Next Generation Desktop

The Next Generation Desktop (NGD) is a Centers for Medicare and Medicaid (CMS) Customer Relationship Management (CRM) system. It was created to handle inquiries for the 1-800-Medicare Helpline and the Affordable Care Act (ACA) Federally Facilitated Marketplace (FFM) Helpline. NGD relies on a team of customer service representatives (CSR) to interact with the beneficiaries. Beneficiaries and the general public do not have direct access to the NGD system.

NGD supports the Virtual Call Center Strategy (VCS) initiatives of the CMS Office of Communications, Call Center Operations Group.

The purpose of NGD is: to provide a resource for beneficiaries and future beneficiaries on general information regarding Medicare and ACA coverages so that the beneficiaries can make informed Medicare decisions; to allow CSRs access to information on Medicare and ACA coverages if a beneficiary has a question about their coverage; and to provide a source for CMS to track consumer interactions about eligibility, enrollment, payment questions and general consumer assistance.

The NGD accesses and stores information about Medicare and ACA beneficiaries. This information is transferred from several other CMS systems that maintain their own Privacy Impact Assessments (PIA) and system security for the information in them.

The separate CMS systems are: Fiscal Intermediary Shared System (FISS), Common Working File (CWF), Medicare Beneficiary Record (MBR), Eligibility Database (EDB), Multi-Carrier System (MCS), Viable Medicare Shared System (VMS) and the National Data Warehouse (NDW). 
 
Beneficiary information that NGD accesses includes Medicare Beneficiary Identifier (MBI) or Health Insurance Claim Number (HICN) - as historic information, name, date of birth, sex, employment status, medical claims information (including Medical Records numbers), telephone number, address, and relationship to beneficiary.  Only the beneficiary's MBI or HICN, name, and e-mail address are stored in NGD order to provide support. Access to Medicare beneficiary information requires callers to submit identifying information.

NGD CSRs access general, publicly available Medicare and ACA healthcare information such as medical plans, links to other CMS resources, scripts to respond to general coverage questions, telephone numbers of other CMS resources and providers' names, addresses and phone numbers.

The NGD maintains a caller history log for CMS auditing and evaluation purposes. The information includes length of call, CSR identifiers, MBI and medical claim number (if applicable).

Information collected by NGD for the system support staff, CMS employees and direct contractors, includes their username, password and business email address. The username is provided as part of the employment process and the password is created by the user.

The NGD is a CSR/CSM platform used to interact with Medicare and ACA beneficiaries and the general public that may have questions about Medicare or ACA. NGD accesses beneficiaries' information, general information about Medicare and ACA, limited medical provider information and system user information.

This information is from several other CMS systems that maintain PIAs for the information in them. The separate CMS systems are: Fiscal Intermediary Shared System (FISS), Common Working File (CWF), Medicare Beneficiary Record (MBR), Eligibility Database (EDB), Multi-Carrier System (MCS), Viable Medicare Shared System (VMS) and the National Data Warehouse (NDW). 
 
Beneficiary information that NGD accesses includes Medicare Beneficiary Identifier (MBI) or prior Health Insurance Claim Number (HICN), name, date of birth, sex, employment status, medical claims information (including Medical Records numbers), telephone number, address, and relationship to beneficiary.  Only the beneficiary's MBI or HICN, name, and e-mail address are stored in NGD order to provide support. Access to Medicare beneficiary information requires callers to submit identifying information. PII is accessed by the CSR for the duration of the call to answer questions, any changes are stored temporarily and transferred to the NDW system nightly. As mentioned, NDW is a separate CMS system with its own PIA for the information contained in it.

NGD accesses general Medicare and ACA healthcare information such as medical plans, links to other CMS resources, scripts to respond to general coverage questions, telephone number of other CMS resources and providers' names, addresses and phone numbers. This information is accessible for as long as it is applicable.

The NGD maintains a caller history log for CMS auditing and evaluation purposes. The information includes length of call, CSR identifiers, MBI and medical claim number (if applicable). The history logs are kept in the active NGD database for 3 years after the interactions are set to a status of “Done”. Then, the completed interactions are purged. For calls, completing the interaction usually takes place within a minute or so of the person hanging up.

Information collected by NGD for the system support staff, CMS employees and direct contractors, includes their username, password and business email address. The username is provided as part of the employment process and the password is created by the user. System user information is retained for the duration of the user's employment.

NGD uses PII to retrieve beneficiary records such as name, Medicare number, Medicare Beneficiary Identifier (MBI). System users' username and password are used to log onto the system.

• Name
• E-Mail Address
• Phone Numbers
• Date of Birth
• Mailing Address
• Medical Records Number
• Employment Status
• Other - Medical claims information, Medicare Beneficiary Identifier (MBI), Health Insurance Claim Number (HICN); Username, Password, Sex, Relationship to the Beneficiary.

• Employees
• Public Citizens
• Vendors/Suppliers/Contractors

PII of beneficiaries is used to respond to questions about Medicare or ACA coverage.

The PII of NGD system support staff is used to access the functionality of the system. 

Authority for maintenance of the system is given under sections 1102, 1804(b), and 1851(d) of the Social Security Act (42 United States Code (U.S.C.) 1302, 1395b–2(b), and 1395w– 21(d)), and OMB Circular A–123, Internal Control Systems, and Title 42 U.S.C. section 1395w–21(d) (Pub. L. 105–3, the Balanced Budget Act of 1997).

Patient Protection and Affordable Care Act (PPACA) (Pub. L. 111–148) as amended by the Health Care and Education Reconciliation Act of 2010 (Pub. L. 111–152) collectively the Affordable Care Act. Title 42 U.S.C.18031, 18041, 18081—18083 and section 1414 of the Affordable Care Act.

The Medicare Modernization Act of 2013

5 U.S.C. Section 301 Departmental Regulations

• In-Person
• Online

• Within the OPDIV

• Members of the Public

Prior to assisting a caller, the CSR advises the caller that their personal information may be needed to provide answers to their questions.

When NGD CSRs access the system, they are presented with the CMS warning banner that they are accessing a government system.

NGD support staff (CMS employees and direct contractors) are notified as part of the general employment hire/onboarding process that personal information is needed to work at CMS or to have access to CMS information systems. 

In order to obtain assistance with their benefits, a beneficiary would need to provide some PII to receive accurate assistance. However, a beneficiary can prevent the information about the interaction from being associated with their Medicare records by refusing to provide a Medicare number or a name when calling. The call is then treated as a ‘contact’ call that comes from a member of the general public rather than a call about a specific beneficiary’s healthcare information.

There is a ‘do not call’ option that the beneficiary may activate by simply requesting it when speaking with a CSR. This option is noted and prevents further contact with the beneficiary.

There is no opt-out process for staff that support NGD application. The PII is required to log into the system to perform their job functions. 

The NGD system is a platform to verify a beneficiary's information stored in other CMS systems. There is not a process to notify a beneficiary that major changes have occurred to NGD as changes would not directly impact the PII.

Support staff for NGD are notified of any major changes that occur to the system via email and/ or NGD program meetings. 

A beneficiary can advise the CSR that their PII is inaccurate and can provide updated information over the telephone. If they believe their PII has been inappropriately obtained, used or disclosed they would be directed to contact medicare.gov help desk.

NGD system support staff (CMS employees and direct contractors) would contact either the CMS Help Desk or follow their corporate procedures to report any concerns.

• Users: Users are the Call Center CSRs. They have access to PII to service tAhe calls from Medicare and Marketplace beneficiaries.
• Administrators: Some types of administrators (database, business analyst) may have access to PII to manage user accounts.
• Contractors: In their roles as administrators or call center employees, CMS direct contractors would have access to PII in accordance to the functions of those roles. 

Role-based training is required for each user with significant security responsibilities who access the system. This training is acknowledged via the completion of training documentation prior to accessing the system.

Administrators with elevated privileges are required to complete additional security-specific training on an annual basis.

Additionally, the NGD National Site Administrator (NSA) and Local Site Administrators (LSA) attend training sessions conducted by the NGD Training team and must pass a certification exam prior to accessing NGD.

The NGD system secures PII with the following technical controls; a multi-tiered technology architecture, multiple types and layers of firewalls, intrusion detection technology and encryption of connections/access, multifactor authentication, encryption of data in transit and at rest. 

Administrative controls include strict role-based access, training of personnel, account review and auditing of user activities, including disabling accounts.

The NGD system and supporting infrastructure is housed in a CMS FISMA ATO-ed datacenter. The physical controls include the use of ID badges, pin numbers and access cards, video monitoring of the data centers and 24-hour security guards.