[Federal Register Volume 79, Number 97 (Tuesday, May 20, 2014)]
[Notices]
[Pages 28970-28971]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2014-11579]
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NATIONAL TRANSPORTATION SAFETY BOARD
Notice of National Transportation Safety Board Public Health
Authority Status
AGENCY: National Transportation Safety Board (NTSB).
ACTION: Notice.
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SUMMARY: The NTSB is publishing this notice to inform health care
providers, including hospitals, health plans, and other health
organizations, of the NTSB's status as a ``public health authority''
under the health care privacy requirements of the Health Insurance
Portability and Accountability Act of 1996 (HIPAA).
FOR FURTHER INFORMATION CONTACT: David Tochen, General Counsel, (202)
314-6080.
SUPPLEMENTARY INFORMATION:
[[Page 28971]]
I. Background
The NTSB is an independent Federal agency with statutory
responsibility for investigating and determining the probable causes of
all civil aviation and certain railroad, highway, marine, hazardous
materials, and pipeline accidents and incidents. See 49 U.S.C. 1116,
1131. Through its comprehensive public reports on transportation
accidents and incidents and safety recommendations, the NTSB protects
and promotes public health and safety by helping prevent recurrences of
accidents and injuries to the hundreds of millions of Americans who
travel or are employed in the nation's channels of transportation each
year. The NTSB has issued more than 13,000 safety recommendations since
its establishment in 1967.
The NTSB possesses statutory authority to obtain information in
investigations by subpoena and ``may inspect any record, process,
control, or facility related to an accident investigation.'' Id.
Sec. Sec. 1113(a)(1), 1134(a)(2). The NTSB may also ``order an autopsy
to be performed and have other tests made when necessary to investigate
an accident.'' Id. Sec. 1134(f)(1). In any accident investigation,
NTSB staff obtains relevant information through a variety of means,
including voluntary measures, subpoenas, and testimony at public
investigative hearings.
II. HIPAA Privacy Rule
Congress enacted HIPAA (Pub. L. 104-191, 110 Stat. 1936 (1996)) to
create and strengthen national standards for the privacy of Americans'
health information, among several other major purposes. In response to
a mandate in section 264(c)(1) of HIPAA, the U.S. Department of Health
and Human Services (HHS) in 2000 finalized a set of regulatory
requirements to protect health information privacy. See Standards for
Privacy of Individually Identifiable Health Information, 65 FR 82462
(Dec. 28, 2000), as amended, 78 FR 5566 (Jan 25, 2013). These
requirements, described collectively as the HIPAA Privacy Rule (Privacy
Rule) and codified in relevant part at 45 CFR parts 160 and 164, govern
uses and disclosures of individuals' health information by ``covered
entities'': health care providers, health plans, and health care
clearinghouses. 45 CFR 160.103.
The Privacy Rule generally limits a covered entity's ability to
disclose an individual's protected health information to another
person. See id. Sec. 164.502(a). An exception to this general
prohibition expressly permits a covered entity to disclose protected
health information without the individual's authorization or
opportunity to object to a
public health authority that is authorized by law to collect or
receive such information for the purpose of preventing or
controlling disease, injury, or disability, including, but not
limited to, the reporting of disease, injury, vital events such as
birth or death, and the conduct of public health surveillance,
public health investigations, and public health interventions. . . .
Id. Sec. 164.512(b)(1)(i). The Privacy Rule defines a ``public health
authority'' as
an agency or authority of the United States, a State, a territory, a
political subdivision of a State or territory, or an Indian tribe,
or a person or entity acting under a grant of authority from or
contract with such public agency, including the employees or agents
of such public agency or its contractors or persons or entities to
whom it has granted authority, that is responsible for public health
matters as part of its official mandate.
Id. Sec. 164.501. In the preamble to the final Privacy Rule, HHS
described the definition of ``public health authority'' as a ``broad''
definition, commensurate with a ``broad Congressional mandate [in
HIPAA] not to interfere with current public health practices'' under
State public health laws. 65 FR 82624.
III. NTSB Public Health Authority Status
The NTSB is a public health authority for purposes of the HIPAA
Privacy Rule. HHS specifically cited the NTSB as an example of a public
health authority in the preamble to a notice of proposed rulemaking
(NPRM) on the Privacy Rule in 1999; the preamble included the NTSB in
an illustrative list of several ``government agencies and entities
[that] carry out public health activities in the course of their
missions.'' Standards for Privacy of Individually Identifiable Health
Information, 64 FR 59918, 59956 (Nov. 3, 1999). The definition of
``public health authority'' adopted in the final rule does not differ
in any relevant respect from the definition contemplated in the
NPRM.\1\ In the 14 years since publication of the final Privacy Rule,
the NTSB's status as a public health authority has facilitated the
Board's access to information that substantially assisted the Board in
issuing safety recommendations that prevented accidents and injuries
and saved lives.
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\1\ In relevant part, the final rule modified the proposed
definition of ``public health authority'' ``slightly to clarify that
a `public health authority' also includes a person or entity acting
under a grant of authority from or contract with a public health
agency.'' 65 FR 82497. The final rule also added language to the
provision authorizing disclosures to a public health authority to
permit disclosures to a foreign government agency acting in
collaboration with a public health authority. See 65 FR 82525.
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Moreover, as HHS noted in the NPRM, NTSB's activities, by design,
``reduce mortality and injury by making recommendations for safety
improvements,'' 64 FR 59956, and fall well within the ambit of public
health activities conducted ``for the purpose of preventing or
controlling . . . injury,'' 45 CFR 164.512(b)(1)(i). NTSB
investigations thoroughly examine causal and contributing factors in
transportation accidents and incidents, including human factors such as
fatigue among crewmembers, so regulators, transportation operators, and
other stakeholders may implement appropriate measures to prevent the
accidents and incidents from recurring. NTSB investigations also
examine the nature and extent of accident victims' injuries so that the
Board may issue appropriate recommendations to improve the
crashworthiness of transportation vehicles and to improve accidents'
survivability. Finally, the NTSB examines emergency responses to
transportation accidents to identify measures that could mitigate
injuries and prevent deaths in the future.
Dated: May 14, 2014.
Christopher A. Hart,
Acting Chairman.
[FR Doc. 2014-11579 Filed 5-19-14; 8:45 am]
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