PII Attachment 1

Attachment 1

(Personally Identifiable Information)

The Medicare Prescription Drug Benefit, Improvement and Modernization Act of 2003 (MMA) requires the collection of Personally Identifiable Information (PII) for eligibility and payments under Medicare Part B. The CMS “Policy for Privacy Act Implementation & Breach Notification (Document Number: CMS-CIO-POL-PRIV01-01), July 23, 2007” contains the Privacy Impact Assessment (PIA) for safeguarding the collection and storage of PII.

The beneficiary’s Social Security Number (SSN), i.e., Health Insurance Claim Number, is electronically collected. The SSN is used to established eligibility to Medicare Part B as required in SEC. 1851 of the Act and CFR 42 Part 422 Subpart B § 422.50. The beneficiary’s health status data (e.g., Diagnoses Codes) is also electronically collected as required under CFR 42 Part 422 Subpart G § 422.310. The health data is collected to ensure that payment calculations are accurate as required under SEC. 1853 of the Act and CFR 42 Part 422 Subpart G § 422.300.