Effective 09/08/94 (59 FR 46439)
SOCIAL SECURITY ADMINISTRATION
NOTICE OF SYSTEM OF RECORDS
REQUIRED BY THE PRIVACY ACT OF 1974
System name: Health Insurance Overpayment Ledger Cards,
Security classification: None.
System location: PSCs (see Appendix A to this publication for
Social Security Administration
Office of Disability Operations
1500 Woodlawn Drive
Baltimore, MD 21241
Categories of individuals covered by the system: All
Social Security HI and SMI enrollees prior to 1982 who received
incorrect Medicare payments or services, who are determined
liable, and against whom it is not possible to adjust subsequent
Part A (Hospital) or Part B (Supplementary Medical) benefits or
who request adjustment of title II benefits to collect incorrect
Categories of records in the system: A clerical record of each
overpaid Medicare benefit; name and address of the individual(s)
involved; recovery efforts made and the date of each action and
planned future actions.
Authority for maintenance of the system: Sections 1814, 1833 and
1870 of the Act.
Purpose(s): The users of this system are selected employees of
SSA's PSC's and ODO.
The information recorded by the PSC's is used to maintain control
of Medicare overpayments referred from the HHS, HCFA for recovery
action in cases in which HCFA is unable to recoup the overpayment
by adjusting subsequent Medicare benefits or the beneficiary
requests that SSA adjust versus his title II benefits. The
information on the ledger cards was used to produce periodic
accounting, management and statistical reports.
Routine uses of records maintained in the system, including
categories of users and the purposes of such uses: Disclosure
may be made for routine uses as indicated below:
- To a congressional office in response to an inquiry from
that office made at the request of the subject of a record.
- Information may be disclosed to contractors and other
Federal agencies, as necessary, for the purpose of assisting
SSA in the efficient administration of its programs. We
contemplate disclosing information under this routine use
only in situations in which SSA may enter a contractual or
similar agreement with a third party to assist in
accomplishing an agency function relating to this system of
- Nontax return information which is not restricted from
disclosure by Federal law may be disclosed to GSA and NARA
for the purpose of conducting records management studies
with respect to their duties and responsibilities under 44
U.S.C. 2904 and 2906, as amended by NARA Act of 1984.
- To DOJ, a court or other tribunal, or another party before
such tribunal when:
- the SSA, any component thereof; or
- any SSA employee in his/her official capacity; or
- any SSA employee in his/her individual capacity where
DOJ (or SSA where it is authorized to do so) has agreed
to represent the employee; or
- the United States or any agency thereof where SSA
determines that the litigation is likely to affect the
operations of SSA or any of its components,
is a party to litigation or has an interest in such
litigation, and SSA determines that the use of such records
by DOJ, the court or other tribunal is relevant and
necessary to the litigation, provided, however, that in each
case, SSA determines that such disclosure is compatible with
the purpose for which the records were collected.
Wage and other information which are subject to the
disclosure provisions of the IRC (26 U.S.C. 6103) will not
be disclosed under this routine use unless disclosure is
expressly permitted by the IRC.
- To student volunteers and other workers, who technically do
not have the status of Federal employees, when they are
performing work for SSA as authorized by law, and they need
access to personally identifiable information in SSA records
in order to perform their assigned Agency functions. ( date
pub. in FR-(9/8/94)-A.Matthews)
Policies and practices for storing, retrieving, accessing,
retaining, and disposing of records in the system:
Storage: Card stock in metal cabinets.
Retrievability: The records in this system are retrieved by SSN.
Safeguards: Records protected through standard security means
for all of SSA's clerical records (e.g., cabinets are locked
after hours, limited access to buildings and limited access by
authorized employees who have a need for the records in the
performance of their official duties). (See Appendix G
to this publication for additional
information relating to safeguards SSA employs to protect
Retention and disposal:
Records are transferred to the FRC after data is converted to the "Recovery of
Overpayments, Accounting and Reporting System, 60-0094."
The FRC retains the data for 4 years and then destroys it by shredding.
System manager(s) and address:
Office of Claims and Payment Requirements
Office of Systems Requirements
Social Security Administration
6401 Security Boulevard
Baltimore, MD 21235
Notification procedure: An individual can determine if this
system contains a record about him/her by providing name and SSN
and following the procedures below. (Furnishing the SSN is
voluntary, but it will make searching for an individual's record
easier and avoid delay.)
If the requested records relate to a Retirement or Survivors
Insurance claim, the individual should contact the appropriate
PSC (based on SSN) (see Appendix A for address and SSN
If the individual named in the record resides outside the
United States or its possessions, contact should be made to SSA's
International PSC (see Appendix A for address information).
If the requested records relate to a DI claim, the individual
should write to SSA's ODO (see Appendix B for address
When requesting notification, an individual should provide his or
her name, SSN and reference this system.
An individual requesting notification of records in person need
not furnish any special documents of identity. Documents he/she
would normally carry on his/her person would be sufficient
(e.g., credit cards, driver's license, or voter registration
card). An individual requesting notification via mail or
telephone must furnish a minimum of his/her name, date of birth,
and address in order to establish identity, plus any additional
information specified in this section. These procedures are in
accordance with HHS Regulations 45 CFR Part 5b.
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 45 CFR Part 5b.
Contesting record procedures: Same as notification procedures.
Requesters should also reasonably identify the record, specify
the information they are contesting and state the corrective
action sought and the reasons for the correction with supporting
justification showing how the record is incomplete, untimely,
inaccurate or irrelevant. These procedures are in accordance
with HHS Regulations 45 CFR Part 5B.
Record source categories: The information is received indirectly
from the providers of Medicare services through HCFA and directly
from HCFA as a result of their audit procedures.
Systems exempted from certain provisions of the Privacy Act: