Privacy Act of 1974; Report of New System of Records

Résumé

In accordance with the requirements of the Privacy Act of 1974, CMS is proposing to establish a new system of records (SOR) titled "One Program Integrity Data Repository (ODR)," System No. 09- 70-0568. Section 1893 of the Social Security Act (the Act) established the "Medicare Integrity Program" that requires CMS to contract with eligible entities to "review activities of providers of services or other individuals and entities furnishing items and services for which payment may be made under this title" by utilizing equipment and software technologies. Likewise, section 1893 of the Act requires CMS to establish the Medicare Medicaid Data Match Program (Medi-Medi) in which data from both the Medicare and Medicaid programs are analyzed together to better detect fraud, waste, and abuse existent in these programs. In order to comply with these requirements and enhance our ability to detect fraud, waste, and abuse in Medicare and Medicaid, CMS is proposing to construct the ODR. CMS maintains numerous systems housing Medicare beneficiary Parts A, B, C, and D entitlement, enrollment, and utilization information. Additionally, CMS maintains data on physicians, providers, employer plans, Me