2016 US Code
Title 42 - The Public Health and Welfare
Chapter 7 - Social Security
Subchapter XI - General Provisions, Peer Review, and Administrative Simplification
Part A - General Provisions
Sec. 1320a-7n - Disclosure of predictive modeling and other analytics technologies to identify and prevent waste, fraud, and abuse
| 42 U.S.C. § 1320a-7n (2016) |
| §1320a–7n. Disclosure of predictive modeling and other analytics technologies to identify and prevent waste, fraud, and abuse |
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(a) Reference to predictive modeling technologies requirements
For provisions relating to the use of predictive modeling and other analytics technologies to identify and prevent waste, fraud, and abuse with respect to the Medicare program under subchapter XVIII, the Medicaid program under subchapter XIX, and the Children's Health Insurance Program under subchapter XXI, see section 1320a–7m of this title. (b) Limiting disclosure of predictive modeling technologiesIn implementing such provisions under such section 1320a–7m with respect to covered algorithms (as defined in subsection (c)), the following shall apply: (1) Nonapplication of FOIAThe covered algorithms used or developed for purposes of such section 1320a–7m (including by the Secretary or a State (or an entity operating under a contract with a State)) shall be exempt from disclosure under section 552(b)(3) of title 5. A State agency may not use or disclose covered algorithms used or developed for purposes of such section 1320a–7m except for purposes of administering the State plan (or a waiver of the plan) under the Medicaid program under subchapter XIX or the State child health plan (or a waiver of the plan) under the Children's Health Insurance Program under subchapter XXI, including by enabling an entity operating under a contract with a State to assist the State to identify or prevent waste, fraud, and abuse with respect to such programs. A State agency shall have in effect data security and control policies that the Secretary finds adequate to ensure the security of covered algorithms used or developed for purposes of such section 1320a–7m and to ensure that access to such information is restricted to authorized persons for purposes of authorized uses and disclosures described in subparagraph (A). State agencies to which information is disclosed pursuant to such section 1320a–7m shall adhere to uniform procedures established by the Secretary. In this section, the term "covered algorithm"— (1) means a predictive modeling or other analytics technology, as used for purposes of section 1320a–7m(a) of this title to identify and prevent waste, fraud, and abuse with respect to the Medicare program under subchapter XVIII, the Medicaid program under subchapter XIX, and the Children's Health Insurance Program under subchapter XXI; and (2) includes the mathematical expressions utilized in the application of such technology and the means by which such technology is developed. |
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(Aug. 14, 1935, ch. 531, title XI, §1128K, as added Pub. L. 114–198, title VII, §706(a), July 22, 2016, 130 Stat. 753.) |
| United States Code, 2012 Edition, Supplement 4, Title 42 - THE PUBLIC HEALTH AND WELFARE |
| Bills and Statutes |
| United States Code |
| Y 1.2/5: |
| Title 42 - THE PUBLIC HEALTH AND WELFARE CHAPTER 7 - SOCIAL SECURITY SUBCHAPTER XI - GENERAL PROVISIONS, PEER REVIEW, AND ADMINISTRATIVE SIMPLIFICATION Part A - General Provisions Sec. 1320a-7n - Disclosure of predictive modeling and other analytics technologies to identify and prevent waste, fraud, and abuse |
| section 1320a-7n |
| 2016 |
| January 6, 2017 |
| No |
| standard |
| 130 Stat. 753 |
| Public Law 114-198 |
