[Federal Register: October 13, 2006 (Volume 71, Number 198)]
[Notices]
[Page 60536-60540]
From the Federal Register Online via GPO Access [wais.access.gpo.gov]
[DOCID:fr13oc06-85]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
Privacy Act of 1974; Report of a Modified or Altered System
AGENCY: Department of Health and Human Services (HHS), Centers for
Medicare & Medicaid Services (CMS).
ACTION: Notice of a Modified or Altered System of Records (SOR).
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SUMMARY: In accordance with the requirements of the Privacy Act of
1974, we are proposing to modify or alter an existing system of records
titled, ``Provider Enrollment, Chain, and Ownership System (PECOS),''
System No. 09-70-0532, established at 66 Federal Register 51961
(October 11, 2001). PECOS will collect information provided by the
applicant related to identity, qualifications, practice locations,
ownership, billing agency information, reassignment of benefits,
electronic funds transfer, the national provider identifier (NPI), and
related organizations. PECOS will also maintain information on business
owners, chain home offices and provider/chain associations, managing/
directing employees, partners, authorized and delegated
representatives, supervising physicians of the supplier, staffing
companies, ambulance vehicle information, and/or interpreting
physicians and related technicians.
We propose to modify existing routine use number 1 that permits
disclosure to agency contractors and consultants to include disclosure
to CMS grantees who perform a task for the agency. CMS grantees,
charged with completing projects or activities that require CMS data to
carry out that activity, are classified separate from CMS contractors
and/or consultants. The modified routine use will remain as routine use
number 1. We will delete routine use number 3 authorizing disclosure to
support constituent requests made to a congressional representative. If
an authorization for the disclosure has been obtained from the data
subject, then no routine use is needed. The Privacy Act allows for
disclosures with the ``prior written consent'' of the data subject.
We propose to add a routine use to assist an individual or
organization for research, evaluation or epidemiological projects
related to the prevention of disease or disability, or the restoration
or maintenance of health, and for payment related projects. The
proposed routine use will be numbered as routine use number 3. We will
broaden the scope of routine uses number 5 and 6, authorizing
disclosures to combat fraud and abuse in the Medicare and Medicaid
programs to include combating ``waste'' which refers to specific
beneficiary/recipient practices that result in unnecessary cost to all
federally-funded health benefit programs.
We are modifying the language in the remaining routine uses to
provide a proper explanation as to the need for the routine use and to
provide clarity to CMS's intention to disclose individual-specific
information contained in this system. The routine uses will then be
prioritized and reordered according to their usage. We will also take
the opportunity to update any sections of the system that were affected
by the recent reorganization or because of the impact of the Medicare
Prescription Drug, Improvement, and Modernization Act of 2003 (MMA)
(Public Law 108-173) provisions and to update language in the
administrative sections to correspond with language used in other CMS
SORs.
The primary purpose of the SOR is to: (1) Collect information for
an applying provider/supplier and record the associations between the
applicant and those who have an ownership or control interest in the
entity; (2) permit informed enrollment decisions to be made based on
past and present business history, any reported exclusions, sanctions
and felonious behavior at their location or in multiple contractor
jurisdictions; and, (3) ensure that correct payments are made under the
Medicare program. Information retrieved from this SOR will also be
disclosed to: (1) Support regulatory, reimbursement, and policy
functions performed within the Agency or by a contractor, consultant,
or CMS grantee; (2) assist another Federal or state agency, agency of a
state government, an agency established by state law, or its fiscal
agent; (3) assist an individual or organization for research,
evaluation, or epidemiological projects; (5) support litigation
involving the Agency; and (5) combat fraud, waste, and abuse in certain
health benefits programs. We have provided background information about
the modified system in the Supplementary Information section below.
Although the Privacy Act requires only that CMS provide an opportunity
for interested persons to comment on the routine uses, CMS invites
comments on all portions of this notice. See Effective Dates section
for comment period.
DATES: Effective Dates: CMS filed a modified or altered system report
with the Chair of the House Committee on Government Reform and
Oversight, the Chair of the Senate Committee on Homeland Security &
Governmental Affairs, and the Administrator, Office of Information and
Regulatory Affairs, Office of Management and Budget (OMB) on October 5,
2006. To ensure that all parties have adequate time in which to
comment, the modified system, including routine uses, will become
effective 30 days from the publication of the notice, or 40 days from
the date it was submitted to OMB and Congress, whichever is later,
unless CMS receives comments that require alterations to this notice.
ADDRESSES: The public should address comments to: CMS Privacy Officer,
Division of Privacy Compliance, Enterprise Architecture and Strategy
Group, Office of Information Services, CMS, Room N2-04-27, 7500
Security
[[Page 60537]]
Boulevard, Baltimore, Maryland 21244-1850. Comments received will be
available for review at this location, by appointment, during regular
business hours, Monday through Friday from 9 a.m.-3 p.m., eastern time
zone.
FOR FURTHER INFORMATION CONTACT: Alisha Banks, Health Insurance
Specialist, Division of Provider/Supplier Enrollment, Program Integrity
Group, Office of Financial Management, CMS, C3-02-16, 7500 Security
Boulevard, Baltimore, Maryland 21244-1850. Ms. Banks can be reached by
telephone at 410-786-0671, or by e-mail at alisha.banks@cms.hhs.gov.
SUPPLEMENTARY INFORMATION:
I. Description of the Modified or Altered System of Records
A. Statutory and Regulatory Basis for System
The Authority for maintenance of the system is given under
provisions of sections 1102(a) (Title 42 U.S.C. 1302(a)), 1128 (42
U.S.C. 1320a-7), 1814(a)) (42 U.S.C. 1395f(a)(1), 1815(a) (42 U.S.C.
1395g(a)), 1833(e) (42 U.S.C. 1395I(3)), 1871 (42 U.S.C. 1395hh), and
1886(d)(5)(F), (42 U.S.C. 1395ww(d)(5)(F) of the Social Security Act;
1842(r) (42 U.S.C. 1395u(r)); section 1124(a)(1) (42 U.S.C. 1320a-
3(a)(1), and 1124A (42 U.S.C. 1320a-3a), section 4313, as amended, of
the BBA of 1997; and section 31001(i) (31 U.S.C. 7701) of the DCIA
(Pub. L. 104-134), as amended.
B. Collection and Maintenance of Data in the System
PECOS will collect information provided by an applicant related to
identity, qualifications, practice locations, ownership, billing agency
information, reassignment of benefits, electronic funds transfer, the
NPI and related organizations. PECOS will also maintain information on
business owners, chain home offices and provider/chain associations,
managing/directing employees, partners, authorized and delegated
officials, supervising physicians of the supplier, staffing companies,
ambulance vehicle information, and/or interpreting physicians and
related technicians.
This system of records will contain the names, social security
numbers (SSN), date of birth (DOB), and employer identification numbers
(EIN) and NPI's for each disclosing entity, owners, as well as
managing/directing employees, with 5 percent or more ownership or
control interest. Managing/directing employees include general manager,
business managers, administrators, directors, and other individuals who
exercise operational or managerial control over the provider/supplier.
The system will also contain Medicare identification numbers (i.e.,
UPIN, OSCAR, PIN and the NPI), demographic data, professional data,
past and present business history as well as information regarding any
adverse actions such as exclusions, sanctions, and felonious behavior.
II. Agency Policies, Procedures, and Restrictions on the Routine Use
A. The Privacy Act permits us to disclose information without an
individual's consent if the information is to be used for a purpose
that is compatible with the purpose(s) for which the information was
collected. Any such disclosure of data is known as a ``routine use.''
The government will only release PECOS information that can be
associated with an individual as provided for under ``Section III.
Proposed Routine Use Disclosures of Data in the System.'' Both
identifiable and non-identifiable data may be disclosed under a routine
use.
We will only collect the minimum personal data necessary to achieve
the purpose of PECOS. CMS has the following policies and procedures
concerning disclosures of information that will be maintained in the
system. Disclosure of information from this system will be approved
only to the extent necessary to accomplish the purpose of the
disclosure and only after CMS:
1. Determines that the use or disclosure is consistent with the
reason that the data is being collected, e.g., to collect information
for an applying provider/supplier and record the associations between
the applicant and those who have an ownership or control interest in
the entity.
2. Determines:
a. That the purpose for which the disclosure is to be made can only
be accomplished if the record is provided in individually identifiable
form;
b. That the purpose for which the disclosure is to be made is of
sufficient importance to warrant the potential effect and/or risk on
the privacy of the individual that additional exposure of the record
might bring; and
c. That there is a strong probability that the proposed use of the
data would in fact accomplish the stated purpose(s).
3. Requires the information recipient to:
a. Establish administrative, technical, and physical safeguards to
prevent unauthorized use of disclosure of the record; and
b. Remove or destroy at the earliest time all patient-identifiable
information.
4. Determines that the data are valid and reliable.
III. Proposed Routine Use Disclosures of Data in the System
A. The Privacy Act allows us to disclose information without an
individual's consent if the information is to be used for a purpose
that is compatible with the purpose(s) for which the information was
collected. Any such compatible use of data is known as a ``routine
use.'' The proposed routine uses in this system meet the compatibility
requirement of the Privacy Act. We are proposing to establish the
following routine use disclosures of information maintained in the
system:
1. To support agency contractors, consultants, or grantees, who
have been engaged by the agency to assist in the performance of a
service related to this collection and who need to have access to the
records in order to perform the activity.
We contemplate disclosing information under this routine use only
in situations in which CMS may enter into a contractual or similar
agreement with a third party to assist in accomplishing CMS function
relating to purposes for this system.
CMS occasionally contracts out certain of its functions when doing
so would contribute to effective and efficient operations. CMS must be
able to give a contractor, consultant or grantee whatever information
is necessary for the contractor or consultant to fulfill its duties. In
these situations, safeguards are provided in the contract prohibiting
the contractor, consultant or grantee from using or disclosing the
information for any purpose other than that described in the contract
and requires the contractor, consultant or grantee to return or destroy
all information at the completion of the contract.
2. To assist another Federal or state agency, agency of a state
government, an agency established by state law, or its fiscal agent to:
a. Contribute to the accuracy of CMS's proper payment of Medicare
benefits,
b. Enable such agency to administer a Federal health benefits
program, or as necessary to enable such agency to fulfill a requirement
of a Federal statute or regulation that implements a health benefits
program funded in whole or in part with federal funds, and/or
c. Evaluate and monitor the quality of home health care and
contribute to the accuracy of health insurance operations.
Other Federal or state agencies in their administration of a
Federal health program may require PECOS information in order to
support
[[Page 60538]]
evaluations and monitoring of reimbursement for services provided.
3. To assist an individual or organization for research, evaluation
or epidemiological projects related to the prevention of disease or
disability, or the restoration or maintenance of health, and for
payment related projects.
The collected data will provide the research, evaluation and
epidemiological projects a broader, longitudinal, national perspective
of the data. CMS anticipates that many researchers will have legitimate
requests to use these data in projects that could ultimately improve
the care provided to Medicare patients and the policy that governs the
care. CMS understands the concerns about the privacy and
confidentiality of the release of data for a research use. Disclosure
of data for research and evaluation purposes may involve aggregate data
rather than individual-specific data.
4. To support the Department of Justice (DOJ), court or
adjudicatory body when:
a. The agency or any component thereof, or
b. Any employee of the agency in his or her official capacity, or
c. Any employee of the agency in his or her individual capacity
where the DOJ has agreed to represent the employee, or
d. The United States Government, is a party to litigation or has an
interest in such litigation, and by careful review, CMS determines that
the records are both relevant and necessary to the litigation and that
the use of such records by the DOJ, court or adjudicatory body is
compatible with the purpose for which the agency collected the records.
Whenever CMS is involved in litigation, and occasionally when
another party is involved in litigation and CMS's policies or
operations could be affected by the outcome of the litigation, CMS
would be able to disclose information to the DOJ, court or adjudicatory
body involved.
5. To assist a CMS contractor (including, but not necessarily
limited to fiscal intermediaries and carriers) that assists in the
administration of a CMS-administered health benefits program, or to a
grantee of a CMS-administered grant program, when disclosure is deemed
reasonably necessary by CMS to prevent, deter, discover, detect,
investigate, examine, prosecute, sue with respect to, defend against,
correct, remedy, or otherwise combat fraud, waste, or abuse in such
program.
We contemplate disclosing information under this routine use only
in situations in which CMS may enter into a contractual relationship or
grant with a third party to assist in accomplishing CMS functions
relating to the purpose of combating fraud, waste, and abuse.
CMS occasionally contracts out certain of its functions and makes
grants when doing so would contribute to effective and efficient
operations. CMS must be able to give a contractor or grantee whatever
information is necessary for the contractor or grantee to fulfill its
duties. In these situations, safeguards are provided in the contract
prohibiting the contractor or grantee from using or disclosing the
information for any purpose other than that described in the contract
and requiring the contractor or grantee to return or destroy all
information.
6. To assist another Federal agency or to an instrumentality of any
governmental jurisdiction within or under the control of the United
States (including any State or local governmental agency), that
administers, or that has the authority to investigate potential fraud,
waste, or abuse in, a health benefits program funded in whole or in
part by Federal funds, when disclosure is deemed reasonably necessary
by CMS to prevent, deter, discover, detect, investigate, examine,
prosecute, sue with respect to, defend against, correct, remedy, or
otherwise combat fraud, waste, or abuse in such programs.
Other agencies may require PECOS information for the purpose of
combating fraud, waste, and abuse in such Federally funded programs.
IV. Safeguards
CMS has safeguards in place for authorized users and monitors such
users to ensure against excessive or unauthorized use. Personnel having
access to the system have been trained in the Privacy Act and
information security requirements. Employees who maintain records in
this system are instructed not to release data until the intended
recipient agrees to implement appropriate management, operational and
technical safeguards sufficient to protect the confidentiality,
integrity and availability of the information and information systems
and to prevent unauthorized access.
This system will conform to all applicable Federal laws and
regulations and Federal, HHS, and CMS policies and standards as they
relate to information security and data privacy. These laws and
regulations may apply but are not limited to: the Privacy Act of 1974;
the Federal Information Security Management Act of 2002; the Computer
Fraud and Abuse Act of 1986; the Health Insurance Portability and
Accountability Act of 1996; the E-Government Act of 2002, the Clinger-
Cohen Act of 1996; the Medicare Modernization Act of 2003, and the
corresponding implementing regulations. OMB Circular A-130, Management
of Federal Resources, Appendix III, Security of Federal Automated
Information Resources also applies. Federal, HHS, and CMS policies and
standards include but are not limited to: all pertinent National
Institute of Standards and Technology publications; the HHS Information
Systems Program Handbook and the CMS Information Security Handbook.
V. Effects of the Modified System of Records on Individual Rights
CMS proposes to modify this system in accordance with the
principles and requirements of the Privacy Act and will collect, use,
and disseminate information only as prescribed therein. Data in this
system will be subject to the authorized releases in accordance with
the routine uses identified in this system of records.
CMS will take precautionary measures (see item IV above) to
minimize the risks of unauthorized access to the records and the
potential harm to individual privacy or other personal or property
rights of patients whose data are maintained in the system. CMS will
collect only that information necessary to perform the system's
functions. In addition, CMS will make disclosure from the proposed
system only with consent of the subject individual, or his/her legal
representative, or in accordance with an applicable exception provision
of the Privacy Act. CMS, therefore, does not anticipate an unfavorable
effect on individual privacy as a result of information relating to
individuals.
Dated: October 4, 2006.
Charlene Frizzera,
Acting Chief Operating Officer, Centers for Medicare & Medicaid
Services.
System No. 09-70-0532
SYSTEM NAME:
``Provider Enrollment, Chain, and Ownership System (PECOS), HHS/
CMS/OFM''
SECURITY CLASSIFICATION:
Level Three Privacy Act Sensitive Data
SYSTEM LOCATION:
The Centers for Medicare & Medicaid Services (CMS) Data Center,
7500 Security Boulevard, North Building, First Floor, Baltimore,
Maryland 21244-
[[Page 60539]]
1850 and South Building, Baltimore, Maryland 21244-1850.
CATEGORIES OF INDIVIDUALS COVERED BY THE SYSTEM:
PECOS will collect information provided by an applicant related to
identity, qualifications, practice locations, ownership, billing agency
information, reassignment of benefits, electronic funds transfer, the
national provider identifier (NPI) and related organizations. PECOS
will also maintain information on business owners, chain home offices
and provider/chain associations, managing/directing employees,
partners, authorized and delegated officials, supervising physicians of
the supplier, staffing companies, ambulance vehicle information, and/or
interpreting physicians and related technicians.
CATEGORIES OF RECORDS IN THE SYSTEM:
This system of records will contain the names, social security
numbers (SSN), date of birth (DOB), and employer identification numbers
(EIN) and NPI's for each disclosing entity, owners, as well as
managing/directing employees, with 5 percent or more ownership or
control interest. Managing/directing employees include general manager,
business managers, administrators, directors, and other individuals who
exercise operational or managerial control over the provider/supplier.
The system will also contain Medicare identification numbers (i.e.,
UPIN, OSCAR, PIN and the NPI), demographic data, professional data,
past and present business history as well as information regarding any
adverse actions such as exclusions, sanctions, and felonious behavior.
AUTHORITY FOR MAINTENANCE OF THE SYSTEM:
The Authority for maintenance of the system is given under
provisions of sections 1102(a) (Title 42 U.S.C. 1302(a)), 1128 (42
U.S.C. 1320a-7), 1814(a)) (42 U.S.C. 1395f(a)(1), 1815(a) (42 U.S.C.
1395g(a)), 1833(e) (42 U.S.C. 1395I(3)), 1871 (42 U.S.C. 1395hh), and
1886(d)(5)(F), (42 U.S.C. 1395ww(d)(5)(F) of the Social Security Act;
1842(r) (42 U.S.C. 1395u(r)); section 1124(a)(1) (42 U.S.C. 1320a-
3(a)(1), and 1124A (42 U.S.C. 1320a-3a), section 4313, as amended, of
the BBA of 1997; and section 31001(i) (31 U.S.C. 7701) of the DCIA
(Pub. L. 104-134), as amended.
PURPOSE(S) OF THE SYSTEM:
The primary purpose of the SOR is to: (1) Collect information for
an applying provider/supplier and record the associations between the
applicant and those who have an ownership or control interest in the
entity; (2) permit informed enrollment decisions to be made based on
past and present business history, any reported exclusions, sanctions
and felonious behavior at their location or in multiple contractor
jurisdictions; and, (3) ensure that correct payments are made under the
Medicare program. Information retrieved from this SOR will also be
disclosed to: (1) Support regulatory, reimbursement, and policy
functions performed within the Agency or by a contractor, consultant,
or CMS grantee; (2) assist another Federal or state agency, agency of a
state government, an agency established by state law, or its fiscal
agent; (3) assist an individual or organization for research,
evaluation, or epidemiological projects; (5) support litigation
involving the Agency; and (5) combat fraud, waste, and abuse in certain
health benefits programs.
ROUTINE USES OF RECORDS MAINTAINED IN THE SYSTEM, INCLUDING CATEGORIES
OR USERS AND THE PURPOSES OF SUCH USES:
The Privacy Act allows us to disclose information without an
individual's consent if the information is to be used for a purpose
that is compatible with the purpose(s) for which the information was
collected. Any such compatible use of data is known as a ``routine
use.'' The proposed routine uses in this system meet the compatibility
requirement of the Privacy Act. We are proposing to establish the
following routine use disclosures of information maintained in the
system:
1. To support agency contractors, consultants, or grantees, who
have been engaged by the agency to assist in the performance of a
service related to this collection and who need to have access to the
records in order to perform the activity.
2. To assist another Federal or state agency, agency of a state
government, an agency established by state law, or its fiscal agent to:
a. Contribute to the accuracy of CMS's proper payment of Medicare
benefits,
b. Enable such agency to administer a Federal health benefits
program, or as necessary to enable such agency to fulfill a requirement
of a Federal statute or regulation that implements a health benefits
program funded in whole or in part with federal funds, and/or
c. Evaluate and monitor the quality of home health care and
contribute to the accuracy of health insurance operations.
3. To assist an individual or organization for research, evaluation
or epidemiological projects related to the prevention of disease or
disability, or the restoration or maintenance of health, and for
payment related projects.
4. To support the Department of Justice (DOJ), court or
adjudicatory body when:
a. The agency or any component thereof, or
b. Any employee of the agency in his or her official capacity, or
c. Any employee of the agency in his or her individual capacity
where the DOJ has agreed to represent the employee, or
d. The United States Government, is a party to litigation or has an
interest in such litigation, and by careful review, CMS determines that
the records are both relevant and necessary to the litigation and that
the use of such records by the DOJ, court or adjudicatory body is
compatible with the purpose for which the agency collected the records.
5. To assist a CMS contractor (including, but not necessarily
limited to fiscal intermediaries and carriers) that assists in the
administration of a CMS-administered health benefits program, or to a
grantee of a CMS-administered grant program, when disclosure is deemed
reasonably necessary by CMS to prevent, deter, discover, detect,
investigate, examine, prosecute, sue with respect to, defend against,
correct, remedy, or otherwise combat fraud, waste, or abuse in such
program.
6. To assist another Federal agency or to an instrumentality of any
governmental jurisdiction within or under the control of the United
States (including any State or local governmental agency), that
administers, or that has the authority to investigate potential fraud,
waste, or abuse in, a health benefits program funded in whole or in
part by Federal funds, when disclosure is deemed reasonably necessary
by CMS to prevent, deter, discover, detect, investigate, examine,
prosecute, sue with respect to, defend against, correct, remedy, or
otherwise combat fraud, waste, or abuse in such programs.
POLICIES AND PRACTICES FOR STORING, RETRIEVING, ACCESSING, RETAINING,
AND DISPOSING OF RECORDS IN THE SYSTEM:
STORAGE:
All records are stored on paper and magnetic disk.
RETRIEVABILITY:
Magnetic media records are retrieved by the name of the employees
or other authorized individual and/or card key number. Paper records
are retrieved alphabetically by name.
SAFEGUARDS:
CMS has safeguards in place for authorized users and monitors such
[[Page 60540]]
users to ensure against excessive or unauthorized use. Personnel having
access to the system have been trained in the Privacy Act and
information security requirements. Employees who maintain records in
this system are instructed not to release data until the intended
recipient agrees to implement appropriate management, operational and
technical safeguards sufficient to protect the confidentiality,
integrity and availability of the information and information systems
and to prevent unauthorized access.
This system will conform to all applicable Federal laws and
regulations and Federal, HHS, and CMS policies and standards as they
relate to information security and data privacy. These laws and
regulations may apply but are not limited to: the Privacy Act of 1974;
the Federal Information Security Management Act of 2002; the Computer
Fraud and Abuse Act of 1986; the Health Insurance Portability and
Accountability Act of 1996; the E-Government Act of 2002, the Clinger-
Cohen Act of 1996; the Medicare Modernization Act of 2003, and the
corresponding implementing regulations. OMB Circular A-130, Management
of Federal Resources, Appendix III, Security of Federal Automated
Information Resources also applies. Federal, HHS, and CMS policies and
standards include but are not limited to: all pertinent National
Institute of Standards and Technology publications; the HHS Information
Systems Program Handbook and the CMS Information Security Handbook.
RETENTION AND DISPOSAL:
CMS will retain identifiable data for a total period of 15 years
from the date the information was collected.
SYSTEM MANAGERS AND ADDRESS:
Director, Division of Provider/Supplier Enrollment, Office of
Financial Management, CMS, 7500 Security Boulevard, Baltimore, Maryland
21244-1850.
NOTIFICATION PROCEDURE:
For purpose of access, the subject individual should write to the
system manager who will require the system name, SSN, EIN, and for
verification purposes, the subject individual's name (woman's maiden
name, if applicable).
RECORD ACCESS PROCEDURE:
For purpose of access, use the same procedures outlined in
Notification Procedures above. Requestors should also reasonably
specify the record contents being sought. (These procedures are in
accordance with Department regulation 45 CFR 5b.5(a)(2).)
CONTESTING RECORD PROCEDURES:
The subject individual should contact the system manager named
above, and reasonably identify the record and specify the information
to be contested. State the corrective action sought and the reasons for
the correction with supporting justification. (These procedures are in
accordance with Department regulation 45 CFR 5b.7.)
RECORD SOURCE CATEGORIES:
Information contained in this system is received from the Form(s)
CMS 855A, ``Medicare Enrollment Application for Institutional
Providers,'' CMS 855B, ``Medicare Enrollment Application for Clinic/
Group Practices and Certain Other Providers,'' CMS 855I, ``Medicare
Enrollment Application for Physician and Non-Physician Practitioners,''
CMS 855R, ``Medicare Enrollment Application for Reassignment of
Medicare Benefits,'' and CMS 855S, ``Medicare Enrollment Application
for Durable Medial Equipment, Prosthetics, Orthotics, and Supplies
(DMEPOS).''
SYSTEMS EXEMPTED FROM CERTAIN PROVISIONS OF THE ACT:
None.
[FR Doc. E6-16954 Filed 10-12-06; 8:45 am]
BILLING CODE 4120-03-P