Scenario 6:

As with each of our scenarios, this is a hypothetical which intentionally places potentially controversial fictional transactions into the setting of existing law, in order to both a) support technical development of an automated transparency and accountability system and b) help to identify changes in law or policy which may be necessary or advisable.

Transaction Data:

This transaction log is from

the Department of Health and Human Services,

Centers for Medicare and Medicaid Services (CMS).

Rebecca Crumpler

voluntarily enrolls in the

Detroit office

Cancer Prevention and Treatment Demonstration for Ethnic and Racial Minorities System (CPTD)

of CMS

by signing her name on an enrollment form.

Alan Turing

is employed as a Researcher

at CMS.

Turing enters

Rebecca Crumpler's name

into the CPTD computer system.

The CPTD system

automatically runs a program

that searches for information

about Rebecca Crumpler

on the internet.

CPTD finds the following information about Rebecca Crumpler

and transfers each item, and the link where it was found, into its own system:

This collection is for the purpose of

establishing demographics of the volunteer participants and

to see if there is any health-related data.

The results are delivered to Turing

who decides the system should keep all the data

except the political opinions, which are deleted.

Turing gets a request for religion data

from the Executive Office of the President

which is trying to decide if this program

should become a faith-based initiative

when the grant funds are up for renewal.


Department of Health and Human Services (HHS)

Centers for Medicare and Medicaid Services (CMS)

Published a System of Records Notice (SORN) at

70 FR 57602


on October 3, 2005

noticing the creation of a new System of Records:

Cancer Prevention and Treatment Demonstration for Ethnic and Racial Minorities System,

also known as CPTD

also known as System No. 09–70–0560

Legal authority:

Public Law (Pub. L.) 106–554, Section 122

("Medicare, Medicaid, and State Children’s Health Insurance Program (SCHIP) Benefits Improvement and Protection Act of 2000" (BIPA))


Health and welfare

"...authority to award at least nine cooperative agreement demonstration projects that will identify methods to reduce disparities

in early cancer screening, diagnosis, and treatment

for Black, Hispanic, Asian American and Pacific Islander, and American Indian (including Alaskan Native, Eskimo, and Aleut)

Medicare beneficiary populations."

"use the best available scientific evidence

to identify promising models of cancer screening, diagnosis and

treatment interventions to promote health and appropriate utilization of Medicare covered services,

eliminate disparities in cancer detection and treatment among ethnic and racial populations of Medicare beneficiaries, and

provide information to improve the effectiveness of the Medicare program."



and cancer health-related data

on Medicare target population beneficiaries

who voluntarily enroll

in the CPTD Project for Ethnic and Racial Minorities."


#not explicitly stated

Routine Use 1

RU1 data-recipient:

#not explicitly stated

RU-1 data-category

#not explicitly stated

RU-1 authorized-purpose

Support regulatory, reimbursement, and policy functions

performed within the agency or by a contractor, grantee, consultant or other legal agent;

Routine Use 2

RU-2 data-recipient:

another Federal or state agency

RU-2 data-category


RU-2 authorized-purpose

health and welfare

# "enable such agency to administer a Federal health benefits program, or

# " to enable such agency to fulfill a requirement of Federal statute or regulation that implements a health benefits program

# "funded in whole or in part with Federal funds;"

Routine Use 3

RU-3 data-recipient:

individual or organization

RU-3 data-category

#not explicitly stated

RU-3 authorized-purpose

assist a party engaged in the performance activities of the demonstration or

in a research project or

in support of an evaluation project

related to the prevention of disease or disability,

the restoration or maintenance of health, or

payment related projects;

Routine Use 4

RU-4 data-recipient:

#not explicitly stated

RU-4 data-category

#not explicitly stated

RU-4 authorized-purpose

support constituent requests made to a congressional representative;

#similar purpose as in FBI and USM RUs

Routine Use 5

RU-5 data-recipient:

#not explicitly stated

RU-5 data-category

#not explicitly stated

RU-5 authorized-purpose

support litigation involving the agency;

#similar purpose as in FBI and USM RUs

Routine Use 6

RU-6 data-recipient:

#not explicitly stated

RU-6 data-category

#not explicitly stated

RU-6 authorized-purpose

combat fraud and abuse in certain health benefits programs.