20 Cfr 30.701 Eeoicpa

20 CFR 30.701 EEOICPA regs.pdf(2006 clearance).pdf

Pharmacy Billing Requirements

20 CFR 30.701 EEOICPA

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Federal Register / Vol. 67, No. 67 / Monday, April 8, 2002 / Notices
DOL/ESA–48
SYSTEM NAME:

‘‘Customer Service component’’ of the
Wage Hour Investigative Support and
Reporting Database (WHISARD).

SAFEGUARDS:

SECURITY CLASSIFICATION:

Only authorized personnel have
access by use of passwords to this online transactional system and its
database.

Most files and data are unclassified.
Files and data in certain cases have Top
Secret classification, but the rules
concerning their maintenance and
disclosure are determined by the agency
that has given the information the
security classification of Top Secret.

RETENTION AND DISPOSAL:
SECURITY CLASSIFICATION:

None.
SYSTEM LOCATION:

Wage and Hour National Office (NO),
Regional Offices (RO) and District
Offices (DO), see The Appendix of this
document for addresses.
CATEGORIES OF INDIVIDUALS COVERED BY THE
SYSTEM:

Persons who contact the Wage and
Hour Division for technical assistance or
to file a complaint.
CATEGORIES OF RECORDS IN THE SYSTEM:

‘‘Browse Customer List’’ records
containing last name, first name, phone
number, address, city, complaint status,
case identification number, WH
employee name, and contact priority.
‘‘Employee Contact Information’’
records containing home address, phone
numbers, fax number, e-mail address
and certain information about the
individual’s complaint.
‘‘Employee Work Information’’
records containing certain employment
and payroll information about the
individual’s complaint.
AUTHORITY FOR MAINTENANCE OF THE SYSTEM:

PURPOSE(S):

To provide Wage and Hour NO, ROS
and DOs with an index of individuals
who contact the Wage and Hour
Division. This information may be used
to provide assistance or facilitate the
processing of a complaint.
ROUTINE USES OF RECORDS MAINTAINED IN THE
SYSTEM, INCLUDING CATEGORIES OF USERS AND
THE PURPOSES OF SUCH USES:

In addition to the routine uses listed
in the General Prefatory Statement to
this document, relevant information
may be provided to other government
agencies for law enforcement purposes.
DISCLOSURE OF CONSUMER REPORT AGENCIES:

None.
POLICIES AND PRACTICES FOR STORING,
RETRIEVING, ACCESSING, RETAINING AND
DISPOSING OF RECORDS IN THE SYSTEM:

SYSTEM MANAGER(S) AND ADDRESS:

Administrator, Wage and Hour
Division, Room S–3502, Frances Perkins
Building, 200 Constitution Avenue, NW,
Washington, DC 20210.
NOTIFICATION PROCEDURES:

Individuals wishing to make inquiries
regarding this system should contact the
system manager, or the regional office
servicing the state where they are
employed (see list of the regional office
addresses in the Appendix of this
document).
Individuals wishing to request access
to these records should contact the
appropriate office listed in the
Appendix.
CONTESTING RECORD PROCEDURES:

Individuals wishing to contest or
amend any records should direct their
request to the appropriate system
manager. In addition, the request should
state clearly and concisely what
information is being contested, the
reason for contesting it, and the
proposed amendment sought for the
information.
RECORD SOURCE CATEGORIES:

Complainants, employers, and Wage
and Hour personnel.
SYSTEMS EXEMPTED FROM CERTAIN PROVISIONS
OF THE ACT:

None.
DOL/ESA–49

STORAGE:

Maintained in an electronic file
Database in the DOL National Office.
RETRIEVABILITY:

By name of the individual.

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Printed investigation forms generated
by the WHISARD system will be
retained in the investigative files of
Wage and Hour District Offices (see
Records Disposal Schedule #NN–168–
43, items 1a and 1b which provides as
follows: Printed information,
concerning cases where violations were
found, is disposed of 12 years after the
date the case is closed. For cases where
no violation were found, printed
information is disposed of three years
after the closing date. Database
information will be captured on tape at
the end of each fiscal year and retained
for 25 years.

RECORD ACCESS PROCEDURES:

5 U.S.C. 301; 29 U.S.C. 201 et seq.

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SYSTEM NAME:

Office of Workers’ Compensation
Programs, Energy Employees
Occupational Illness Compensation
Program Act File.

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SYSTEM LOCATION:

U.S. Department of Labor,
Employment Standards Administration,
Office of Workers’ Compensation
Programs, Frances Perkins Building, 200
Constitution Ave., NW, Washington, DC
20210, and district offices located
throughout the United States.
CATEGORIES OF INDIVIDUALS COVERED BY THE
SYSTEM:

Individuals or their survivors who
claim benefits under the Energy
Employees Occupational Illness
Compensation Program Act (EEOICPA).
These individuals include, but are not
limited to, federal employees or
survivors of federal employees;
employees or survivors of employees of
the Department of Energy, its
predecessor agencies, and their
contractors and subcontractors; and
members of the armed forces.
CATEGORIES OF RECORDS IN THE SYSTEM:

This system may contain the
following kinds of records: Claim forms
filed by or on behalf of injured
individuals or their survivors seeking
benefits under the EEOICPA; reports by
the employee and/or the U.S.
Department of Energy; employment
records; exposure records; safety records
or other incident reports; dose
reconstruction records; workers’ or
family members contemporaneous
diaries, journals, or other notes; forms
authorizing medical care and treatment;
other medical records and reports; bills
and other payment records;
compensation payment records; formal
orders for or against the payment of
benefits; transcripts of hearings
conducted; and any other medical,
employment, or personal information
submitted or gathered in connection
with the claim. The system may also
contain information relating to dates of
birth, marriage, divorce, and death;
notes of telephone conversations
conducted in connection with the claim;
information relating to vocational and/
or medical rehabilitation plans and
progress reports; records relating to
court proceedings, insurance, banking
and employment; articles from
newspapers and other publications;
information relating to other benefits
(financial and otherwise) the claimant
may be entitled to, including previously

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filed claims; and information received
from various investigative agencies
concerning possible violations of
Federal civil or criminal law.
The system may also contain
consumer credit reports on individuals
indebted to the United States,
information relating to the debtor’s
assets, liabilities, income and expenses,
personal financial statements,
correspondence to and from the debtor,
information relating to the location of
the debtor, and other records and
reports relating to the implementation of
the Federal Claims Collection Act (as
amended), including investigative
reports or administrative review
matters. Individual records listed here
are included in a claim file only insofar
as they may be pertinent or applicable
to the individual claiming benefits.
AUTHORITY FOR MAINTENANCE OF THE SYSTEM:

Energy Employees Occupational
Illness Compensation Program Act, Title
XXXVI of Pub. L. 106–398, October 30,
2000, 114 Stat. 1654.
PURPOSE(S):

To maintain records on individuals
who file claims under the Energy
Employees Occupational Illness
Compensation Program Act, which
establishes a program for compensating
certain individuals for covered illnesses
related to exposure to beryllium,
cancers related to exposure to radiation,
and chronic silicosis. These records
provide information and verification
about individual claimants’ covered
illnesses on which may be based any
entitlement to medical treatment,
compensation and survivors’ benefits,
under the EEOICPA and certain other
statutes.
ROUTINE USES OF RECORDS MAINTAINED IN THE
SYSTEM, INCLUDING CATEGORIES OF USERS AND
THE PURPOSE OF SUCH USES:

In addition to those Department-wide
routine uses set forth above 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 both
relevant and necessary and is
compatible with the purpose for which
the information was collected:
a. To any attorney or other
representative of an EEOICPA
beneficiary for the purpose of assisting
in a claim or litigation against a third
party or parties potentially liable to pay
damages as a result of the beneficiary’s
compensable condition, and for the
purpose of administering the provisions
of sections 3641–3642 of the EEOICPA.

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Any such third party, or a representative
acting on that third party’s behalf, may
be provided information or documents
concerning the existence of a record and
the amount and nature of compensation
paid to or on behalf of the beneficiary
for the purpose of assisting in the
resolution of the claim or litigation
against that party or administering the
provisions of sections 3641–3642 of the
EEOICPA.
b. To the Department of Energy, its
contractors and subcontractors, and
federal agencies that employed the
employee at the time of the alleged
exposure of the employee, and to other
entities that may possess relevant
information, to assist in administering
the EEOICPA, to answer questions about
the status of the claim, to consider other
actions the agency may be required to
take with regard to the claim, or to
permit the agency to evaluate its safety
and health program. Disclosure to
federal agencies, including the
Department of Justice, may be made
where OWCP determines that such
disclosure is relevant and necessary for
the purpose of providing assistance in
regard to asserting a defense based upon
the EEOICPA’s exclusive remedy
provision to an administrative claim or
to litigation filed under the Federal Tort
Claims Act.
c. To the personnel, contractors,
grantees, and cooperative agreement
holders of the Department of Energy, the
Department of Health and Human
Services, the Department of Justice, and
other federal agencies designated by the
President to implement the federal
compensation program established by
the EEOICPA, for the purpose of
assisting in the adjudication or
processing of a claim under that Act.
d. To physicians, pharmacies, and
other health care providers for their use
in treating the claimant, in conducting
an examination or preparing an
evaluation on behalf of OWCP and for
other purposes relating to the medical
management of the claim, including
evaluation of and payment for charges
for medical and related services and
supplies.
e. To medical insurance or health and
welfare plans (or their designees) that
cover the claimant in instances where
OWCP had paid for treatment of a
medical condition that is not
compensable under the EEOICPA, or
where a medical insurance plan or
health and welfare plan has paid for
treatment of a medical condition that
may be compensable under the
EEOICPA, for the purpose of resolving
the appropriate source of payment in
such circumstances.

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f. To a federal, state or local agency
for the purpose of obtaining information
relevant to a determination concerning
initial or continuing eligibility for
EEOICPA benefits, and for a
determination concerning whether
benefits have been or are being properly
paid, including whether dual benefits
that are prohibited under any applicable
federal or state statute are being paid;
and for the purpose of utilizing salary
offset and debt collection procedures,
including those actions required by the
Debt Collection Act of 1982, to collect
debts arising as a result of overpayments
of EEOICPA compensation and debts
otherwise related to the payment of
EEOICPA benefits.
g. To the Internal Revenue Service
(IRS) for the purpose of obtaining
taxpayer mailing addresses for the
purposes of locating a taxpayer to
collect, compromise, or write-off a
federal claim against such taxpayer; and
informing the IRS of the discharge of a
debt owed by an individual. Records
from this system of records may be
disclosed to the IRS for the purpose of
offsetting a federal claim from any
income tax refund that may be due to
the debtor.
h. Where an investigation, settlement
of claims, or the preparation and
conduct of litigation is undertaken, a
record may be disclosed to (1) a person
representing the United States or the
Department of Labor in the
investigation, settlement or litigation,
and to individuals assisting in such
representation; (2) others involved in
the investigation, settlement, and
litigation, and their representatives and
assistants; and (3) a witness, potential
witness, or their representatives and
assistants, and to any other person who
possesses information pertaining to the
matter, when such disclosure is
necessary for the conduct of the
investigation, settlement, or litigation,
or is necessary to obtain information or
testimony relevant to the matter.
i. To the Defense Manpower Data
Center—Department of Defense and the
United States Postal Service to conduct
computer matching programs for the
purpose of identifying and locating
individuals who are receiving Federal
salaries or benefit payments and are
delinquent in their repayment of debts
owed to the United States under
programs administered by the DOL in
order to collect the debts under the
provisions of the Debt Collection Act of
1982 (Pub. L. 97–365) by voluntary
repayment, or by salary or
administrative offset procedures.
j. To a credit bureau for the purpose
of obtaining consumer credit reports
identifying the assets, liabilities,

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expenses, and income of a debtor in
order to ascertain the debtor’s ability to
repay a debt incurred under the FECA,
to collect the debt, or to establish a
payment schedule.
k. The amount, status and history of
overdue debts, the name and address,
taxpayer identification (SSN), and other
information necessary to establish the
identity of a debtor, the agency and
program under which the claim arose,
may be disclosed pursuant to 5 U.S.C.
552a(b)(12) to consumer reporting
agencies as defined by section 603(f) of
the Fair Credit Reporting Act (15 U.S.C.
1681a(f)) or in accordance with section
3(d)(4)(A)(ii) of the Federal Claims
Collection Act of 1966 as amended (31
U.S.C. 3711(f)) for the purpose of
encouraging the repayment of an
overdue debt.
l. To individuals, and their attorneys
and other representatives, and
government agencies, seeking to enforce
a legal obligation on behalf of such
individual or agency, to pay alimony
and/or child support for the purpose of
enforcing such an obligation, pursuant
to an order of a state or local court of
competent jurisdiction, including
Indian tribal courts, within any State,
territory or possession of the United
States, or the District of Columbia or to
an order of a State agency authorized to
issue income withholding notices
pursuant to State or local law or
pursuant to the requirements of section
666(b) of title 42, United States Code, or
for the purpose of denying the existence
of funds subject to such legal obligation.
m. To the spouse, children, parents,
grandchildren, or grandparents of
deceased employees who may be
covered under the EEOICPA to enable
them to determine their eligibility for
benefits under the EEOICPA, and to
inform them of decisions regarding
benefit eligibility, so that they have the
opportunity to take action to protect any
rights they may have as potentially
eligible beneficiaries.
Note: Disclosure of information contained
in this system of records to the subject of the
record, a person who is duly authorized to
act on his or her behalf, or to others to whom
disclosure is authorized by these routine
uses, may be made over the telephone or by
electronic means. Disclosure over the
telephone or by electronic means will only be
done where the requestor provides
appropriate identifying information.
Telephonic or electronic disclosure of
information is essential to permit efficient
administration and adjudication of claims
under the EEOICPA.

taxpayer identification (SSAN), and
other information necessary to establish
the identity of a debtor, the agency and
program under which the claim arose,
may be disclosed pursuant to 5 U.S.C.
552a(b)(12) to consumer reporting
agencies as defined by section 603(f) of
the Fair Credit Reporting Act (15 U.S.C.
1681a(f)) or in accordance with section
3(d)(4)(A)(ii) of the Federal Claims
Collection Act of 1966 as amended (31
U.S.C. 3711(f)) for the purpose of
encouraging the repayment of an
overdue debt.
POLICIES AND PRACTICES FOR STORING,
RETRIEVING, ACCESSING, RETAINING AND
DISPOSING OF RECORDS IN THE SYSTEM:
STORAGE:

Paper case files are maintained in
filing cabinets. Automated data,
including case files that have been
transformed into electronic form, are
stored in computer discs or magnetic
tapes, which are stored in cabinets.
Microfiche is stored in cabinets.
RETRIEVABILITY:

Files and automated data are retrieved
after identification by coded file number
and/or Social Security Number which is
cross-referenced to employee by name,
employer and/or contractor, and date
and nature of injury.
SAFEGUARDS:

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.
RETENTION AND DISPOSAL:

All case files and automated data
pertaining to a claim are destroyed 15
years after the case file has become
inactive. Paper files that have been
scanned to create electronic copies are
destroyed after the copies are verified.
Automated data is retained in its most
current form only, however, and as
information is updated, outdated
information is deleted. Some related
financial records are retained only in
electronic form, and destroyed 6 years
and 3 months after creation or receipt.
SYSTEM MANAGER(S) AND ADDRESS:

Director, Office of Workers’
Compensation Programs, 200
Constitution Avenue, NW, Washington,
DC 20210.

DISCLOSURE TO CONSUMER REPORTING
AGENCIES:

NOTIFICATION PROCEDURES:

The amount, status and history of
overdue debts, the name and address,

An individual wishing to inquire
whether this system of records contains

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information about him/her may write or
telephone the OWCP district office that
services the state in which the
individual resided or worked at the time
he or she believes a claim was filed. In
order for the record to be located, the
individual must provide his or her full
name, OWCP claim number (if known),
date of injury (if known), and date of
birth.
RECORD ACCESS PROCEDURES:

Any individual seeking access to nonexempt information about a case in
which he/she is a party in interest may
write or telephone the OWCP district
office where the case is located, or the
systems manager.
CONTESTING RECORD PROCEDURES:

Any individual requesting
amendment of non-exempt records
should contact the appropriate OWCP
district office, or 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.
RECORD SOURCE CATEGORIES:

Injured employees who are the
subjects of the record, their family
members and beneficiaries; employing
Federal agencies; State governments,
State agencies, and other Federal
agencies; State and Federal workers’
compensation offices; physicians and
other medical professionals; hospitals;
clinics; medical laboratories; suppliers
of health care products and services and
their agents and representatives;
educational institutions; attorneys;
Members of Congress; OWCP field
investigations; consumer credit reports;
investigative reports; correspondence
with the debtor including personal
financial statements; records relating to
hearings on the debt; and other DOL
systems of records.
SYSTEMS EXEMPTED FROM CERTAIN PROVISIONS
OF THE ACT:

In accordance with 5 U.S.C.
552a(k)(2), investigative material in this
system of records compiled for law
enforcement purposes is exempt from
subsections (c)(3), (d), (e)(1), (e)(4)(G),
(H) and (I), and (f) of 5 U.S.C. 552a,
provided, however, that if any
individual is denied any right, privilege,
or benefit that he or she would
otherwise be entitled to by Federal law,
or for which he or she would otherwise
be eligible, as a result of the
maintenance of these records, such
material shall be provided to the
individual, except to the extent that the
disclosure of the material would reveal
the identity of a source who furnished
information to the Government under an

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express promise that the identity of the
source would be held in confidence, or
prior to January 1, 1975, under an
implied promise that the identity of the
source would be held in confidence.
DOL/ESA–50

Office of Workers’ Compensation
Programs, Physicians and Health Care
Providers Excluded under the Energy
Employees Occupational Illness
Compensation Program Act.

PURPOSE(S):

SECURITY CLASSIFICATION:

None.
SYSTEM LOCATION:

U.S. Department of Labor,
Employment Standards Administration,
Office of Workers’ Compensation
Programs, Frances Perkins Building, 200
Constitution Ave., NW, Washington, DC
20210.
CATEGORIES OF INDIVIDUALS COVERED BY THE
SYSTEM:

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).
CATEGORIES OF RECORDS IN THE SYSTEM:

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 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

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AUTHORITY FOR MAINTENANCE OF THE SYSTEM:

Energy Employees Occupational
Illness Compensation Program Act, Title
XXXVI of Pub. L. 106–398, October 30,
2000, 114 Stat. 1654.

SYSTEM NAME:

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reinstatement, along with
recommendations and decisions; lists of
excluded providers released by the
OWCP.

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.
ROUTINE USES OF RECORDS MAINTAINED IN THE
SYSTEM, INCLUDING CATEGORIES OF USERS AND
THE PURPOSE OF SUCH USES:

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.
Note: Disclosure of information contained
in the file to the claimant, a person who is

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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.
DISCLOSURE TO CONSUMER REPORTING
AGENCIES:

None.
POLICIES AND PROCEDURES FOR STORING,
RETRIEVING, ACCESSING, RETAINING, AND
DISPOSING OF RECORDS IN THIS SYSTEM:
STORAGE:

The records are in manual files,
magnetic tapes or other computer
storage media, or on computer
printouts.
RETRIEVABILITY:

Material is retrieved either by the
name of the provider, a case citation, or
date of release.
SAFEGUARDS:

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.
RETENTION AND DISPOSAL:

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.
SYSTEM MANAGER(S) AND ADDRESS:

Director, Office of Workers’
Compensation Programs, 200
Constitution Avenue, NW, Washington,
DC 20210.
NOTIFICATION PROCEDURE:

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.

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