[Federal Register Volume 71, Number 198 (Friday, October 13, 2006)]
[Notices]
[Pages 60540-60544]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: E6-16955]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services


Privacy Act of 1974; Report of a Modified or Altered System of 
Records

AGENCY: Department of Health and Human Services (HHS), Centers for 
Medicare & Medicaid Services (CMS).

ACTION: Notice of a Modified or Altered System of Records (SOR).

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SUMMARY: In accordance with the Privacy Act of 1974, we are proposing 
to modify or alter an existing SOR, ``Evaluations of the Medicaid 
Reform Demonstrations (EMRD),'' System No. 09-70-0068, last published 
at 67 Federal Register 2216 (January 16, 2002). CMS is reorganizing its 
databases because of the impact of the Medicare Prescription Drug, 
Improvement, and Modernization Act of 2003 (MMA) (Public Law (Pub. L.) 
108-173) provisions and the large volume of information the Agency 
collects to administer the Medicare program. We propose to assign a new 
CMS identification number to this system to simplify the obsolete and 
confusing numbering system originally designed to identify the Bureau, 
Office, or Center that maintained the system of records. The new 
assigned identifying number for this system should read: System No. 09-
70-0523.
    We propose to modify existing routine use number 1 that permits 
disclosure to agency contractors and consultants to include disclosure 
to CMS grantees who perform a task for the agency. CMS grantees, 
charged with completing projects or activities that require CMS data to 
carry out that activity, are classified separate from CMS contractor 
and/or consultants. The modified routine use will remain as routine use 
number 1.
    We propose to combine routine uses 2 and 3 to assist another 
Federal or state agency with information to contribute to the accuracy 
of CMS's proper payment of Medicare benefits, enable such agency to 
administer a Federal health benefits program, or to enable such agency 
to fulfill a requirement of Federal statute or regulation that 
implements a health benefits program funded in whole or in part with 
Federal funds. As they were duplicative of each other.
    We will delete routine use number 4, authorizing disclosure to 
support constituent requests made to a Congressional representative. If 
an authorization for the disclosure has been obtained from the data 
subject, then no routine use is needed. The Privacy Act allows for 
disclosures with the ``prior written consent'' of the data subject.
    We will broaden the scope of routine uses number 6 and 7, 
authorizing disclosures to combat fraud and abuse in the Medicare and 
Medicaid programs to include combating ``waste'' which refers to 
specific beneficiary/recipient practices that result in unnecessary 
cost to all Federally-funded health benefit programs.
    We are modifying the language in the routine uses to provide a 
proper explanation as to the need for the routine use and 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 or MMA provisions and to update language in the 
administrative sections to correspond with language used in other CMS 
SORs.
    The primary purpose of this modified system is to collect and 
provide data

[[Page 60541]]

necessary to evaluate a series of Medicaid Reform Demonstrations that 
rely on waivers of section 1115 of the Social Security Act (the Act). 
This system will allow measurement of the effects of the demonstration 
on beneficiaries' eligibility, access to care, utilization, health care 
costs, satisfaction with care, quality of care and health status. The 
information retrieved from this system of records will also be 
disclosed to: (1) Support program administration, reporting, and 
regulator, reimbursement, and policy functions performed within the CMS 
or by a contractor, consultant, or grantee; (2) assist another Federal 
or state agency with information to contribute to the accuracy of CMS's 
proper payment of Medicare benefits, enable such agency to administer a 
Federal health benefits program, or to enable such agency to fulfill a 
requirement of Federal statute or regulation that implements a health 
benefits program funded in whole or in part with Federal funds; (3) 
support an individual or organization for a research project or in 
support of an evaluation project related to the prevention of disease 
or disability, the restoration or maintenance of health, or payment 
related projects; (4) support litigation involving the agency; and (5) 
combat fraud, waste, and abuse in a Federally-funded health benefits 
programs. We have provided background information about the modified 
system in the Supplementary Information section below. Although the 
Privacy Act requires only that CMS provide an opportunity for 
interested persons to comment on the modified or altered routine uses, 
CMS invites comments on all portions of this notice. See Effective 
Dates section for comment period.

DATES: Effective Date: CMS filed a modified or altered SOR report with 
the Chair of the House Committee on Government Reform and Oversight, 
the Chair of the Senate Committee on Homeland Security & Governmental 
Affairs, and the Administrator, Office of Information and Regulatory 
Affairs, Office of Management and Budget (OMB) on October 5, 2006. To 
ensure that all parties have adequate time in which to comment, the 
modified system will become effective 30 days from the publication of 
the notice, or 40 days from the date it was submitted to OMB and the 
Congress, whichever is later. We may defer implementation of this 
system or one or more of the routine use statements listed below if we 
receive comments that persuade us to defer implementation.

ADDRESSES: The public should address comments to the CMS Privacy 
Officer, Division of Privacy Compliance, Enterprise Architecture and 
Strategy Group, CMS, Mail Stop 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: Paul J. Boben, Division of State 
Program Research, Research and Evaluation Group, Office of Research, 
Development and Information, CMS, Mail Stop C3-19-07, 7500 Security 
Boulevard, Baltimore, Maryland 21244-1850. He can also be reached by 
telephone at 410-786-6629, or via e-mail at [email protected].

SUPPLEMENTARY INFORMATION: This system was last published in the 
Federal Register (FR) at 67 FR 2216 (January 16, 2002). The EMRD SOR 
provides data necessary to evaluate CMS' Evaluation of the Medicaid 
Reform Demonstrations, as part of this effort individually identifiable 
data will be used to analyze the effects of the demonstration on 
beneficiary eligibility, access to care, utilization, health care 
costs, satisfaction with care, quality of care, and health status.

I. Description of the Modified or Altered System of Records

A. Statutory and Regulatory Basis for SOR

    Authority for maintenance of the system is given under 42 United 
States Code (U.S.C.) 1315 Sec.  1115, and 42 U.S.C. 1395ll Sec.  
1875(a) of the Social Security Act.

B. Collection and Maintenance of Data in the System

    EMRD contains information on demonstration participants and 
comparison group members and their experiences in accessing health care 
before, during, and after the demonstration period. Information 
collected in the EMRD contains, but is not limited to, name, address, 
phone number, social security number, health insurance claim number, 
Medicaid identification number, gender, ethnicity, date of birth, 
employment, health care coverage, diagnostic and health status 
information, utilization and cost of health care services, and 
responses to survey or other types of data collection methods

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

A. 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 EMRD information that can be 
associated with an individual as provided for under ``Section III. 
Proposed Routine Use Disclosures of Data in the System.'' Both 
identifiable and non-identifiable data may be disclosed under a routine 
use.
    We will only collect the minimum personal data necessary to achieve 
the purpose of EMRD. CMS has the following policies and procedures 
concerning disclosures of information that will be maintained in the 
system. Disclosure of information from this system will be approved 
only to the extent necessary to accomplish the purpose of the 
disclosure and only after CMS:
    1. Determines that the use or disclosure is consistent with the 
reason that the data is being collected, e.g., to collect and provide 
data necessary to evaluate a series of Medicaid Reform Demonstrations 
that rely on waivers of section 1115 of the Act. This system will allow 
measurement of the effects of the demonstration on beneficiaries' 
eligibility, access to care, utilization, health care costs, 
satisfaction with care, quality of care and health status.
    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 patient-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.

[[Page 60542]]

    4. Determines that the data are valid and reliable.

III. Proposed Routine Use Disclosures of Data in the System

    A. The Privacy Act allows us to disclose information without an 
individual's consent if the information is to be used for a purpose 
that is compatible with the purpose(s) for which the information was 
collected. Any such compatible use of data is known as a ``routine 
use.'' The proposed routine uses in this system meet the compatibility 
requirement of the Privacy Act. We are proposing to establish the 
following routine use disclosures of information maintained in the 
system:
    1. To support agency contractors, consultants, or grantee who have 
been contracted by the agency to assist in the performance of a service 
related to this system and who need to have access to the records in 
order to perform the activity.
    We contemplate disclosing this 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 system.
    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, consultant, or grantee whatever information 
is necessary for the contractor, consultant, or grantee to fulfill its 
duties. In these situations, safeguards are provided in the contract 
prohibiting the contractor, consultant, or grantee from using or 
disclosing the information for any purpose other than that described in 
the contract and requires the contractor, consultant or grantee to 
return or destroy all information at the completion of the contract.
    2. To enable another Federal or state agency 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.
    CMS, and other Federal or state and local agencies, all contribute 
data to the databases included in this system, and (both separately and 
jointly) have an interest in performing program evaluation, conducting 
research and maintaining program integrity.
    3. To support an individual or organization for a research project 
or in support of an evaluation project related to the prevention of 
disease or disability, the restoration or maintenance of health, or 
payment related projects.
    The EMRD data will provide for research or in support of evaluation 
projects, a broader, national perspective of the status of Medicare, 
Medicaid and SCHIP 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, Medicaid and SCHIP 
beneficiaries and the policy that governs the care.
    4. To support 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 and that 
the use of such records by the DOJ, court or adjudicatory body is 
compatible with the purpose for which the agency collected the records.
    Whenever CMS is involved in litigation, and occasionally when 
another party is involved in litigation and CMS' 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.
    5. To support a CMS contractor (including, but not necessarily 
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, waste, or abuse in such 
program.
    We contemplate disclosing information under this routine use only 
in situations in which CMS may enter into a contractual relationship or 
grant with a third party to assist in accomplishing CMS functions 
relating to the purpose of combating fraud, waste, and abuse.
    CMS occasionally contracts out certain of its functions and makes 
grants 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.
    6. To support 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, 
waste, 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, waste, or abuse in such programs.
    Other agencies may require EMRD information for the purpose of 
combating fraud, waste, and abuse in such federally-funded programs.
    B. Additional Provisions Affecting Routine Use Disclosures: To the 
extent this system contains Protected Health Information (PHI) as 
defined by HHS regulation ``Standards for Privacy of Individually 
Identifiable Health Information'' (45 CFR parts 160 and 164, Subparts A 
and E) 65 FR 82462 (12-28-00). Disclosures of such PHI that are 
otherwise 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.'' (See 45 CFR 164.512(a)(1)).
    In addition, our policy will be to prohibit release even of data 
not directly identifiable, except pursuant to one of the routine uses 
or if required by law, if we determine 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 could, because of the small size, use this information to 
deduce the identity of the beneficiary).

IV. Safeguards

    CMS has safeguards in place for authorized users and monitors such 
users to ensure against excessive or unauthorized use. Personnel having

[[Page 60543]]

access to the system have been trained in the Privacy Act and 
information security requirements. Employees who maintain records in 
this system are instructed not to release data until the intended 
recipient agrees to implement appropriate management, operational and 
technical safeguards sufficient to protect the confidentiality, 
integrity and availability of the information and information systems 
and to prevent unauthorized access.
    This system will conform to all applicable Federal laws and 
regulations and Federal, HHS, and CMS policies and standards as they 
relate to information security and data privacy. These laws and 
regulations may apply but are not limited to: the Privacy Act of 1974; 
the Federal Information Security Management Act of 2002; the Computer 
Fraud and Abuse Act of 1986; the Health Insurance Portability and 
Accountability Act of 1996; the E-Government Act of 2002, the Clinger-
Cohen Act of 1996; the Medicare Modernization Act of 2003, and the 
corresponding implementing regulations. OMB Circular A-130, Management 
of Federal Resources, Appendix III, Security of Federal Automated 
Information Resources also applies. Federal, HHS, and CMS policies and 
standards include but are not limited to: all pertinent National 
Institute of Standards and Technology publications; the HHS Information 
Systems Program Handbook and the CMS Information Security Handbook.

V. Effects of the Modified or Altered System of Records on Individual 
Rights

    CMS proposes to modify this system in accordance with the 
principles and requirements of the Privacy Act and will collect, use, 
and disseminate information only as prescribed therein. Data in this 
system will be subject to the authorized releases in accordance with 
the routine uses identified in this system of records.
    CMS will take precautionary measures to minimize the risks of 
unauthorized access to the records and the potential harm to individual 
privacy or other personal or property rights of patients whose data are 
maintained in the system. CMS will collect only that information 
necessary to perform the system's functions. In addition, CMS will make 
disclosure from the proposed system only with consent of the subject 
individual, or his/her legal representative, or in accordance with an 
applicable exception provision of the Privacy Act. CMS, therefore, does 
not anticipate an unfavorable effect on individual privacy as a result 
of information relating to individuals.

    Dated: October 4, 2006.
Charlene Frizzera,
Acting Chief Operating Officer, Centers for Medicare & Medicaid 
Services.
System No. 09-70-0523

SYSTEM NAME:
    ``Evaluations of the Medicaid Reform Demonstrations (EMRD),'' HHS/
CMS/ORDI

SECURITY CLASSIFICATION:
    Level Three Privacy Act Sensitive Data

SYSTEM LOCATION:
    The Centers for Medicare & Medicaid Services (CMS) Data Center, 
7500 Security Boulevard, North Building, First Floor, Baltimore, 
Maryland 21244-1850 and at various contractor sites and at CMS Regional 
Offices.

CATEGORIES OF INDIVIDUALS COVERED BY THE SYSTEM:
    EMRD contains information on demonstration participants and 
comparison group members and their experiences in access health care 
before, during, and after the demonstration period.

CATEGORIES OF RECORDS IN THE SYSTEM:
    Information collected in the EMRD contains, but is not limited to, 
name, address, phone number, social security number (SSN), health 
insurance claim number (HICN), Medicaid identification number, gender, 
ethnicity, date of birth, employment, health care coverage, diagnostic 
and health status information, utilization and cost of health care 
services, and responses to survey or other types of data collection 
methods.

AUTHORITY FOR MAINTENANCE OF THE SYSTEM:
    Authority for maintenance of the system is given under 42 United 
States Code (U.S.C.) 1315 Sec.  1115, and 42 U.S.C. 1395ll Sec.  
1875(a) of the Social Security Act.

PURPOSE(S) OF THE SYSTEM:
    The primary purpose of this modified system is to collect and 
provide data necessary to evaluate a series of Medicaid Reform 
Demonstrations that rely on waivers of section 1115 of the Social 
Security Act (the Act). This system will allow measurement of the 
effects of the demonstration on beneficiaries' eligibility, access to 
care, utilization, health care costs, satisfaction with care, quality 
of care and health status. The information retrieved from this system 
of records will also be disclosed to: (1) Support program 
administration, reporting, and regulator, reimbursement, and policy 
functions performed within the CMS or by a contractor, consultant, or 
grantee; (2) assist another Federal or state agency with information to 
contribute to the accuracy of CMS's proper payment of Medicare 
benefits, enable such agency to administer a Federal health benefits 
program, or to enable such agency to fulfill a requirement of Federal 
statute or regulation that implements a health benefits program funded 
in whole or in part with Federal funds; (3) support an individual or 
organization for a research project or in support of an evaluation 
project related to the prevention of disease or disability, the 
restoration or maintenance of health, or payment related projects; (4) 
support litigation involving the agency; and (5) combat fraud, waste, 
and abuse in a Federally-funded health benefits programs.

ROUTINE USES OF RECORDS MAINTAINED IN THE SYSTEM, INCLUDING CATEGORIES 
OR USERS AND THE PURPOSES OF SUCH USES:
    A. The Privacy Act allows us to disclose information without an 
individual's consent if the information is to be used for a purpose 
that is compatible with the purpose(s) for which the information was 
collected. Any such compatible use of data is known as a ``routine 
use.'' The proposed routine uses in this system meet the compatibility 
requirement of the Privacy Act. We are proposing to establish the 
following routine use disclosures of information maintained in the 
system:
    1. To support agency contractors, consultants, or grantee who have 
been contracted by the agency to assist in the performance of a service 
related to this system and who need to have access to the records in 
order to perform the activity.
    2. To enable another Federal or state agency 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 support an individual or organization for a research project 
or in support of an evaluation project related to the prevention of 
disease or disability, the restoration or maintenance of health, or 
payment related projects.
    4. To support the Department of Justice (DOJ), court or 
adjudicatory body when:
    a. The agency or any component thereof, or

[[Page 60544]]

    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 and that 
the use of such records by the DOJ, court or adjudicatory body is 
compatible with the purpose for which the agency collected the records.
    5. To support a CMS contractor (including, but not necessarily 
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, waste, or abuse in such 
program.
    6. To support 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, 
waste, 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, waste, or abuse in such programs.
    B. Additional Provisions Affecting Routine Use Disclosures: To the 
extent this system contains Protected Health Information (PHI) as 
defined by HHS regulation ``Standards for Privacy of Individually 
Identifiable Health Information'' (45 CFR parts 160 and 164, Subparts A 
and E) 65 FR 82462 (12-28-00). Disclosures of such PHI that are 
otherwise 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.'' (See 45 CFR 164.512(a) (1)).
    In addition, our policy will be to prohibit release even of data 
not directly identifiable, except pursuant to one of the routine uses 
or if required by law, if we determine 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 could, because of the small size, use this information to 
deduce the identity of the beneficiary).

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

RETRIEVABILITY:
    Information can be retrieved using the beneficiary's name, Medicaid 
identification number, HICN, or SSN.

SAFEGUARDS:
    CMS has safeguards in place 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 
information security requirements. Employees who maintain records in 
this system are instructed not to release data until the intended 
recipient agrees to implement appropriate management, operational and 
technical safeguards sufficient to protect the confidentiality, 
integrity and availability of the information and information systems 
and to prevent unauthorized access.
    This system will conform to all applicable Federal laws and 
regulations and Federal, HHS, and CMS policies and standards as they 
relate to information security and data privacy. These laws and 
regulations may apply but are not limited to: the Privacy Act of 1974; 
the Federal Information Security Management Act of 2002; the Computer 
Fraud and Abuse Act of 1986; the Health Insurance Portability and 
Accountability Act of 1996; the E-Government Act of 2002, the Clinger-
Cohen Act of 1996; the Medicare Modernization Act of 2003, and the 
corresponding implementing regulations. OMB Circular A-130, Management 
of Federal Resources, Appendix III, Security of Federal Automated 
Information Resources also applies. Federal, HHS, and CMS policies and 
standards include but are not limited to: all pertinent National 
Institute of Standards and Technology publications; the HHS Information 
Systems Program Handbook and the CMS Information Security Handbook.

RETENTION AND DISPOSAL:
    CMS will retain information for a total period not to exceed 10 
years. All claims-related records are encompassed by the document 
preservation order and will be retained until notification is received 
from DOJ.

SYSTEM MANAGER(S) AND ADDRESS:
    Director, Division of State Program Research, Research and 
Evaluation Group, Office of Research, Development and Information, CMS, 
Mail Stop C3-19-07, 7500 Security Boulevard, Baltimore, Maryland 21244-
1850.

NOTIFICATION PROCEDURE:
    For purpose of access, the subject individual should write to the 
system manager who will require the system name, HICN, address, date of 
birth, and gender, and for verification purposes, the subject 
individual's name (woman's maiden name, if applicable), and SSN. 
Furnishing the SSN is voluntary, but it may make searching for a record 
easier and prevent delay.

RECORD ACCESS PROCEDURE:
    For purpose of access, use the same procedures outlined in 
Notification Procedures above. Requestors should also specify the 
record contents being sought. (These procedures are in accordance with 
department regulation 45 CFR 5b.5(a)(2)).

CONTESTING RECORDS PROCEDURES:
    The subject individual should contact the system manager named 
above, and reasonably identify the records 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).

RECORDS SOURCE CATEGORIES:
    Sources on information contained in this system include: State 
Medicaid Management Information Systems, managed care organizations, 
fee-for-service providers, surveys of demonstration participants or 
providers and comparison group members, medical records, Social 
Security Administration databases, vital statistics and other relevant 
data systems.

SYSTEMS EXEMPTED FROM CERTAIN PROVISIONS OF THE ACT:
    None.

[FR Doc. E6-16955 Filed 10-12-06; 8:45 am]
BILLING CODE 4120-03-P