[Federal Register Volume 83, Number 217 (Thursday, November 8, 2018)]
[Notices]
[Pages 55889-55890]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2018-24421]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services (CMS)


Privacy Act of 1974; Matching Program

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

ACTION: Notice of a New Matching Program.

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SUMMARY: In accordance with subsection (e)(12) of the Privacy Act of 
1974, as amended, the Department of Health and Human Services (HHS), 
Centers for Medicare & Medicaid Services (CMS) is providing notice of a 
new matching program between CMS and the Office of Personnel Management 
(OPM), ``Verification of Eligibility for Minimum Essential Coverage 
Under the Patient Protection and Affordable Care Act Through an Office 
of Personnel Management Health Benefit Plan.''

DATES: The deadline for comments on this notice is December 10, 2018. 
The re-established matching program will commence not sooner than 30 
days after publication of this notice, provided no comments are 
received that warrant a change to this notice. The matching program 
will be conducted for an initial term of 18 months (from approximately 
January 2019 to July 2020) and within three months of expiration may be 
renewed for one additional year if the parties make no change to the 
matching program and certify that the program has been conducted in 
compliance with the matching agreement.

ADDRESSES: Interested parties may submit written comments on this 
notice, by mail or email, to the CMS Privacy Officer, Division of 
Security, Privacy Policy & Governance, Information Security & Privacy 
Group, Office of Information Technology, Centers for Medicare & 
Medicaid Services, Location: N1-14-56, 7500 Security Blvd., Baltimore, 
MD 21244-1850, [email protected].

FOR FURTHER INFORMATION CONTACT: If you have questions about the 
matching program, you may contact Jack Lavelle, Senior Advisor, 
Marketplace Eligibility and Enrollment Group, Center for Consumer 
Information and Insurance Oversight, CMS, 7501 Wisconsin Ave., 
Bethesda, MD 20814, (410) 786-0639, or by email at 
[email protected].

SUPPLEMENTARY INFORMATION: The Privacy Act of 1974, as amended (5 
U.S.C. 552a) provides certain protections for individuals applying for 
and receiving federal benefits. The law governs the use of computer 
matching by federal agencies when records in a system of records 
(meaning, federal agency records about individuals retrieved by name or 
other personal identifier) are matched with records of other federal or 
non-federal agencies. The Privacy Act requires agencies involved in a 
matching program to:
    1. Enter into a written agreement, which must be prepared in 
accordance with the Privacy Act, approved by the Data Integrity Board 
of each source and recipient federal agency, provided to Congress and 
the Office of Management and Budget (OMB), and made available to the 
public, as required by 5 U.S.C. 552a(o), (u)(3)(A), and (u)(4).
    2. Notify the individuals whose information will be used in the 
matching program that the information they provide is subject to 
verification through matching, as required by 5 U.S.C. 552a(o)(1)(D).
    3. Verify match findings before suspending, terminating, reducing, 
or making a final denial of an individual's benefits or payments or 
taking other adverse action against the individual, as required by 5 
U.S.C. 552a(p).
    4. Report the matching program to Congress and the OMB, in advance 
and annually, as required by 5 U.S.C. 552a(o) (2)(A)(i), (r), and 
(u)(3)(D).
    5. Publish advance notice of the matching program in the Federal 
Register as required by 5 U.S.C. 552a(e)(12).
    This matching program meets these requirements.

Barbara Demopulos,
CMS Privacy Advisor, Information Security and Privacy Group, Division 
of Security, Privacy Policy and Governance, Office of Information 
Technology, Centers for Medicare & Medicaid Services.

Participating Agencies

    Department of Health and Human Services (HHS), Centers for Medicare 
& Medicaid Services (CMS) is the recipient agency, and the Office of 
Personnel Management (OPM) is the source agency.

Authority for Conducting the Matching Program

    The matching program is authorized under 42 U.S.C. 18001, et seq.

Purpose(s)

    The purpose of the matching program is to assist CMS in determining 
individuals' eligibility for financial assistance in paying for private 
health insurance coverage. In this matching program, OPM provides CMS 
with data, on a monthly basis, verifying each active federal employee's 
status as enrolled in or eligible for coverage under an OPM Health 
Benefit Plan, and an annual premium spread index file identifying the 
lowest premium available to a federal employee in each of 32 premium 
localities. CMS and state administering entities will use the OPM data 
to verify whether an applicant for or enrollee in private health 
insurance coverage under a qualified health plan through a federally-
facilitated or state-

[[Page 55890]]

based health insurance exchange is eligible for coverage under an OPM 
health benefit plan. OPM health benefit plans provide minimum essential 
coverage (MEC), and eligibility for such plans usually precludes 
eligibility for financial assistance (including an advance payment of 
the premium tax credit (APTC) or cost sharing reduction (CSR), which 
are types of insurance affordability programs). The OPM data will be 
used by CMS to authenticate identity, determine eligibility, and 
determine the amount of any financial assistance.

Categories of Individuals

    The categories of individuals whose information is involved in the 
matching program are:
     Active federal employees; and
     consumers who apply for or are enrolled in a qualified 
health plan through an exchange established under the Patient 
Protection and Affordable Care Act (ACA) and receive determinations of 
eligibility for insurance affordability programs.

Categories of Records

    The categories of records which OPM will provide to CMS are monthly 
status files consisting of identity records and minimum essential 
coverage period records, and an annual premium spread index file 
containing premium information based on locality. The data elements are 
as follows:
     Monthly status file:
    a. Record type;
    b. record number;
    c. unique person ID;
    d. social security number;
    e. last name;
    f. middle name;
    g. first name;
    h. last name suffix;
    i. gender;
    j. date of birth; and
    k. health plan code.
     Annual Premium Spread Index File:
    a. State;
    b. plan;
    c. option;
    d. enrollment code;
    e. current total bi-weekly premium;
    f. future total bi-weekly premium;
    g. future government pays bi-weekly premium;
    h. future employee pays bi-weekly premium
    i. future change in employee payment bi-weekly premium;
    j. current total monthly premium;
    k. future total monthly premium;
    l. future government pays monthly premium;
    m. future employee pays monthly premium; and
    n. future change in employee payment monthly premium.
    CMS will not send any data about individual applicants/enrollees to 
OPM in order to receive this data from OPM about active federal 
employees.

System(s) of Records

    The records used in this matching program will be disclosed to CMS 
from the OPM system of records identified below, and will be matched 
against applicant/enrollee records in the CMS system of records 
identified below:

A. System of Records Maintained by CMS

     CMS Health Insurance Exchanges System (HIX), System No. 
09-70-0560, last published in full at 78 FR 63211 (Oct. 23, 2013), as 
amended at 83 FR 6591 (Feb. 14, 2018).

B. System of Records Maintained by OPM

     General Personnel Records (OPM/GOVT-1), 77 FR 73694 (Dec. 
11, 2012). The disclosures to CMS will be made in accordance with 
routine use ``rr.''

[FR Doc. 2018-24421 Filed 11-7-18; 8:45 am]
 BILLING CODE 4120-03-P