[Federal Register Volume 85, Number 181 (Thursday, September 17, 2020)]
[Notices]
[Pages 58062-58063]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2020-19956]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services


Privacy Act of 1974; Matching Program

AGENCY: Centers for Medicare and Medicaid Services, Department of 
Health and Human Services.

ACTION: Notice of a new matching program.

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SUMMARY: In accordance with the Privacy Act of 1974, as amended, the 
Department of Health and Human Services, Centers for Medicare & 
Medicaid Services (CMS) is providing notice of a new agreement re-
establishing the ``Do Not Pay Initiative'' matching program between CMS 
and the Department of Treasury, Bureau of Fiscal Service (Fiscal 
Service).

DATES: The deadline for comments on this notice is October 19, 2020. 
The 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. Pursuant to 31 U.S.C. 3354(d)(1)(C), 
the matching program will be conducted for an initial term of 36 months 
(approximately October 13, 2020 to October 12, 2023) and within three 
months of expiration may be renewed for three additional years 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 to the CMS Privacy Act Officer by mail at: 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, or email [email protected].

FOR FURTHER INFORMATION CONTACT: If you have questions about the 
matching program, you may contact John Sofokles, Government Technical 
Lead, Center for Program Integrity, Centers for Medicare & Medicaid 
Services, at 410-786-6373, by email at [email protected], or by 
mail at 7500 Security Blvd., Baltimore, MD 21244.

SUPPLEMENTARY INFORMATION: The Privacy Act of 1974, as amended (5 
U.S.C. 552a), provides certain protections for individuals applying for 
and receiving payments under federal benefit programs. 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.
Privacy Advisor, Division of Security, Privacy Policy and Governance, 
Office of Information Technology, Centers for Medicare & Medicaid 
Services.

PARTICIPATING AGENCIES:
    The Department of Health and Human Services (HHS), Centers for 
Medicare & Medicaid Services (CMS) is the recipient agency, and the 
Department of the Treasury (Treasury), Bureau of Fiscal Service (Fiscal 
Service) is the source agency.

AUTHORITY FOR CONDUCTING THE MATCHING PROGRAM:
    The statutory authorities for the matching program are Executive 
Order 13520 ``Reducing Improper Payments''

[[Page 58063]]

(Nov. 20, 2009); Presidential Memorandum on Enhancing Payment Accuracy 
through a ``Do Not Pay List'' (June 18, 2010); 31 U.S.C. 3351 et seq.; 
OMB Memorandum M-18-20 Transmittal of Appendix C to OMB Circular A-123, 
Requirements for Payment Integrity Improvement (June 16, 2018), and 5 
U.S.C. 552a.

PURPOSE(S):
    The purpose of the matching program is to provide CMS with 
information from Treasury's Working System which CMS will use to 
identify Medicare providers and suppliers who are ineligible for 
Medicare enrollment; to promptly suspend or revoke the Medicare billing 
privileges of the identified disqualified providers and suppliers; to 
enable recoupment of past payments made to those providers and 
suppliers; to assist CMS in detecting and preventing fraud, waste, 
abuse and in avoiding making future improper payments to disqualified 
providers and suppliers; and to enhance patient safety for 
beneficiaries in CMS programs.

CATEGORIES OF INDIVIDUALS:
    The categories of individuals involved in the matching program are 
individual providers and suppliers who bill Medicare for payment.

CATEGORIES OF RECORDS:
    The categories of records used in the matching program are 
identifying data, and payment eligibility status data. To request 
information from Treasury's Working System, CMS will provide Fiscal 
Service with the following information about a Medicare provider or 
supplier: Tax Identification Number (TIN), Business Name, Person First 
Name, Person Middle Name, Person Last Name, Address, City Name, State 
Code, Person Date of Birth, Person Sex, Vendor/Payee Phone Number, 
Vendor/Payee Email Address.
    When Fiscal Service is able to match the TIN and other identifying 
data provided by CMS, Fiscal Service will disclose to CMS the following 
information about that provider or supplier:
    Record Code.
    Payee Identifier.
    Agency Location Code.
    Tax Identification Type.
    Tax Identification Number.
    Business or Individual or Government.
    DUNS Number.
    Payee Business Name.
    Payee Business DBA Name.
    Person Full Name.
    Person First Name.
    Person Middle Name.
    Person Last Name.
    Address.
    Person Date of Birth.
    Person Sex.
    Vendor/Payee Status.
    Phone Type.
    Vendor/Payee Phone Number.
    Vendor/Payee Fax Number.
    Vendor/Payee Email Address.
    Vendor/Payee Active Date.
    Vendor/Payee Expiration Date.
    Agency Record Grouping.
    Other Agency Data.
    Match Type.
    Match Source.
    Match Level.
    Match Date/Time.
    Matched Party Type.
    Matched Tax ID Number.
    Matched Tax ID Type Code (alternate).
    Matched Tax ID Number (alternate).
    Match DUNS Number.
    Matched Full Name.
    Matched First Name.
    Matched Middle Name.
    Matched Last Name.
    Matched Business Name.
    Matched DBA Business Name.
    Matched Birth Date.
    Matched Death Date.
    Matched List Status Code.
    Matched List Status Code Description.
    Matched List Effective Date.
    Matched Address.
    Matched City.
    Matched State Code.
    Matched Zip Code.
    Matched Country Code.

SYSTEM(S) OF RECORDS:
    The records used in this matching program will be disclosed from 
the following systems of records, as authorized by relevant routine 
uses published in the System of Records Notices (SORNs) cited below:

A. System of Records Maintained by CMS:
     The Provider Enrollment, Chain, and Ownership System 
(PECOS), System No. 09-70-0532, 71 FR 60536 (Oct. 13, 2006), 78 FR 
32257 (May 29, 2013) and 83 FR 6591 (Feb. 14, 2018).

B. System of Records Maintained by Fiscal Service:
     The Department of the Treasury, Bureau of the Fiscal 
Service .017--Do Not Pay Payment Verification Records, 85 FR 11776 at 
11803 (Feb. 27, 2020).

[FR Doc. 2020-19956 Filed 9-16-20; 8:45 am]
BILLING CODE 4120-03-P