Office of Workers' Compensation Programs, Physicians and Health Care
Providers Excluded under the Energy Employees Occupational Illness Compensation
Program Act.
None.
U.S. Department of Labor, Employment Standards Administration, Office
of Workers' Compensation Programs, Frances Perkins Building, 200 Constitution
Ave., NW, Washington, DC 20210.
Providers of medical goods and services, including physicians,
hospitals, and providers of medical support services or supplies excluded or
considered for exclusion from payment under the Energy Employees Occupational
Illness Compensation Program Act for fraud or abuse (20 CFR §
30.715-30.726, or as updated).
Copies of letters, lists and documents from Federal and state agencies
concerning the administrative debarment of providers from participation in
programs providing benefits similar to those of the Energy Employees
Occupational Illness Compensation Program Act and their reinstatement;
materials concerning possible fraud or abuse which could lead to exclusion of a
provider; documents relative to reinstatement of providers, materials
concerning the conviction of providers for fraudulent activities in connection
with any Federal or state program for which payments are made to providers for
similar medical services; all letters, memoranda, and other documents regarding
the consideration of a provider's exclusion, the actual exclusion, or
reinstatement under the provisions of 20 CFR ºº 30.715-30.726 (or as
updated); copies of all documents in a claim file relating to medical care
and/or treatment including bills for such services, as well as letters,
memoranda, and other documents obtained during investigations, hearings and
other administrative proceedings concerning exclusion for fraud or abuse, as
well as reinstatement, along with recommendations and decisions; lists of
excluded providers released by the OWCP.
Energy Employees Occupational Illness Compensation Program Act, Title
XXXVI of Pub. L. 106-398, October 30, 2000, 114 Stat. 1654.
To maintain records in order to determine the propriety of instituting
debarment actions under the Energy Employees Occupational Illness Compensation
Program Act. These records also provide information on treatment, billing and
other aspects of a medical provider's actions, and/or documentation relating to
the debarment of the medical care provider under another Federal or state
program.
In addition to those universal routine uses listed in the General
Prefatory Statement to this document, disclosure of information from this
system of records may be made to the following individuals and entities for the
purposes noted when the purpose of the disclosure is compatible with the
purpose for which the information is collected:
a. Federal, state or local government agencies, state licensing boards,
professional organizations, claimants, patients, employers, insurance
companies, and any other entities or individuals, for the purpose of
identifying an excluded or reinstated provider, to ensure that authorization is
not issued nor payment made to an excluded provider, and for the purpose of
providing notice that a formerly excluded provider has been reinstated.
b. Federal, state or local government agencies, state licensing boards,
professional organizations, claimants, patients, employers, insurance
companies, and any other entities or individuals, for the purpose of obtaining
information necessary to ensure that the list of excluded providers is correct,
useful, and updated, as appropriate, and for the purpose of obtaining
information relevant to a Departmental decision regarding a debarment action.
This routine use encompasses the disclosure of such information that will
enable the Department to properly verify the identity of a provider, to
identify the nature of a violation, and the penalty imposed for such
violation.
Disclosure of information contained
in the file to the claimant, a person who is duly authorized to act on his/her
behalf, or to others to whom disclosure is authorized by these routine uses,
may be made over the telephone. Disclosure over the telephone will only be done
where the requestor provides appropriate identifying information. Telephonic
disclosure of information is essential to permit efficient administration and
adjudication of claims.
None.
The records are in manual files, magnetic tapes or other computer
storage media, or on computer printouts.
Material is retrieved either by the name of the provider, a case
citation, or date of release.
Files and automated data are maintained under supervision of OWCP
personnel during normal working hours - only authorized personnel, with the
appropriate password, may handle, retrieve, or disclose any information
contained therein. Access to electronic records is controlled by password or
other user identification code.
File is retained in the office for three years after the debarment
action is final and then transferred to the Federal Records Center, and
destroyed thirty years after the debarment action is final. Where the period of
exclusion is defined as a set period of time, the file will be retained two
years after the period of exclusion expires (or the individual is otherwise
reinstated), then transferred to the Federal Records Center, and destroyed
thirty years after the debarment action is final.
Director, Office of Workers' Compensation Programs, 200 Constitution
Avenue, NW, Washington, DC 20210.
An individual wishing to inquire whether this system of records
contains information about him/her may write the system manager at the address
above. In order for the record to be located, the individual must provide his
or her full name, date of birth, and signature.
Any individual seeking access to non-exempt information about a record
within this system of records may write the system manager, and arrangements
will be made to provide review of the file. In order for the record to be
located, the individual must provide his or her full name, date of birth, and
signature.
Any individual requesting amendment of non-exempt records should
contact the system manager. Individuals requesting amendment of records must
comply with the Department's Privacy Act regulations at 29 CFR 71.1 and
71.9.
Information in this system is obtained from Federal, state or local
government agencies, state licensing boards, professional organizations,
claimants, patients, employers, insurance companies, any other entities or
individuals, public documents, and newspapers, as well as from other Department
of Labor systems of records.
In accordance with 5 U.S.C. 552a(k)(2), investigatory material compiled
for law enforcement purposes which is maintained in the investigation files of
the Office of Workers' Compensation Programs, is exempt from subsections
(c)(3), (d), (e)(1), (e)(4)(G), (H), and (I), and (f) of 5 U.S.C. 552a. The
disclosure of information contained in civil investigative files, including the
names of persons and agencies to whom the information has been transmitted,
would substantially compromise the effectiveness of the investigation.
Knowledge of such investigations would enable subjects to take such action as
is necessary to prevent detection of illegal activities, conceal evidence or
otherwise escape civil enforcement action. Disclosure of this information could
lead to the intimidation of, or harm to, informants and witnesses, and their
respective families, and the well being of investigative personnel and their
families.
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