2019 Department of Health and Human Services (HHS) Annual Computer Matching Report

A. Current Composition of the HHS Data Integrity Board (DIB)

B. Matching Agreements HHS Entered Into in 2019

• CMA HHS #1901

Participant Agencies: HHS/Administration for Children and Families (ACF) is the source agency, and State Agency Administering Supplemental Nutrition Assistance Program (SNAP), is the recipient agency.

Title: "Information Comparisons and Disclosures to Assist in Administering the Supplemental Nutrition Assistance Program"

Description: This matching agreement, hereinafter "agreement," governs a matching program between the U.S Department of Health and Human Services, Administration for Children and Families, Office of Child Support Enforcement (OCSE) and the state agency administering the Supplemental Nutrition Assistance Program (SNAP), hereinafter "state agency." This is a standard agreement between OCSE and all state agencies participating in the matching program. OCSE is the "source agency" and the state agency is the "non-federal agency," as defined by the Privacy Act. 5 U.S.C. §552a(a)(9) and (11). OCSE and participating state agencies have entered into matching agreements and renewals since 2009, the latest of which expires August 15, 2019. (See Appendix B of this agreement.) The agreement includes a security addendum and a cost-benefit analysis (See Appendix A of this agreement).

Link posted in the Agency's website: https://www.hhs.gov/sites/default/files/acf-snap-cmd-1901.pdf

Please provide an account of whether the agency has fully adhered to the terms of the matching agreement.

By signing the CMA, OCSE and state SNAP agencies agreed to fully adhere to the terms and conditions of the SNAP-NDNH computer matching program.

Please provide an account of whether all disclosures of agency records for use in the matching program continue to be justified.

After verification of previously unknown income, participating state SNAP agencies collectively reported closing or reducing benefits for 140,535 cases in FY2018. As a result, state SNAP agencies avoided approximately $27,687,975 million in improper payments to SNAP recipients with previously unknown earnings. The savings are attributable to employment and wage information derived from the SNAP-NDNH computer matching program; therefore, the disclosures made for use in the matching program continue to be justified.

Please indicate whether a cost-benefit analysis was performed, the results of the cost-benefit analysis, and an explanation of why the agency proceeded with any matching program for which the results of the cost-benefit analysis did not demonstrate that the program is likely to be cost effective.

The cost-benefit analysis of FY2017 is part of HHS CMA #1901. Collectively, participating state SNAP agencies paid $203,883 in FY2017 fees but avoided approximately $150,744,276 million costs. The FY2017 cost-benefit analysis and subsequent FY2018 performance outcomes demonstrate the cost savings resulting from the SNAP-NDNH matching program exceeds the cost to participate.

• CMA HHS #1905

Participant Agencies: HHS/Centers for Medicare & Medicaid Services (CMS) is the source agency, and Department of Veterans Affairs (VA) is the recipient agency.

Title: "Disclosure of Information to Support the Veteran Affairs' Seek to Prevent Fraud, Waste, and Abuse Initiative"

Description: This matching program establishes the terms, conditions, and procedures under which the Department of Health and Human Services (HHS), Centers for Medicare & Medicaid Services (CMS) will provide certain data to the Department of Veterans Affairs (VA) that supports the VA's Seek to Prevent Fraud, Waste, and Abuse (STOP FWA) initiatives. Under this matching program, VA internal and external providers will be matched against the database of Medicare providers and suppliers who have been revoked by CMS pursuant to 42 Code of Federal Regulations (CFR) § 424.535.

Link posted in the Agency's website:https://www.hhs.gov/sites/default/files/cms-va-cma-1905.pdf

Please provide an account of whether the agency has fully adhered to the terms of the matching agreement.

By signing the CMA, CMS has fully adhered to the terms of the matching agreement.

Please provide an account of whether all disclosures of agency records for use in the matching program continue to be justified.

All disclosures of the records used in this matching program continue to be justified.

Please indicate whether a cost-benefit analysis was performed, the results of the cost-benefit analysis, and an explanation of why the agency proceeded with any matching program for which the results of the cost-benefit analysis did not demonstrate that the program is likely to be cost effective.

A Cost Benefits Analysis was performed and found that the total costs for the matching program are estimated to be $479,716 and total monetary benefits for the matching program are estimated to be $1,032,006 for the 18-month period of the Agreement. However, the matching program does not involve avoiding or recovering improper payments; the $1,032,006 benefit is the amount VA estimates it would cost to use contractors to perform a provider screening process similar to the APS process CMS uses which generates the adverse enrollment actions reflected in PECOS (which costs CMS more than $76 million over a five-year period). Not all anticipated benefits to VA are currently quantifiable, because an initial match has not been previously conducted on which to base an estimate of the potential benefits, Furthermore, some of the adverse actions that VA will take against VA providers as a result of this matching program will concern patient safety issues, which are a moral and ethical imperative, and are non-quantifiable.

Because the four Key Elements of the CBA do not demonstrate that the matching program is likely to be cost-effective, each Data Integrity Board is requested to make a written determination in accordance with 5 U.S.C. $ 552a(u)(4)(B) that a CBA (i.e., cost-effectiveness) is not required to support DIB approval of this agreement and that DIB approval is based on the other benefits stated.

• CMA HHS #1906

Participant Agencies: HHS/Centers for Medicare & Medicaid Services (CMS) is the source agency, and Federal Communications Commission (FCC) is the recipient agency.

Title: "Disclosure of Information to Support Eligibility Determination for Participation in the Federal Lifeline Program"

Description: This matching agreement establishes the terms, conditions, safeguards, and procedures between the Department of Health and Human Services (HHS), Centers for Medicare & Medicaid Services (CMS), and the Federal Communications Commission (FCC) governing the disclosure of Medicaid eligibility information to support eligibility determinations for participation in the Federal Universal Service Fund (USF or Fund) Lifeline Program. The Universal Services Administrative Company (USAC) has been designated by the FCC as the permanent Federal Administrator of the USF programs, including the Lifeline program that is the subject of this Agreement.

This Agreement seeks to ensure that Lifeline program applicants and subscribers are eligible to receive the Lifeline benefit as set forth in 47 Code of Federal Regulations (CFR) § 54.400 et seq. USAC will match Lifeline program applicant or subscriber data against CMS Medicaid data to provide affirmative or negative responses using a secure Automated Programming Interface (API). The results generated by this matching program will serve as one of several data points to verify eligibility of applicants to and subscribers of the USF Lifeline program using the National Lifeline Eligibility Verifier and to further the integrity of the Lifeline program.

Link posted in the Agency's website: https://www.hhs.gov/sites/default/files/cms-fcc-cma-1906.pdf

Please provide an account of whether the agency has fully adhered to the terms of the matching agreement.

By signing the CMA, CMS has fully adhered to the terms of the matching agreement.

Please provide an account of whether all disclosures of agency records for use in the matching program continue to be justified.

All disclosures of the records used in this matching program continue to be justified.

Please indicate whether a cost-benefit analysis was performed, the results of the cost-benefit analysis, and an explanation of why the agency proceeded with any matching program for which the results of the cost-benefit analysis did not demonstrate that the program is likely to be cost effective.

A cost benefit analysis was performed and the results demonstrated that the program is likely to be cost effective.

• CMA HHS #1907

Participant Agencies: HHS/Centers for Medicare & Medicaid Services (CMS) is the source agency, and the Social Security Administration (SSA) is the recipient agency.

Title: "Disclosure of Medicare Non-Utilization Information (Ages 90 and Above)"

Description: This matching program establishes the terms, conditions, and safeguards under which the Centers for Medicare & Medicaid Services (CMS) will disclose to the Social Security Administration (SSA) Medicare non-utilization information for Social Security Title II beneficiaries aged 90 and above.

CMS will identify Medicare enrollees whose records have been inactive for three or more years. SSA will use this data as an indicator to select and prioritize cases for review to determine continued eligibility for benefits under Title II of the Social Security Act (Act). SSA will contact these individuals to verify ongoing eligibility. In addition, SSA will use this data for the purposes of fraud discovery and the analysis of fraud programs operations; this agreement allows for SSA's Office of Anti-Fraud Programs (OAFP) to evaluate the data for the purposes of fraud detection. SSA will refer individual cases of suspected fraud, waste, or abuse to the Office of the Inspector General for investigation.

Link posted in the Agency's website: https://www.hhs.gov/sites/default/files/cms-ssa-cma-1907.pdf

Please provide an account of whether the agency has fully adhered to the terms of the matching agreement.

By signing the CMA, CMS has fully adhered to the terms of the matching agreement.

Please provide an account of whether all disclosures of agency records for use in the matching program continue to be justified.

All disclosures of the records used in this matching program continue to be justified.

Please indicate whether a cost-benefit analysis was performed, the results of the cost-benefit analysis, and an explanation of why the agency proceeded with any matching program for which the results of the cost-benefit analysis did not demonstrate that the program is likely to be cost effective.

A cost benefit analysis was performed and the results demonstrated that the program is likely to be cost effective.

• CMA HHS #1908

Participant Agencies: HHS/Centers for Medicare & Medicaid Services (CMS) is the recipient agency, and the Department of the Treasury (Treasury), Internal Revenue Service (IRS) is the source agency.

Title: "Verification of Household Income and Family Size for Insurance Affordability Programs and Exemptions"

Description: This matching program establishes the terms, conditions, safeguards, and procedures by which Return Information will be provided by the Department of the Treasury (Treasury), Internal Revenue Service (IRS) to the Department of Health and Human Services (HHS), Centers for Medicare & Medicaid Services (CMS), for use by CMS and Administering Entities (AE) in verifying Household Income and Family Size for an Applicant receiving an Eligibility Determination.

Link posted in the Agency's website: https://www.hhs.gov/sites/default/files/cms-irs-aca-cms-1908-508.pdf

Please provide an account of whether the agency has fully adhered to the terms of the matching agreement.

By signing the CMA, CMS has fully adhered to the terms of the matching agreement.

Please provide an account of whether all disclosures of agency records for use in the matching program continue to be justified.

All disclosures of the records used in this matching program continue to be justified.

Please indicate whether a cost-benefit analysis was performed, the results of the cost-benefit analysis, and an explanation of why the agency proceeded with any matching program for which the results of the cost-benefit analysis did not demonstrate that the program is likely to be cost effective.

A cost-benefit analysis was performed. Although the cost-benefit analysis does not demonstrate that this matching program is likely to be cost effective, the program is justified for other reasons, as explained in this section. In accordance with 5 U.S.C. § 552a(u)(4)(B), the DIB may waive the requirements of a cost-benefit analysis if it determines in writing, in accordance with guidelines prescribed by the Director of the Office of Management and Budget, that a cost-benefit analysis is not required.

1. Certain matching programs (such as this matching program with IRS) are required and are not discretionary. However, some other matching programs are based on permissive routine use disclosure authority, not a statutory obligation.
2. The matching programs' verification service results in improved accuracy of consumer Eligibility Determinations, which CMS anticipates will continue to produce expedited Eligibility Determinations while minimizing administrative burdens and achieving operational efficiencies.
3. The matching programs provide a significant net benefit to the public by accurately determining eligibility for insurance affordability programs.
4. An efficient eligibility and enrollment process contributes to greater numbers of consumers enrolling in QHP coverage on the exchanges, resulting in a reduction of the uninsured population, therefore improving overall health care delivery.
5. Continuing to use the current matching program structure, which is less costly than any alternative structure, is expected to increase the public's trust in the participating agencies as stewards of taxpayer dollars.

Further, OMB guidance provides that when a matching program is being negotiated for re-establishment, pursuant to OMB Circular A-108, the Privacy Act "does not require the showing of a favorable ratio for the match to be continued. The intention is to provide Congress with information to help evaluate the cost-effectiveness of statutory matching requirements with a view to revising or eliminating them where appropriate." See OMB Guidelines, 54 Fed. Reg. at 25828.

• CMA HHS #1909

Participant Agencies: HHS/ Administration for Children and Families (ACF) is the source agency, and the Social Security Administration (SSA) is the recipient agency.

Title: "SSI-OCSE Quarterly Match Agreement" and "Online Query for SSI, Disability Insurance, & Ticket-to-Work Agreement"

Description: This matching agreement is to cover the following information exchange operations between OCSE and SSA from the National Directory of New Hires (NDNH): online query access for Supplemental Security Income (SSI), Disability Insurance (DI), and Ticket-to-Work and Self-Sufficiency (Ticket) programs, and SSI Quarterly Wage batch match. This agreement assists SSA in (1) establishing or verifying eligibility or payment amounts, or both under the SSI program; (2) establishing or verifying eligibility or continuing entitlement under the DI program; and (3) administering the Ticket programs.

Link posted in the Agency's website: https://www.hhs.gov/sites/default/files/acf-ssa-cma-1909.pdf

Please provide an account of whether the agency has fully adhered to the terms of the matching agreement.

By signing the CMA, the Social Security Administration agreed to fully adhere to the terms and conditions of the Title II Quarterly Match-NDNH computer matching program.

Please provide an account of whether all disclosures of agency records for use in the matching program continue to be justified.

The Title II-NDNH matching program is justified because SSA's use of NDNH information supports program administration and reduces overpayments. It also satisfies the Government Accountability Office recommendations to improve SSA's ability to effectively identify federal workers who are likely to incur overpayments and to recover debt and avoid overpayments by obtaining more timely earnings information for DI program beneficiaries who may be working. There is no other administrative activity that can accomplish the same purpose and provide the same security safeguards with the same degree of efficiency as the Title II-NDNH matching program.

Please indicate whether a cost-benefit analysis was performed, the results of the cost-benefit analysis, and an explanation of why the agency proceeded with any matching program for which the results of the cost-benefit analysis did not demonstrate that the program is likely to be cost effective.

In FY17 these matching operations result in an overall savings of about $1,218,630,553. The total costs are approximately $303,378,081. These actual savings to the United States Treasury makes this matching operation cost effective with a benefit to cost ratio of 4.02:1; therefore, this match is cost effective.

C. Programs Where Cost/Benefit Analysis was waived

N/A

D. Matching Agreements the DIB Disapproved

N/A

E. Any Violations of Matching Agreements that Have Been Alleged or Identified

N/A