[Federal Register Volume 84, Number 160 (Monday, August 19, 2019)]
[Pages 42935-42936]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2019-17761]

[[Page 42935]]



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 


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'' Office of Management and Budget (OMB) Control Number 0917-0030.
    This previously approved information collection project was last 
published in the Federal Register (84 FR 19088) on May 3, 2019, and 
allowed 60 days for public comment. One public comment was received in 
response to the notice. The comment was not pertinent to the collection 
itself. 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 

DATES: September 18, 2019. 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: Direct your comments to OMB: 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.

FOR FURTHER INFORMATION CONTACT: To request additional information, 
please contact Evonne Bennett by one of the following methods:
     Mail: Evonne Bennett, Information Collection Clearance 
Officer, Indian Health Service, 5600 Fisher Lane, Mail stop: 09E47, 
Rockville, MD 20857.
     Phone: 301-443-4750.
     Email: [email protected].

SUPPLEMENTARY INFORMATION: Title of Collection: 0917-0030, IHS Forms to 
Implement the Privacy Rule (45 CFR parts 160 & 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 & 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 generally requires covered entities 
to obtain or receive a valid authorization for its use or disclosure of 
protected health information, unless otherwise permitted or required by 
the Privacy Rule. (See, e.g., 45 CFR 164.506 for a common exception to 
this general rule, which involves uses and disclosure for treatment, 
payment, or healthcare operations.) 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, and with a limited 
exception, a covered entity is not required to agree to a requested 
restriction. 45 CFR 164.522(a)(1)(vi). 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 the IHS 
agreed or disagreed with the restriction. Section 164.522(a)(2) permits 
a covered entity to terminate its agreement to a restriction under 
certain conditions. For example, termination may occur if the 
individual agrees to or requests the termination in writing. 45 CFR 
164.522(a)(2)(i). The form IHS-912-2 ``Request for Revocation of 
Restriction(s)'' is used to document the individual's request, the 
individual's agreement, and/or the agency's decision to terminate a 
formerly agreed to restriction regarding the use and disclosure of 
protected health information.
    45 CFR 164.528: This provision requires covered entities to provide 
an accounting of certain disclosures of protected health information 
made by the covered entity. See also, 45 CFR 5b.9(c). 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: Under this provision, individuals have a right to 
amend protected health information or a record about the individual in 
a designated record set, under certain conditions. 45 CFR 164.526(a). 
This provision further requires covered entities to permit an 
individual to request that the covered entity amend protected health 
information. 45 CFR 164.526(b). The covered entity must inform the 
individual if the covered entity accepts the requested amendment, in 
whole or in part. The covered entity must provide the individual with a 
written denial containing certain information if the covered entity 
denies the requested amendment, in whole or in part. 45 CFR 
164.526(d)(1). The form IHS-917 ``Request for Correction/Amendment of 
Protected Health Information'' will be used to document an individual's 
request to amend his/her 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).

[[Page 42936]]

                                                                     Number of    Average burden
           Data collection instrument                Number of     responses per     hour per      Total annual
                                                    respondents     respondent      response *     burden hours
Authorization for Use or Disclosure of Protected         210,954               1           10/60          35,159
 Health Information (OMB Form No. 0917-0030, IHS-
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-
    Total Annual Burden.........................         211,264  ..............  ..............          35,211
* 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.

Chris Buchanan,
RADM, Assistant Surgeon General, U.S. Public Health Service, Deputy 
Director, Indian Health Service.
[FR Doc. 2019-17761 Filed 8-16-19; 8:45 am]