Notice2023-24081
Privacy Act of 1974; Matching Program
Primary source
Metadata and text below are from the Federal Register, a public-domain U.S. government work. Always verify the official published version before relying on it for any legal matter.
Published
November 1, 2023
Issuing agencies
Health and Human Services DepartmentCenters for Medicare & Medicaid Services
Abstract
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 Department of Defense, Defense Manpower Data Center for "Verification of Eligibility for Minimum Essential Coverage Under the Patient Protection and Affordable Care Act through a Department of Defense Health Benefits Plan."
Full Text
<html>
<head>
<title>Federal Register, Volume 88 Issue 210 (Wednesday, November 1, 2023)</title>
</head>
<body><pre>
[Federal Register Volume 88, Number 210 (Wednesday, November 1, 2023)]
[Notices]
[Pages 74998-74999]
From the Federal Register Online via the Government Publishing Office [<a href="http://www.gpo.gov">www.gpo.gov</a>]
[FR Doc No: 2023-24081]
-----------------------------------------------------------------------
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
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.
-----------------------------------------------------------------------
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 Department of Defense,
Defense Manpower Data Center for ``Verification of Eligibility for
Minimum Essential Coverage Under the Patient Protection and Affordable
Care Act through a Department of Defense Health Benefits Plan.''
DATES: The deadline for comments on this notice is December 1, 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 30, 2023 to May 29, 2025) and within 3 months of expiration
may be renewed for up to 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 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 by
email at <a href="/cdn-cgi/l/email-protection#fdbf9c8f9f9c8f9cd3b99890928d8891928ebd9e908ed395958ed39a928b"><span class="__cf_email__" data-cfemail="41032033232033206f05242c2e31342d2e3201222c326f2929326f262e37">[email protected]</span></a>.
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 443-955-9966, by email at <a href="/cdn-cgi/l/email-protection#86e7e8e8e3a8f6e3f5f2e9c6e5ebf5a8eeeef5a8e1e9f0"><span class="__cf_email__" data-cfemail="badbd4d4df94cadfc9ced5fad9d7c994d2d2c994ddd5cc">[email protected]</span></a>, 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
[[Page 74999]]
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 Defense (DoD), Defense Manpower Data Center (DMDC) 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 DoD data
verifying individuals' eligibility for coverage under a DoD Health
Benefit Plan (i.e., TRICARE), when requested by CMS and state-based
administering entities (AE) for the purpose of determining the
individuals' eligibility for insurance affordability programs under the
Patient Protection and Affordable Care Act (PPACA). CMS and the
requesting AE will use the DoD data to determine whether an enrollee in
private health coverage under a qualified health plan through a
federally-facilitated or state-based health insurance exchange is
eligible for coverage under TRICARE, and the dates the individual was
eligible for TRICARE coverage. DoD health benefit plans provide minimum
essential coverage (MEC), and eligibility for such plans precludes
eligibility for financial assistance in paying for private coverage.
CMS and AE will use the DoD data to authenticate identity, determine
eligibility for financial assistance (including an advance tax credit
and cost-sharing reduction, which are types of insurance affordability
programs), and determine the amount of any financial assistance.
Categories of Individuals
The categories of individuals whose information is involved in the
matching program are: (1) active duty service members and their family
members and (2) retirees and their family members whose TRICARE
eligibility records at DoD match data provided to DoD by CMS (submitted
by AEs) about individual consumers who are applying for or are enrolled
in private health insurance coverage under a qualified health plan
through a federally-facilitated or state-based health insurance
exchange.
Categories of Records
The categories of records used in the matching program are identity
records and minimum essential coverage (MEC) period records. To request
information from DoD, CMS will submit a request to DoD that may
contain, but is not limited to, the following specified data elements
in a fixed record format: Social Security Number (SSN), first name,
middle name, surname (last name), date of birth, gender, and requested
Qualified Health Plan (QHP) coverage effective date and end date. When
DoD is able to match the SSN and name provided by CMS and information
is available, DoD will provide CMS with the following about each
individual, as relevant: SSN, response code indicating enrollment in
MEC under a TRICARE plan, and, as applicable, begin date(s) and end
date(s) of enrollment in MEC under a TRICARE plan.
System(s) of Records
The records used in the matching program are disclosed from these
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), and
amended at 83 FR 6591 (Feb. 14, 2018). Routine use 3 authorizes CMS'
disclosures of identifying information about applicants to DoD for use
in this matching program.
B. System of Records Maintained by DoD
The DoD system of records and routine use that support this
matching program are Routine Use h in DMDC 02 DoD, Defense Enrollment
Eligibility Reporting Systems (DEERS), last published at 87 FR 32384
(May 31, 2022). Routine use H supports DoD's disclosures to CMS.
[FR Doc. 2023-24081 Filed 10-31-23; 8:45 am]
BILLING CODE 4120-03-P
</pre><script data-cfasync="false" src="/cdn-cgi/scripts/5c5dd728/cloudflare-static/email-decode.min.js"></script></body>
</html>Indexed from Federal Register on November 1, 2023.
This is legal information, not legal advice. Laws vary by jurisdiction and change frequently. Always verify current law with official sources and consult a licensed attorney in your jurisdiction for advice on your specific situation.