Notice2026-02472
Privacy Act of 1974; Matching Program
Primary source
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Published
February 9, 2026
Issuing agencies
Health and Human Services DepartmentCenters for Medicare & Medicaid Services
Abstract
In accordance with subsection (e)(12) of 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 Social Security Administration (SSA). Under this matching program, SSA will provide CMS with information for determining individuals' eligibility for enrollment in a Qualified Health Plan, issuing certificates of exemption, and eligibility redeterminations and renewals. This matching program is titled, "Determining Enrollment or Eligibility for Insurance Affordability Programs Under the Patient Protection and Affordable Care Act."
Full Text
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<title>Federal Register, Volume 91 Issue 26 (Monday, February 9, 2026)</title>
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[Federal Register Volume 91, Number 26 (Monday, February 9, 2026)]
[Notices]
[Pages 5772-5773]
From the Federal Register Online via the Government Publishing Office [<a href="http://www.gpo.gov">www.gpo.gov</a>]
[FR Doc No: 2026-02472]
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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 & Medicaid Services (CMS), Department of
Health and Human Services (HHS).
ACTION: Notice of new matching program.
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SUMMARY: In accordance with subsection (e)(12) of 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 Social
Security Administration (SSA). Under this matching program, SSA will
provide CMS with information for determining individuals' eligibility
for enrollment in a Qualified Health Plan, issuing certificates of
exemption, and eligibility redeterminations and renewals. This matching
program is titled, ``Determining Enrollment or Eligibility for
Insurance Affordability Programs Under the Patient Protection and
Affordable Care Act.''
DATES: The deadline for comments on this notice is March 11, 2026. 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 March 9,
2026 to September 8, 2027) 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 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 <a href="/cdn-cgi/l/email-protection#2a684b58484b584b044e4f47455a5f4645596a49475904424259044d455c"><span class="__cf_email__" data-cfemail="c587a4b7a7a4b7a4eba1a0a8aab5b0a9aab685a6a8b6ebadadb6eba2aab3">[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 443-844-9966, by email at <a href="/cdn-cgi/l/email-protection#31505f5f541f415442455e71525c421f5959421f565e47"><span class="__cf_email__" data-cfemail="32535c5c571c425741465d72515f411c5a5a411c555d44">[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
[[Page 5773]]
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
Social Security Administration (SSA) is the source agency.
Authority for Conducting the Matching Program
The statutory authority for the matching program is 42 U.S.C. 18081
and 18083.
Purpose(s)
The purpose of the matching program is to provide CMS with SSA
information which CMS will use to determine individuals' eligibility
for initial enrollment in a Qualified Health Plan through an Exchange
established under the Patient Protection and Affordable Care Act; for
Insurance Affordability Programs (IAPs); for certificates of exemption
from the shared responsibility payment; and to make eligibility
redeterminations and renewal decisions, including appeal
determinations. IAPs include:
1. Advance payments of the premium tax credit (APTC) and cost
sharing reductions (CSRs),
2. Medicaid,
3. Children's Health Insurance Program (CHIP), and
4. Basic Health Program (BHP).
Categories of Individuals
The individuals whose information will be used in the matching
program are consumers (applicants and enrollees) who receive the
eligibility determinations and redeterminations described in the
preceding Purpose(s) section.
Categories of Records
The categories of records used in the matching program are identity
information, citizenship and death/disability indicators, incarceration
information, and income information. To request information from SSA,
CMS will submit a submission file to SSA that contains the following
mandatory specified data elements: last name, first name, date of
birth, Social Security Number (SSN), and citizenship indicator. When
SSA is able to match the SSN and name provided by CMS and information
is available, SSA will provide CMS with the following about each
individual, as relevant: last name, first name, date of birth, death
indicator, disability indicator, incarceration information, Title II
(annual and monthly) income information, and confirmation of
attestations of citizenship status and SSN. SSA may also provide
Quarters of Coverage data when CMS requests it.
Systems of Records
The systems of records that support this matching program are
identified below:
A. System of Records Maintained by CMS
<bullet> 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. Systems of Records Maintained by SSA
<bullet> Master Files of SSN Holders and SSN Applications (referred
to as the Enumeration System), 60-0058, last fully published at 90 FR
50879 (Nov. 12, 2025);
<bullet> Prisoner Update Processing System (PUPS), 60-0269, last
fully published at 64 FR 11076 (Mar. 8, 1999) and updated at 72 FR
69723 (Dec. 10, 2007), 78 FR 40542 (July 5, 2013), 83 FR 54969 (Nov. 1,
2018), and 90 FR 53413 (Nov. 25, 2025);
<bullet> Master Beneficiary Record (MBR) 60-0090, last fully
published at 71 FR 1826 (Jan. 11, 2006), and updated at 72 FR 69723
(Dec. 10, 2007), 78 FR 40542 (July 5, 2013), 83 FR 31250 (July 3,
2018), 83 FR 54969 (Nov. 1, 2018), 89 FR 825 (Jan. 5, 2024), and 89 FR
14554 (Feb. 27, 2024); and
<bullet> Earnings Recording and Self-Employment Income System
(referred to as the Master Earnings File (MEF)), 60-0059, last fully
published at 71 FR 1819 (Jan. 11, 2006) and amended at 78 FR 40542
(July 5, 2013), 83 FR 54969 (Nov. 1, 2018), and 89 FR 825 (Jan. 5,
2024).
[FR Doc. 2026-02472 Filed 2-6-26; 8:45 am]
BILLING CODE 4120-03-P
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