CMS-10496.Supporting Statement Part A

Supporting Statement – Part A

Supporting Statement for Paperwork Reduction Act Submission
State Health Insurance Exchange Incident Report
A. Background
As part of the privacy and security oversight of State Health Insurance Exchanges the States will
be required to report security incidents including breaches of personally identifiable information
(PII). This reporting will be made by completing and electronically submitting the State Health
Insurance Exchange Security Incident Report (Incident Report), or providing identical information
telephonically.
B. Justification
1 . Need and Legal Basis
45 CFR part 155 (attached) implements the Affordable Insurance Exchanges (“Exchanges”)
consistent with Title I of the Patient Protection and Affordable Care Act of 2010, referred to
collectively as the Affordable Care Act. Section 155.260 describes Exchange requirements
regarding the privacy and security of personally identifiable information (PII) including the
establishment and implementation of standards consistent with the principle of accountability
(Section 155.260(a)(3)(viii). The accountability principle “should be implemented, and
adherence assured, through appropriate monitoring and other means and methods should be in
place to report and mitigate non-adherence and breaches.”
For the purposes of oversight and monitoring PII safeguards the Centers for Medicare &
Medicaid Services (CMS) will execute a Computer Matching Agreement (CMA) with the
State-Based Administering Entities1 (AEs). The CMA includes a requirement for AEs to
report suspected or confirmed security incidents2 affecting loss or suspected loss of PII within
one hour of discovery to their designated CCIIO State Officer who will then notify the
affected Federal agency data sources, i.e., Internal Revenue Service, Department of Defense,
Department of Homeland Security, Social Security Administration, Peace Corps, Office of
Personnel Management and Veterans Health Administration. The Incident Report will be
used by the States to communicate breaches to CMS.
1 Administering Entities (AEs) are state entities administering Insurance Affordability Programs and who will use the
data, accessed through the CMS Data Services Hub (Hub), to make Eligibility Determinations for Insurance
Affordability Programs and certificates of exemption.
2 A security incident means the act of violating an explicit or implied security policy, which includes attempts (either
failed or successful) to gain unauthorized access to a system or its data, unwanted disruption or denial of service, the
unauthorized use of a system for the processing or storage of data; and changes to system hardware, firmware or
software without the owner’s knowledge, instruction or consent. An incident becomes a breach when PII is involved.

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2.

Information Users
The information collected will be used by CMS conduct oversight of incidents occurring at
the State Exchanges.

3.

Use of Information Technology
States may submit Incident Reports by either completing the form either handwritten or
electronically, and submitting it via email, or by calling the designated CMS Center for
Consumer Information and Insurance Oversight (CCIIO) State Officer and providing the
information verbally. These reporting options allow 24 hour submission of reports. It is
anticipated that approximately 90% of all reports will be submitted electronically.
Respondents are not required to sign the report.

4.

Duplication of Efforts
This information collection does not duplicate any other effort and the information cannot be
obtained from any other source.

5.

Small Businesses
This collection of information will not impact small businesses or other small entities.

6.

Less Frequent Collection
This data collection is essential to ensuring that incidents, which include breaches of PII, are
captured expeditiously. In the absence of this reporting, incidents may not be detected and
mitigated, thereby placing the public at a high risk of identity fraud and other misuses of the
information.

7.

Special Circumstances
Incident Reports must be submitted upon detection of the actual or suspected incident.
Reporting less frequently increases the risk to the public for identity fraud and other misuses
of the information.

8.

Federal Register/Outside Consultation
The emergency Federal Register notice published on August 21, 2013.

9.

Payments/Gifts to Respondents

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Not Applicable
10. Confidentiality
CMS will comply with all Privacy Act (5 U.S.C. §552a), Freedom of Information laws
(5 U.S.C. 552) and regulations (45 C.F.R. Part 5b; 45 C.F.R. Part 5
11. Sensitive Questions
There are not sensitive questions associated with this collection.
12. Burden Estimates (Hours & Wages)
The cost per respondent per form was determined using the follow wage:

$ 42.93 per hour (Information Security Analyst wage Per BLS)
18 respondents x 0.25 hour reporting burden/report x 52 reports/year
= 234 hours annual burden
234 hours x $42.93/hr wage = $10,045.62
States have never provided this type of reporting to CMS in the past. Estimates are based on
similar processes used within the Agency.
13. Capital Costs
There is no capital cost associated with this collection.
14. Cost to Federal Government
Incident Reports will be processed in the normal course of Federal duties. 6 FTE’s GS13,
41.00 hr x2=82x6=$502.00
15. Changes to Burden
Not Applicable
16. Publication/Tabulation Dates
This collection of information will not be published.
17. Expiration Date

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CMS would like an exemption from displaying the expiration date as these forms are used on
a continuing basis.
18. Certification Statement
There are no exceptions to item 19 of OMB Form 83-I.

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