[Federal Register Volume 86, Number 84 (Tuesday, May 4, 2021)]
[Notices]
[Pages 23728-23729]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2021-09292]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services


Privacy Act of 1974; Matching Program

AGENCY: Center for Consumer Information and Insurance Oversight 
(CCIIO), 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 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 the re-establishment of 
a computer matching program between CMS and the Office of Personnel 
Management (OPM), ``Verification of Eligibility of 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 June 3, 2021. 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 June 8, 
2021 to December 7, 2022) 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 comments:
    1. Electronically. You may send your comments electronically to 
http://www.regulations.gov. Follow the instructions for ``Comment or 
Submission'' or ``More Search Options'' to find the information 
collection document(s) that are accepting comments.
    2. By Regular Mail. You may mail written comments to the following 
address: Centers for Medicare & Medicaid Services, Division of 
Security, Privacy Policy & Governance, Information Security & Privacy 
Group, Office of Information Technology, Location: N1-14-56, 7500 
Security Blvd., Baltimore, MD 21244-1850.

FOR FURTHER INFORMATION CONTACT: If you have questions about the 
matching program, you may contact Anne Pesto, Senior Advisor, 
Marketplace Eligibility and Enrollment Group, Center for Consumer 
Information and Insurance Oversight, Centers for Medicare & Medicaid 
Services, at 410-786-3492, 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 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,
Privacy Officer, 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 
Office of Personnel Management (OPM) is the source agency.

Authority for Conducting the Matching Program

    The principal authority for conducting the matching program is 42 
U.S.C. 18001 et seq.

Purpose(s)

    The purpose of the matching program is to provide CMS with OPM data 
which CMS and state Administering Entities (AEs) need to determine 
individuals' eligibility for financial assistance in

[[Page 23729]]

paying for private health insurance coverage, under provisions of the 
Patient Protection and Affordable Care Act. In this matching program, 
OPM provides CMS with monthly data identifying 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 AEs use the OPM data to verify 
whether an individual who is applying for or is enrolled in private 
health insurance coverage under a qualified health plan through a 
federally-facilitated or state-based health insurance exchange is 
eligible for coverage under an OPM health benefit plan, for the purpose 
of determining if the individual is eligible for financial assistance 
(including an advance tax credit and cost sharing reduction, which are 
types of insurance affordability programs) in paying for the private 
coverage. OPM health benefit plans provide minimum essential coverage, 
and eligibility for such plans precludes eligibility for financial 
assistance in paying for private coverage.

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 and receive determinations of 
eligibility for insurance affordability programs.

Categories of Records

    The categories of records used in the matching program are identity 
information about the above consumers, which are maintained by CMS, and 
identity information and minimum essential coverage period records 
about all active federal employees, and annual premium information, 
maintained by OPM. The data elements provided to CMS by OPM 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 or enrollees 
to OPM in order to receive this data from OPM.

System(s) of Records

    The records used in the matching program are maintained in these 
systems of records:
     CMS Health Insurance Exchanges System (HIX), System No. 
09-70-0560, last published in full at 78 FR 63211 (Oct. 23, 2013), and 
amended at 83 FR 6591 (Feb. 14, 2018).
     OPM/GOVT-1 General Personnel Records, last published in 
full at 77 FR 73694 (Dec. 11, 2012), and amended at 80 FR 42133 (July 
16, 2015) and 80 FR 74815 (Nov. 30, 2015). The disclosures of OPM data 
to CMS are authorized by Routine Use ``rr''.

[FR Doc. 2021-09292 Filed 5-3-21; 8:45 am]
BILLING CODE 4120-03-P