Privacy Act of 1974; Report of a New System of Records

Résumé

In accordance with the requirements of the Privacy Act of 1974, we propose to create a new system of records titled, "Medicare True Out-of-Pocket (TrOOP) Expenditures System," HHS/CMS/OIS, System No. 09-70-0557. The TrOOP facilitation process is mandated by the Medicare Prescription Drug Benefit Program enacted into law December 8, 2003 under provisions of Section 101 of Title 1 of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA) (Pub. L. 108-173). MMA amends Title XVIII, Section 1860D of the Social Security Act (the Act). Section 1860D-2 of the Act requires the tracking of beneficiaries' TrOOP expenditures. TrOOP costs are treated as "incurred" only if they were paid by the individual (or by another person, such as a family member, on behalf of the individual), paid on behalf of a low-income subsidy-eligible individual under the Sec. 1860D-14 provisions, or paid under a State Pharmaceutical Assistance Program (SPAP) as defined in Sec. 1860D-23. Section 1860D- 2(b)(4)(D)(i) of the MMA authorizes CMS to establish procedures for determining whether costs for Part D enrollees are being reimbursed by excluded payers and alerting Part D plans about the ex