[Federal Register: March 29, 2006 (Volume 71, Number 60)]
[Notices]
[Page 15705-15707]
From the Federal Register Online via GPO Access [wais.access.gpo.gov]
[DOCID:fr29mr06-58]
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DEPARTMENT OF DEFENSE
Office of the Secretary
[DoD-2006-OS-0050]
Privacy Act of 1974; System of Records
AGENCY: Office of the Secretary, DoD.
ACTION: Notice to amend systems of records.
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SUMMARY: The Office of the Secretary of Defense is amending a system of
records notice in its existing inventory of record systems subject to
the Privacy Act of 1974, (5 U.S.C. 552a), as amended.
DATES: This proposed action will be effective without further notice on
April
[[Page 15706]]
28, 2006 unless comments are received which result in a contrary
determination.
ADDRESSES: Send comments to the OSD Privacy Act Coordinator, Records
Management Section, Washington Headquarters Services, 1155 Defense
Pentagon, Washington, DC 20301-1155.
FOR FURTHER INFORMATION CONTACT: Ms. Juanita Irvin at (703) 696-4940.
SUPPLEMENTARY INFORMATION: The Office of the Secretary of Defense
systems of records notices subject to the Privacy Act of 1974, (5
U.S.C. 552a), as amended, have been published in the Federal Register
and are available from the address above.
The specific changes to the record system being amended are set
forth below followed by the notice, as amended, published in its
entirety. The proposed amendments are not within the purview of
subsection (r) of the Privacy Act of 1974, (5 U.S.C. 552a), as amended,
which requires the submission of a new or altered system report.
Dated: March 23, 2006.
L.M. Bynum,
OSD Federal Register Liaison Officer, Department of Defense.
DTMA 01
System name:
Health Benefits Authorization Files (May 9, 2003, 68 FR 24938).
Changes:
Notification procedure:
Add the following to the end of the entry: ``or TRICARE Management
Activity Privacy Office, Skyline 5, Suite 810, 5111 Leesburg Pike,
Falls Church, VA 22041-3201.''
Record access procedures:
Add the following to the end of the entry: ``or TRICARE Management
Activity Privacy Office, Skyline 5, Suite 810, 5111 Leesburg Pike,
Falls Church, VA 22041-3201.''
DTMA 01
System name:
Health Benefits Authorization Files.
System location:
TRICARE Management Activity, Department of Defense, 16401 East
Centretech Parkway, Aurora, CO 80011-9066, and contractors under
contract to TRICARE. A listing of TRICARE contractors maintaining these
records is available from the system manager.
Categories of individuals covered by the system:
All individuals who seek authorization or pre-authorization for
medical and dental health care under TRICARE/CHAMPUS and CHAMPVA.
Categories of records in the system:
Original correspondence to and from individuals; medical/dental
statements; medical/dental histories; Health Care Advise Nurse records;
Congressional inquiries; medical/dental treatment records;
authorization and pre-authorization requests for care; case status
sheets; memoranda for the record; follow-up reports justifying extended
care; correspondence with contractors; and work-up sheets maintained by
case workers.
Authority for maintenance of the system:
41 CFR part 101-11.000; chapter 55, 10 U.S.C. 613, chapter 17, 38
U.S.C.; 32 CFR part 199; and E.O. 9397 (SSN).
Purpose(s):
To maintain and control records pertaining to requests for
authorization or pre\authorization of health and dental care under
TRICARE/CHAMPUS.
To determine eligibility of an individual, authorize payment,
control and review health care management plans, health care
demonstration programs, control accomplishment of reviews, and
coordinate subject matter clearance for internal and external audits
and reviews of the program.
Routine uses of records maintained in the system, including categories
of users and purposes of such uses:
In addition to those disclosures generally permitted under 5 U.S.C.
552a(b) of the Privacy Act, these records or information contained
therein may specifically be disclosed outside the DoD as a routine use
pursuant to 5 U.S.C. 552a(b)(3) as follows:
To the Department of Health and Human Services and/or the
Department of Veterans Affairs consistent with their statutory
administrative responsibilities under TRICARE/CHAMPUS and CHAMPVA
pursuant to chapter 55, 10 U.S.C. and section 613, chapter 17, 38
U.S.C.
Referral to Federal, state, local, or foreign governmental
agencies, and to private business entities, including individual
providers of care (participating and non-participating), on matters
relating to eligibility, claims pricing and payment, fraud, program
abuse, utilization review, quality assurance, peer review, program
integrity, third-party liability, coordination of benefits, and civil
or criminal litigation related to the operation of TRICARE/CHAMPUS.
Disclosure to the Department of Justice and the United States
Attorneys in situations where the United States is an interested party.
Disclosure to third-party contacts in situations where the party to
be contacted has, or is expected to have, information necessary to
establish the validity of evidence or to verify the accuracy of
information presented by the individual concerning his or her
entitlement, the amount of benefit payments, any review of suspected
abuse or fraud, or any concern for program integrity or quality
appraisal.
The DoD `Blanket Routine Uses' set forth at the beginning of OSD's
compilation of systems of records notices apply to this system.
Note: This system of records contains individually identifiable
health information. The DoD Health Information Privacy Regulation
(DoD 6025.18-R) issued pursuant to the Health Insurance Portability
and Accountability Act of 1996, applies to most such health
information. DoD 6025.18-R may place additional procedural
requirements on the uses and disclosures of such information beyond
those found in the Privacy Act of 1974 or mentioned in this system
of records notice.
Policies and practices for storing, retrieving, accessing, retaining,
and disposing of records in the system:
Storage:
Records are maintained on paper, electronic, microfilm, imaging, or
optical formats.
Retrievability:
Information is retrieved by sponsor's Social Security Number and
sponsor's or beneficiary's name.
Safeguards:
Records are maintained in areas accessible only to authorized
personnel who are properly screened, cleared, and trained.
Decentralized automated segments within contractor's operations are
accessible on-line only to authorized persons possessing user
identification codes. Security systems and/or security guards protect
buildings where records are maintained.
Retention and disposal:
Automated indexes are maintained for six years. Hard copy records
are closed out at the end of the calendar year in which finalized and
held six additional years. Where hard copy records have been converted
to electronic, microfilm, imaging, or optical formats, the hard copy is
destroyed and the electronic, microfilm, imaging, or optical format is
[[Page 15707]]
kept by the contractor for six years after claim is processed to
completion.
System manager(s) and address:
TRICARE Management Activity, Department of Defense, Administration
and Evaluation Directorate, 16401 East Centretech Parkway, Aurora, CO
80011-9066.
Notification procedure:
Individuals seeking to determine whether information about
themselves is contained in this system should address written inquiries
to the TRICARE Management Activity, Department of Defense, ATTN:
Privacy Act Officer, 16401 Centretech Parkway, Aurora, CO 80011-9066;
or TRICARE Management Activity Privacy Office, Skyline 5, Suite 810,
5111 Leesburg Pike, Falls Church, VA 22041-3201.
Record access procedures:
Individuals seeking access to information about themselves
contained in this system should address written inquiries to the
TRICARE Management Activity, Department of Defense, ATTN: Privacy Act
Officer, 16401 Centretech Parkway, Aurora, CO 80011-9066; or TRICARE
Management Activity Privacy Office, Skyline 5, Suite 810, 5111 Leesburg
Pike, Falls Church, VA 22041-3201.
Written requests for information should include the full name of
the beneficiary, the full name of the sponsor and sponsor's Social
Security Number, current address and telephone number. For personal
visits to examine records, the individual should provide some
acceptable identification such as a driver's license or other form of
picture identification.
If it is determined that the release of medical information to the
requester could have an adverse effect upon the individual's physical
or mental health, the requester should be prepared to provide the name
and address of a physician who would be willing to receive the medical
record, and at the physician's discretion, inform the individual
covered by the system of the contents of that record. In the event the
physician does not agree to convey the information contained within the
record to the individual, TRICARE Management Activity will take
positive measures to ensure the individual is provided the requested
information.
Contesting record procedures:
The OSD rules for accessing records, for contesting contents and
appealing initial agency determinations are published in OSD
Administrative Instruction 81; 32 CFR part 311; or may be obtained from
the system manager.
Record source categories:
Contractors, Health Benefits Advisors, all branches of the
Uniformed Services, congressional offices, providers of care,
consultants and individuals.
Exemptions claimed for the system:
None.
[FR Doc. 06-3003 Filed 3-28-06; 8:45 am]
BILLING CODE 5001-06-M