09-90-0039 SYSTEMS
LISTING
System name:
National
Disaster Claims Processing System.
Security
classification:
None.
System
location:
Office of
Emergency Preparedness (OEP),
Categories
of individuals covered by the system
Individuals
requiring definitive medical care at an NDMS hospital as the result of a
medical condition caused by, or exacerbated by, a natural or technical
disaster, or a terrorist act.
Categories
of records in the system
Medical claims
data will be in uniform claim forms accepted by the Health Care Financing
Administration (HCFA) for institutional and non-institutional claims. Records
will include: Beneficiaries Name, Social Security Number, Address, Dates of
Care, DRG/CPT, Provider Name, Provider Address, HIPAA Provider Number, Amount
Billed, Amount Allowed, Other Insurance Payment, and Amount to be paid. In
addition information from the providing hospital including the Employer
Identification Number (EIN) and information for submitting electronic payment
will be collected.
Authority
for maintenance of the system
The authority
for maintaining this system of records is from 42 U.S.C. 243(c)(1).
Purpose(s):
To justify and
document reimbursement payments for services provided in connection with the
National Disaster Medical System (NDMS).
Routine
uses of records maintained in the system, including categories of users and the
purposes of such uses:
1.
1.To
a Congressional Office from the records of an individual in response to an
inquiry made from the Congressional Office made at the request of that
individual.
2.
To
the Department of Justice (DOJ), court or other tribunal, or to another party
before such tribunal, when:
a.
HHS
or any component thereof; or
b.
Any
HHS employee in his or her official capacity; or
c.
Any
HHS employee in his or her individual capacity where the Department of Justice
(or HHS where it is authorized to do so) has agreed to represent employee; or
d.
The
United States or any Agency thereof, where HHS determines that the litigation
is likely to affect HHS or any of it's components; is a party to litigation or
has an interest in such litigation, and HHS determines that the use of such
records by the Department of Justice, the tribunal, or other party is relevant
and necessary to the litigation and would help in the effective representation
of the governmental party, however, that in each case, HHS determines that each
disclosure is compatible with the purpose for which the records were collected.
3.
To a
contractor for the purpose of collating, analyzing, aggregating, or otherwise
refining or processing records in this system, or for developing, modifying,
and/or manipulating it with automatic data processing (ADP) software. Data
would also be available to users incidental to consultation, programming,
operation, user assistance, or maintenance for an ADP or telecommunications
system containing or supporting records in the system.
Policies
and practices for storing, retrieving, accessing, retaining, and disposing of
records in the system:
Storage:
Paper and
computer form.
Retrievability:
Information will
be retrieved by beneficiary's name; and may be sorted by medical diagnosis,
geographical area, or medical provider.
Safeguards:
1.
Authorized
Users: Only HHS personnel or HHS contract personnel whose duties require the
use of the system may access the data. In addition, such HHS personnel or
contractors are advised that the information is confidential and the criminal
sanctions for unauthorized disclosure of private information may be applied.
2.
Physical
Safeguards: Physical paper records are stored in locked files cabinets or
secured areas.
3.
Procedural
Safeguards: Employees who maintain records in the system are instructed to
grant access only to authorized users. Data stored in computers are accessed
through the use of passwords known only to authorized personnel. Contractors
who use records in this system are instructed to make no further disclosure of
the records except as authorized by the system manager and permitted by the
Privacy Act. Privacy Act language is in contracts related to this system.
4.
Implementation
Guidelines: HHS Chapter 45-13 of the General Administration Manual, “Safeguarding
Records Contained in Systems of Records and the HHS Automated Information Systems
Security Program Handbook, Information Resources Management Manual.”
Retention
and disposal:
Disposition of
records is according to the National Archives and Records Administration (NARA)
guidelines, as set forth in the Office of Emergency Preparedness Records Management
Manual.
System
manager(s) and address(es):
Chief, National
Disaster Medical System Branch, Office of Emergency Preparedness,
Notification
procedureS:
Inquiries and
requests for system records should be addressed to the system manager at the address
indicated above. The requestor must specify the name, address, and health
insurance number.
Record
access procedures:
Same as
notification procedures. Requesters should also reasonably specify the record
contents being sought. These procedures are in accordance with HHS Regulations
at 45 CFR 5b.5(a)(2) and 45 CFR 5b.6
Contesting
record procedures:
Contact the
system manager named above and reasonably identify the record and specify the
information to be contested. State the reason for contesting the record (e.g.,
why it is inaccurate, irrelevant, incomplete, or not current), the corrective
action being sought, and give any supporting justification. (These procedures
are in accordance with HHS Regulations 45 CFR 5b.7.)
Record
source categories:
Information
contained in these records will be obtained from NDMS hospitals seeking reimbursement
for treatment provided to disaster victims.
Systems
exempted from certain provisions of the act:
None.