[Federal Register Volume 81, Number 55 (Tuesday, March 22, 2016)]
[Notices]
[Pages 15347-15348]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2016-06445]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Indian Health Service


Request for Public Comment: 30-Day Information Collection: Indian 
Health Service Forms To Implement the Privacy Rule

AGENCY: Indian Health Service, HHS.

ACTION: Notice and request for comments. Request for extension of 
approval.

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SUMMARY: In compliance with the Paperwork Reduction Act of 1995, the 
Indian Health Service (IHS) invites the general public to comment on 
the information collection titled, ``IHS Forms to Implement the Privacy 
Rule (45 CFR parts 160 and 164),'' Office of Management and Budget 
(OMB) Control Number 0917-0030.

DATES: Comment Due Date: April 21, 2016. Your comments regarding this 
information collection are best assured of having full effect if 
received within 30 days of the date of this publication.

ADDRESSES: Send your comments and suggestions regarding the proposed 
information collection contained in this notice, especially regarding 
the estimated public burden and associated response time to: Office of 
Management and Budget, Office of Regulatory Affairs, New Executive 
Office Building, Room 10235, Washington, DC 20503, Attention: Desk 
Officer for IHS.
    To request more information on the proposed collection, or to 
obtain a copy of the data collection instruments and/or instruction(s), 
contact Tamara Clay by one of the following methods:
     Mail: Tamara Clay, Information Collection Clearance 
Officer, Indian Health Service, Office of Management Services, Division 
of Regulatory Affairs, 5600 Fishers Lane, Mail Stop 09E70, Rockville, 
MD 20857.
     Phone: 301-443-4750.
     Email: [email protected].
     Fax: 301-443-2316.

SUPPLEMENTARY INFORMATION: This previously approved information 
collection project was last published in the Federal Register (81 FR 
3806) on January 22, 2016, and allowed 60 days for public comment. No 
public comment was received in response to the notice. This notice 
announces our intent to submit the collection, which expires April 30, 
2016, to OMB for approval of an extension, and to solicit comments on 
specific aspects of the information collection. The purpose of this 
notice is to allow 30 days for public comment to be submitted directly 
to OMB. A copy of the supporting statement is available at 
www.regulations.gov (see Docket ID IHS-2016-1).
    Title of Collection: 0917-0030, IHS Forms to Implement the Privacy 
Rule (45 CFR parts 160 and 164). Type of Information Collection 
Request: Extension of the currently approved information collection, 
0917-0030, IHS Forms to Implement the Privacy Rule (45 CFR parts 160 
and 164). Form(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 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

[[Page 15348]]

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 for 
this information collection: Types of data collection instruments, 
estimated number of respondents, number of responses per respondent, 
average burden hour per response, and total annual burden hour(s).

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                                                                     Number of    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         210,954               1           10/60          35,159
 Health Information (OMB Form No. 0917-0030, IHS-
 810)...........................................
Request for Restriction(s) (OMB Form No. 0917-               214               1           10/60              36
 0030, IHS-912-1)...............................
Request for Revocation of Restriction(s) (OMB                  3               1           10/60              .5
 Form No. 0917-0030, IHS-912-2).................
Request for Accounting of Disclosures (OMB Form               39               1           10/60             6.5
 No. 0917-0030, IHS-913)........................
Request for Correction/Amendment of Protected                 54               1           10/60               9
 Health Information (OMB Form No. 0917-0030, IHS-
 917)...........................................
                                                 ---------------------------------------------------------------
    Total Annual Burden.........................         211,264  ..............  ..............          35,211
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* For ease of understanding, burden hours are provided in actual minutes.

    The total estimated burden for this collection of information is 
35,211 hours.
    There are no capital costs, operating costs and/or maintenance 
costs to respondents.
    Requests 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 the 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 
estimates 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.

    Dated: March 10, 2016.
Mary Smith,
Principal Deputy Director, Indian Health Service.
[FR Doc. 2016-06445 Filed 3-21-16; 8:45 am]
 BILLING CODE 4165-16-P