[Federal Register Volume 88, Number 174 (Monday, September 11, 2023)]
[Notices]
[Pages 62376-62377]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2023-19481]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare and Medicaid Services


Privacy Act of 1974; Matching Program

AGENCY: Centers for Medicare & 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 (HHS), Centers for Medicare & 
Medicaid Services (CMS) is providing notice of the re-establishment of 
a matching program between CMS and the Department of Veterans Affairs 
(VA), Veterans Health Administration (VHA), ``Verification of 
Eligibility for Minimum Essential Coverage Under the Patient Protection 
and Affordable Care Act Through a Veterans Health Administration 
Plan.''

DATES: The deadline for comments on this notice is October 11, 2023. 
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 
November 2, 2023 to May 1, 2025) and within 3 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 the new 
matching program 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 by email at [email protected].

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 443-844-9966, 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 Act 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 
Department of Veterans Affairs (VA), Veterans Health Administration 
(VHA) is the source agency.

Authority for Conducting the Matching Program

    The statutory authority for the matching program is 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, VHA provides CMS 
with data when a state administering entity (AE) requests it and VHA is 
authorized to release it, verifying whether an individual who is 
applying for or is enrolled in private health insurance coverage under 
a qualified health plan through a federally-facilitated health 
insurance exchange or state-based exchange is eligible for coverage 
under a VHA health plan. CMS makes the data provided by VHA available 
to the requesting AE through a data services hub to use in determining 
the applicant's or enrollee's eligibility for financial assistance 
(including an advance tax credit and cost-sharing reduction, which are 
types of insurance affordability programs) in paying for private health 
insurance coverage. VHA health plans provide minimum essential 
coverage, and eligibility for such plans precludes eligibility for 
financial assistance in paying for private coverage. The data provided 
by VHA under this matching program will be used by CMS and AEs to 
authenticate each enrollee's identity, determine the enrollee's 
eligibility for financial assistance, and determine the amount of the 
financial assistance.

Categories of Individuals

    The categories of individuals whose information will be used in the 
matching program are Veterans whose records at VHA match identifying 
data provided to VHA by CMS (submitted by AEs) about individuals who 
are applying for or are enrolled in private insurance coverage under a 
qualified health plan through a federally-facilitated health insurance 
exchange or state-based exchange.

Categories of Records

    The categories of records used in the matching program are identity 
records and minimum essential coverage period records, consisting of 
the following data elements:
    Data provided by CMS to VHA:

a. first name (required)
b. middle name/initial (if provided by applicant)
c. surname (applicant's last name) (required)

[[Page 62377]]

d. date of birth (required)
e. gender (required)
f. social security number (SSN) (required)
g. requested qualified health plan (QHP) coverage effective date 
(required)
h. requested QHP coverage end date (required)
i. State identification (required)
j. transaction ID (required)

    Data provided by VHA to CMS:

a. SSN (required)
b. start/end date(s) of enrollment period(s) (when match occurs)
c. a blank date response when a non-match occurs
d. a blank date when a match is made but VHA's record contains a date 
of death
e. enrollment period(s) is/are defined as the timeframe during which 
the individual was enrolled in a VHA Health Care Program.

System(s) of Records

    The records used in the matching program will be disclosed from the 
following systems of records, as authorized by routine uses published 
in the system of records notices (SORNs) cited below:

A. System of Records Maintained by CMS

    CMS Health Insurance Exchanges System (HIX), CMS 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). Routine use 3 authorizes CMS' 
disclosures to VHA.

B. Systems of Records Maintained by VHA

    54VA10NB3 Veterans and Beneficiaries Purchased Care Community 
Health Care Claims, Correspondence, Eligibility, Inquiry and Payment 
Files--VA, published at 80 FR 11527 (March 3, 2015). Routine use 25 
authorizes VHA's disclosures to CMS.

[FR Doc. 2023-19481 Filed 9-8-23; 8:45 am]
BILLING CODE 4120-03-P