[Federal Register Volume 77, Number 139 (Thursday, July 19, 2012)]
[Notices]
[Pages 42555-42556]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2012-17506]


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DEPARTMENT OF VETERANS AFFAIRS

[OMB Control No. 2900-0260]


Proposed Information Collection (Request for and Authorization To 
Release Medical Records or Health Information) Activity: Comment 
Request

AGENCY: Veterans Health Administration, Department of Veterans Affairs.

ACTION: Notice.

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SUMMARY: The Veterans Health Administration (VHA) is announcing an 
opportunity for public comment on the proposed collection of certain 
information by the agency. Under the Paperwork Reduction Act (PRA) of 
1995, Federal agencies are required to publish notice in the Federal 
Register concerning each proposed collection of information, including 
each proposed revision of a currently approved collection, and allow 60 
days for public comment in response to the notice. This notice solicits 
comments on information needed to obtain a patient written consent to 
disclose medical records or health information to individuals or third 
parties.

DATES: Written comments and recommendations on the proposed collection 
of information should be received on or before September 17, 2012.

ADDRESSES: Submit written comments on the collection of information 
through the Federal Docket Management System (FDMS) at 
www.Regulations.gov; or to Cynthia Harvey-Pryor, Veterans Health 
Administration (10P7BFP), Department of Veterans Affairs, 810 Vermont 
Avenue NW., Washington, DC 20420 or email: [email protected]. 
Please refer to ``2900-0260'' in any correspondence. During the comment 
period, comments may be viewed online through FDMS.

FOR FURTHER INFORMATION CONTACT: Cynthia Harvey-Pryor (202) 461-5870 or 
Fax (202) 273-9387.

SUPPLEMENTARY INFORMATION: Under the PRA of 1995 (Pub. L. 104-13; 44 
U.S.C. 3501-3521), Federal agencies must obtain approval from the 
Office of Management and Budget (OMB) for each collection of 
information they conduct or sponsor. This request for comment is being 
made pursuant to Section 3506(c)(2)(A) of the PRA.
    With respect to the following collection of information, VHA 
invites comments on: (1) Whether the proposed collection of information 
is necessary for the proper performance of VHA's functions, including 
whether the information will have practical utility; (2) the accuracy 
of VHA's estimate of the burden of the proposed collection of 
information; (3) ways to enhance the quality, utility, and clarity of 
the information to be collected; and (4) ways to minimize the burden of 
the collection of information on respondents, including through the use 
of automated collection techniques or the use of other forms of 
information technology.
    Titles:
    a. Request for and Authorization to Release Medical Records or 
Health Information, VA Form 10-5345.
    b. Individual's Request for a Copy of their Own Health Information, 
VA Form 10-5345a.
    c. My HealtheVet (MHV)--Individuals' Request for a Copy of Their 
Own Health Information, VA Form 10-5345a-MHV.
    d. Restriction of the Release of Individually-Identifiable Health 
Information through Nationwide Health Information Network (NwHIN), VA 
Form 10-0525a.
    e. Request for and Authorization to Release Protected Health 
Information to Nationwide Health Information Network, VA Form 10-0485.
    OMB Control Number: 2900-0260.
    Type of Review: Revision of a currently approved collection.
    Abstracts:
    a. VA Form 10-5345 is used to obtain a written consent from 
patients before information concerning his or her treatment for 
alcoholism or alcohol abuse, drug abuse, sickle cell anemia, or 
infection with the human immunodeficiency virus (HIV) can be disclosed 
to private insurance companies, physicians and other third parties.
    b. Patients complete VA Form 10-5345a to request a copy of their 
health information maintained at Department of Veterans Affairs.
    c. VA Form 10-5345a-MHV is completed by individuals requesting 
their health information electronically through My HealtheVet.
    d. VA Form 10-0525a is completed by individuals to restrict the 
sharing their electronic health information through the NWHIN.
    e. VA Form 10-0485 is used to electronically exchange protected 
health information between VA and approved

[[Page 42556]]

Nationwide Health Information Network participants.
    Affected Public: Individuals or households.

Estimated Total Annual Burden

    a. VA Form 10-5345--10,000 hours.
    b. VA Form 10-5345a--15,000 hours.
    c. VA Form 10-5345a-MVH--35,000 hours.
    d. VA Form 10-0525a--50 hours.
    e. VA Form 10-0485--500 hours.
    Estimated Average Burden Per Respondent--2 minutes for VA Form 10-
5345 and 3 minutes for VA Forms 10-5345a, 10-5345a-MVH, 10-0525a, 10-
0485.
    Frequency of Response: On occasion.
    Estimated Number of Respondents:
    a. VA Form 10-5345--300,000.
    b. VA Form 10-5345a--300,000.
    c. 10-5345a-MVH--700,000.
    d. VA Form 10-0525a--1,000.
    e. VA Form 10-0485--10,000.

    Dated: July 13, 2012.

    By direction of the Secretary.
Denise McLamb,
Program Analyst, Enterprise Records Service.
[FR Doc. 2012-17506 Filed 7-18-12; 8:45 am]
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