[Federal Register Volume 77, Number 191 (Tuesday, October 2, 2012)]
[Notices]
[Pages 60129-60130]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2012-24119]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Indian Health Service
60-Day Proposed Information Collection: Indian Health Service
Forms To Implement the Privacy Rule; Request for Public Comment
AGENCY: Indian Health Service, HHS.
ACTION: Notice.
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SUMMARY: In compliance with Section 3506(c)(2)(A) of the Paperwork
Reduction Act of 1995, which requires 60 days for public comment on
proposed information collection projects, the Indian Health Service
(IHS) is publishing for comment a summary of a proposed information
collection to be submitted to the Office of Management and Budget (OMB)
for review.
Proposed Collection: Title: 0917-0030, ``IHS Forms to Implement the
Privacy Rule (45 CFR Parts 160 & 164)''. Type of Information Collection
Request: Extension, without revisions, of currently approved
information collection, 0917-0030, ``IHS Forms to Implement the Privacy
Rule (45 CFR Parts 160 & 164)''. Form Number(s): IHS-810, IHS-912-1,
IHS-912-2, IHS-913 and IHS-917. Need and Use of Information Collection:
This collection of information is made necessary by the Department of
Health and Human Services Rule entitled ``Standards for Privacy of
Individually Identifiable Health Information'' (Privacy Rule) (45 CFR
parts 160 and 164). The Privacy Rule implements the privacy
requirements of the Administrative Simplification subtitle of the
Health Insurance Portability and Accountability Act of 1996, creates
national standards to protect individual's personal health information,
and gives patients increased access to their medical records. 45 CFR
164.508, 164.522, 164.526 and 164.528 of the Rule require the
collection of information to implement these protection standards and
access requirements. The IHS will continue to use the following data
collection instruments to meet the information collection requirements
contained in the Rule.
45 CFR 164.508: This provision requires covered entities to obtain
or receive a valid authorization for its use or disclosure of protected
health information for other than for treatment, payment and healthcare
operations. Under the provision individuals may initiate a written
authorization permitting covered entities to release their protected
health information to entities of their choosing. The form IHS-810
``Authorization for Use or Disclosure of Protected Health Information''
is used to document an individual's authorization to use or disclose
their protected health information.
45 CFR 164.522: Section 164.522(a)(1) requires a covered entity to
permit individuals to request that the covered entity restrict the use
and disclosure of their protected health information. The covered
entity may or may not agree to the restriction. The form IHS-912-1
``Request for Restrictions(s)'' is used to document an individual's
request for restriction of their protected health information, and
whether IHS agreed or disagreed with the restriction. Section
164.522(a)(2) permits a covered entity to terminate its agreement to a
restriction if the individual agrees to or requests the termination in
writing. The form IHS-912-2 ``Request for Revocation of
Restriction(s)'' is used to document the agency or individual request
to terminate a formerly agreed to restriction regarding the use and
disclosure of protected health information.
45 CFR 164.528 and 45 CFR 5b.9(c): This provision requires covered
entities to permit individuals to request that the covered entity
provide an accounting of disclosures of protected health information
made by the covered entity. The form IHS-913 ``Request for an
Accounting of Disclosures'' is used to document an individual's request
for an accounting of disclosures of their protected health information
and the agency's handling of the request.
45 CFR 164.526: This provision requires covered entities to permit
an individual to request that the covered entity amend protected health
information. If the covered entity accepts the requested amendment, in
whole or in part, the covered entity must inform the individual that
the amendment is accepted. If the covered entity denies the requested
amendment, in whole or in part, the covered entity must provide the
individual with a written denial. The form IHS-917 ``Request for
Correction/Amendment of Protected Health Information'' will be used to
document an individual's request to amend their protected health
information and the agency's decision to accept or deny the request.
Completed forms used in this collection of information are filed in the
IHS medical, health and billing record, a Privacy Act System of Records
Notice. Affected Public: Individuals and households. Type of
Respondents: Individuals. Burden Hours: The table below provides the
estimated burden hours for this information collection:
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Average burden
Data collection instrument Number of Responses per hour per Total annual
respondents respondent response * burden hours
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Authorization for Use or Disclosure of Protected 500,000 1 20/60 166,667
Health Information (OMB Form No. 0917-0030, IHS-
810)...........................................
Request for Restriction(s) (OMB Form No. 0917- 15,000 1 10/60 2,500
0030, IHS-912-1)...............................
Request for Revocation of Restriction(s) (OMB 5,000 1 10/60 833
Form No. 0917-0030, IHS-912-2).................
Request for Accounting of Disclosures (OMB Form 15,000 1 10/60 2,500
No. 0917-0030, IHS-913)........................
Request for Correction/Amendment of Protected 7,500 1 15/60 1,875
Health Information (OMB Form No. 0917-0030, IHS-
917)...........................................
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Total Annual Burden......................... .............. 5 .............. 174,375
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* For ease of understanding, burden hours are provided in actual minutes.
[[Page 60130]]
The total estimated burden for this collection of information is
174,375 hours. There are no capital costs, operating costs and/or
maintenance costs to respondents.
Request for Comments: Your written comments and/or suggestions are
invited on one or more of the following points: (a) Whether the
information collection activity is necessary to carry out an agency
function; (b) whether the agency processes the information collected in
a useful and timely fashion; (c) the accuracy of public burden estimate
(the estimated amount of time needed for individual respondents to
provide the requested information); (d) whether the methodology and
assumptions used to determine the estimate are logical; (e) ways to
enhance the quality, utility, and clarity of the information being
collected; and (f) ways to minimize the public burden through the use
of automated, electronic, mechanical, or other technological collection
techniques or other forms of information technology.
Send Comments and Requests for Further Information: Send your
written comments and requests for more information on the proposed
collection or requests to obtain a copy of the data collection
instrument(s) and instructions to: Tamara Clay, IHS Reports Clearance
Officer, 801 Thompson Avenue, TMP, Suite 450, Rockville, MD 20852, call
non-toll free (301) 443-1611, send via facsimile to (301) 443-2316, or
send your email requests, comments, and return address to:
[email protected].
Comment Due Date: Your comments regarding this information
collection are best assured of having their full effect if received
within 60 days of the date of this publication.
Dated: September 20, 2012.
Yvette Roubideaux,
Director, Indian Health Service.
[FR Doc. 2012-24119 Filed 10-1-12; 8:45 am]
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