Notice2023-24331
Privacy Act of 1974; Matching Program
Primary source
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Published
November 3, 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 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."
Full Text
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<title>Federal Register, Volume 88 Issue 212 (Friday, November 3, 2023)</title>
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[Federal Register Volume 88, Number 212 (Friday, November 3, 2023)]
[Notices]
[Pages 75596-75597]
From the Federal Register Online via the Government Publishing Office [<a href="http://www.gpo.gov">www.gpo.gov</a>]
[FR Doc No: 2023-24331]
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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 December 4, 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
December 8, 2023 to June 7, 2025) and within three 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#31735043535043501f75545c5e41445d5e4271525c421f5959421f565e47"><span class="__cf_email__" data-cfemail="21634053434053400f65444c4e51544d4e5261424c520f4949520f464e57">[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#2f4e41414a015f4a5c5b406f4c425c0147475c01484059"><span class="__cf_email__" data-cfemail="1a7b74747f346a7f696e755a79776934727269347d756c">[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 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
[[Page 75597]]
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
Office of Personnel Management (OPM) is the source agency.
Authority for Conducting the Matching Program
The principal authority for 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 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: (1) active federal employees, and (2) 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:
<bullet> 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.
<bullet> 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:
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), and amended at
83 FR 6591 (Feb. 14, 2018).
B. System of Records Maintained by OPM
OPM/GOVT-1 General Personnel Records, last published in full at 77
FR 79694 (Dec. 11, 2012), and amended at 80 FR 74815 (Nov. 30, 2015)
and 87 FR 5874 (Feb. 2, 2022). The disclosures of OPM data to CMS are
authorized by Routine Use ``rr''.
[FR Doc. 2023-24331 Filed 11-2-23; 8:45 am]
BILLING CODE 4120-03-P
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