[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