[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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