TrailBlazer, P.O. BOX 660156, DALLAS, TX
75266-0156.
Medicare Coordinator, Cahaba GBA, STATION 7, 636 GRAND AVENUE,
DES MOINES, IA 50309-2551.
Medicare Coordinator, KANSAS B/C, P.O. BOX 239, 1133 TOPEKA
AVE., TOPEKA, KS 66629-0001.
Medicare Coordinator, NEBRASKA B/C, P.O. BOX 3248, MAIN PO
STATION, OMAHA, NE 68180-0001.
Medicare Coordinator, MUTUAL OF OMAHA, P.O. BOX 1602, OMAHA, NE
68101.
Medicare Coordinator, MONTANA B/C, P.O. BOX 5017, GREAT FALLS
DIV., GREAT FALLS, MT 59403-5017.
Medicare Coordinator, Noridian, 4510 13TH AVENUE S.W., FARGO, ND
58121-0001.
Medicare Coordinator, UTAH B/C, P.O. BOX 30270, 2455 PARLEYS
WAY, SALT LAKE CITY, UT 84130-0270.
Medicare Coordinator, WYOMING B/C, 4000 HOUSE AVENUE, CHEYENNE,
WY 82003.
Medicare Coordinator, ARIZONA B/C, P.O. BOX 37700, PHOENIX, AZ
85069.
Medicare Coordinator, UGS, P.O. BOX 70000, VAN NUYS, CA 91470-
0000.
Medicare Coordinator, Regents BC, P.O. BOX 8110 M/S D-4A,
PORTLAND, OR 97207-8110.
Medicare Coordinator, Premera BC, P.O. BOX 2847, SEATTLE, WA
98111-2847.
IV. Medicare Carriers
Medicare Coordinator, NHIC, 75 Sargent William Terry Drive,
Hingham, MA 02044.
Medicare Coordinator, B/S Rhode Island (RI BS), 444 Westminster
Street, Providence, RI 02903-2790.
Medicare Coordinator, Trailblazer Health Enterprises, Meriden
Park, 538 Preston Ave., Meriden, CT 06450.
[[Page 54436]]
Medicare Coordinator, Upstate Medicare Division, 11 Lewis Road,
Binghamton, NY 13902.
Medicare Coordinator, Empire Medicare Services, 2651 Strang
Blvd., Yorktown Heights, NY, 10598.
Medicare Coordinator, Empire Medicare Services, NJ, 300 East
Park Drive, Harrisburg, PA 17106.
Medicare Coordinator, Triple S, #1441 F.D., Roosvelt Ave.,
Guaynabo, PR 00968.
Medicare Coordinator, Group Health Inc., 4th Floor, 88 West End
Avenue, New York, NY 10023.
Medicare Coordinator, Highmark, P.O. Box 89065, 1800 Center
Street, Camp Hill, PA 17089-9065.
Medicare Coordinator, Trailblazers Part B, 11150 McCormick
Drive, Executive Plaza 3 Suite 200, Hunt Valley, MD 21031.
Medicare Coordinator, Trailblazer Health Enterprises, Virginia,
P.O. Box 26463, Richmond, VA 23261-6463. United Medicare
Coordinator, Tricenturion, 1 Tower Square, Hartford, CT 06183.
Medicare Coordinator, Alabama B/S, 450 Riverchase Parkway East,
Birmingham, AL 35298.
Medicare Coordinator, Cahaba GBA, 12052 Middleground Road, Suite
A, Savannah, GA 31419.
Medicare Coordinator, Florida B/S, 532 Riverside Ave,
Jacksonville, FL 32202-4918.
Medicare Coordinator, Administar Federal, 9901 Linnstation Road,
Louisville, KY 40223.
Medicare Coordinator, Palmetto GBA, 17 Technology Circle,
Columbia, SC 29203-0001.
Medicare Coordinator, CIGNA, 2 Vantage Way, Nashville, TN 37228.
Medicare Coordinator, Railraod Retirement Board, 2743 Perimeter
Parkway, Building 250, Augusta, GA 30999.
Medicare Coordinator, Cahaba GBA, Jackson Miss, P.O. Box 22545,
Jackson, MI 39225-2545.
Medicare Coordinator, Adminastar Federal (IN), 8115 Knue Road,
Indianapolis, IN 46250-1936.
Medicare Coordinator, Wisconsin Physicians Service, P.O. Box
8190, Madison, Wi 53708-8190.
Medicare Coordinator, Nationwide Mutual Insurance Co., P.O. Box
16788, 1 Nationwide Plaza, Columbus, Oh 43216-6788.
Medicare Coordinator, Arkansas B/S, 601 Gaines Street, Little
Rock, AR 72203.
Medicare Coordinator, Arkansas-New Mexico, 601 Gaines Street,
Little Rock, AR 72203.
Medicare Coordinator, Palmetto GBA--DMERC, 17 Technology Circle,
Columbia, SC 29203-0001.
Medicare Coordinator, Trailblazer Health Enterprises, 901 South
Central Expressway, Richardson, TX 75080.
Medicare Coordinator, Nordian, 636 Grand Avenue, Des Moines, IA
50309-2551.
Medicare Coordinator, Kansas B/S, P.O. Box 239, 1133 Topeka
Ave., Topeka, KS 66629-0001.
Medicare Coordinator, Kansas B/S--NE, P.O. Box 239, 1133 Topeka
Ave., Topeka, KS 66629-0239.
Medicare Coordinator, Montana B/S, P.O. Box 4309, Helena, MT
59601.
Medicare Coordinator, Nordian, 4305 13th Avenue South, Fargo, ND
58103-3373.
Medicare Coordinator, Noridian Bcbsnd (C0), 730 N. Simms #100,
Golden, CO 80401-4730.
Medicare Coordinator, Noridian Bcbsnd(WY), 4305 13th Avenue
South, Fargo, ND 58103-3373.
Medicare Coordinator, Utah B/S, P.O. Box 30270, 2455 Parleys
Way, Salt Lake City, UT 84130-0270.
Medicare Coordinator, Transamerica Occidental, P.O. Box 54905,
Los Angeles, CA 90054-4905.
Medicare Coordinator, NHIC--California, 450 W. East Avenue,
Chico, CA 95926.
Medicare Coordinator, Cigna, Suite 254, 3150 Lakeharbor, Boise,
ID 83703.
Medicare Coordinator, Cigna, Suite 506, 2 Vantage Way,
Nashville, TN 37228.
V. Payment Safeguard Contractors
Medicare Coordinator, Aspen Systems Corporation, 2277 Research
Blvd., Rockville, MD 20850.
Medicare Coordinator, DynCorp Electronic Data Systems (EDS),
11710 Plaza America Drive, 5400 Legacy Drive, Reston, VA 20190-6017.
Medicare Coordinator, Lifecare Management Partners Mutual of
Omaha Insurance Co., 6601 Little River Turnpike, Suite 300, Mutual
of Omaha Plaza, Omaha, NE 68175.
Medicare Coordinator, Reliance Safeguard Solutions, Inc., P.O.
Box 30207, 400 South Salina Street, 2890 East Cottonwood Pkwy.,
Syracuse, NY 13202.
Medicare Coordinator, Science Applications International, Inc.,
6565 Arlington Blvd. P.O. Box 100282, Falls Church, VA.
Medicare Coordinator, California Medical Review, Inc.,
Integriguard Division Federal Sector Civil Group, One Sansome
Street, San Francisco, CA 94104-4448.
Medicare Coordinator, Computer Sciences Corporation, Suite 600,
3120 Timanus Lane, Baltimore, MD 21244.
Medicare Coordinator, Electronic Data Systems (EDS), 11710 Plaza
America Drive, 5400 Legacy Drive, Plano, TX 75204.
Medicare Coordinator, TriCenturion, L.L.C., P.O. Box 100282,
Columbia, SC 29202.
[FR Doc. 02-21374 Filed 8-21-02; 8:45 am]
BILLING CODE 4120-03-P