New Routine Use of CMS Systems of Record Afforded Health Plans
June 4, 2013 09:44 AM
The May 29, 2013 Federal Register included a notice from the Centers for Medicare & Medicaid Services (CMS) that it will add twenty-three CMS systems of records “to assist in preventing and detecting fraud, waste and abuse."
According to the notice, the new routine use will authorize CMS to disclose provider and beneficiary-identifiable records to representatives of health plans as defined by the Social Security Act. Included in the list, along with such systems of record as Fiscal Intermediary Shared System (FISS) and the Common Working File (CWF), are the Long Term Care MDS and the HHA Outcome and Assessment Information Set (OASIS).
Health plans are:
“A plan or program that provides health benefits, whether directly or though insurance, or otherwise and includes: (1) a policy of health insurance; (2) a contract of a service benefit organization/ and (3) a membership agreement with a health maintenance organization or other prepaid health plan.”
The Center for Program Integrity at CMS will coordinate the routine use which will become effective 30 days after publication unless comments received result in revision of the notice. The notice and details for submission of comments can be found online here.