Request for Public Comment: 30-Day Proposed Information Collection: Indian Health Service Forms To Implement the Privacy Rule, 2412-2413 [2013-00363]
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2412
Federal Register / Vol. 78, No. 8 / Friday, January 11, 2013 / Notices
SURVEY PRETEST—Continued
Number of
respondents
Form name
Number of
responses per
respondent
Total
responses
Average
burden per
response
(in hours)
Total
burden hours
Patient Recruitment (At clinic) .............................................
Patient Survey (Administered at clinic) ................................
Patient Recruitment (Through local advertisements/flyers/
word-of-mouth) .................................................................
Patient Survey (Administered following local advertising) ...
21
16
1
1
21
16
.17
1.25
3.57
20.00
71
55
1
1
71
55
.08
1.25
5.68
68.75
Total Pretest .................................................................
........................
........................
........................
........................
116.00
Total
responses
Average
burden per
response
(in hours)
NATIONAL STUDY
Number of
respondents
Form name
Number of
responses per
respondent
Total
burden hours
Grantee/Site Recruitment and Training ...............................
Patient Recruitment .............................................................
Patient Survey ......................................................................
165
9,207
6,600
3
1
1
495
9,207
6,600
3.75
.17
1.25
1,856.25
1,565.19
8,250.00
Total National Study .....................................................
........................
........................
........................
........................
11,671.44
Addresses: Submit your comments to
paperwork@hrsa.gov or mail the HRSA
Reports Clearance Officer, Room 10–29,
Parklawn Building, 5600 Fishers Lane,
Rockville, MD 20857.
Deadline: Comments on this
Information Collection Request must be
received within 60 days of this notice.
Dated: January 3, 2013.
Bahar Niakan,
Director, Division of Policy and Information
Coordination.
[FR Doc. 2013–00364 Filed 1–10–13; 8:45 am]
BILLING CODE 4165–15–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Indian Health Service
Request for Public Comment: 30-Day
Proposed Information Collection:
Indian Health Service Forms To
Implement the Privacy Rule
Indian Health Service, HHS.
Notice.
AGENCY:
ACTION:
In compliance with Section
3507(a)(1)(D) of the Paperwork
Reduction Act of 1995 which requires
30 days for public comment on
proposed information collection
projects, the Indian Health Service (IHS)
is publishing for comment a summary of
a proposed information collection to be
submitted to the Office of Management
and Budget (0MB) for review. This
proposed information collection project
was previously published in the Federal
Register (77 FR 60219) on October 2,
mstockstill on DSK4VPTVN1PROD with
SUMMARY:
VerDate Mar<15>2010
16:38 Jan 10, 2013
Jkt 229001
2012, and allowed 60 days for public
comment, as required by 3506(c)(2)(A).
No public comment was received in
response to the notice. The purpose of
this notice is to allow 30 days for public
comment to be submitted directly to
OMB.
Proposed Collection: Title: 0917–
0030, ‘‘IHS Forms to Implement the
Privacy Rule (45 CFR parts 160 & 164).’’
Type of Information Collection Request:
Extension, without revisions, of
currently approved information
collection, 0917–0030, ‘‘IHS Forms to
Implement the Privacy Rule (45 CFR
parts 160 & 164).’’ Form Number(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
individuals’ 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
PO 00000
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Fmt 4703
Sfmt 4703
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 for 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
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
E:\FR\FM\11JAN1.SGM
11JAN1
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Federal Register / Vol. 78, No. 8 / Friday, January 11, 2013 / Notices
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
Number of
respondents
Data collection instrument
Authorization for Use or Disclosure of Protected Health Information (OMB
Form No. 0917–0030, IHS–810) ..................................................................
Request for Restriction(s) (OMB Form No. 0917–0030, IHS–912–1) ............
Request for Revocation of Restriction(s) (OMB Form No. 0917–0030, IHS–
912–2) ..........................................................................................................
Request for Accounting of Disclosures (OMB Form No. 0917–0030, IHS–
913) ..............................................................................................................
Request for Correction/Amendment of Protected Health Information (OMB
Form No. 0917–0030, IHS–917) ..................................................................
Total Annual Burden .................................................................................
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 the estimated burden
hours for this information collection:
Average
burden hour
per
response *
Responses
per
respondent
Total
annual
burden
hours
500,000
15,000
1
1
20/60
10/60
166,667
2,500
5,000
1
10/60
833
15,000
1
10/60
2,500
7,500
1
15/60
1,875
........................
5
........................
174,375
mstockstill on DSK4VPTVN1PROD with
* For ease of understanding, burden hours are provided in actual minutes.
The total estimated burden for this
collection of information is 174,375
hours. There are no capital costs,
operating costs and/or maintenance
costs to respondents.
Request 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 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
estimate 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.
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
VerDate Mar<15>2010
16:38 Jan 10, 2013
Jkt 229001
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,
Reports Clearance Officer, 801
Thompson Avenue, TMP, Suite 450,
Rockville, MD 20852, call non-toll free
(301) 443–4750, send via facsimile to
(301) 443–2316, or send your email
requests, comments, and return address
to: Tamara.Clay@ihs.gov.
Comment Due Date: February 11,
2013. Your comments regarding this
information collection are best assured
of having full effect if received within
30 days of the date of this publication.
SUMMARY:
Dated: December 27, 2012.
Yvette Roubideaux,
Director, Indian Health Service.
ADDRESSES:
[FR Doc. 2013–00363 Filed 1–10–13; 8:45 am]
BILLING CODE 4165–16–P
The purpose of this Notice is
to announce an Indian Health Service
(IHS) Listening Session on the draft
Policy on Conferring with Urban Indian
Organizations (UIOs). IHS will provide
an opportunity for interested parties to
provide oral comments on the draft
Policy on Conferring with UIOs that was
published in the Federal Register on
July 26, 2012.
Name of Listening Session: IHS Urban
Listening Session.
Type of Meeting: Open Listening
Session.
January 22, 2013.
Time: 1 p.m. to 3 p.m. Eastern Time—
Approximate end time.
DATES:
The Listening Session will
be held at: Indian Health Service
Headquarters, 801 Thompson Avenue,
Rhoades Conference Center, Reyes
Building 4th floor, Rockville, MD 20852.
The link
to the Federal Register is: https://
www.federalregister.gov/articles/2012/
07/26/2012-18300/draft-policy-onconferring-with-urban-indianorganizations. Information about the
Urban Indian health program and a
registration link for this Listening
Session are available on the IHS Web
site: www.ihs.gov.
Cost: There is no cost to attend the
Listening Session.
SUPPLEMENTARY INFORMATION:
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Indian Health Service
Office of Urban Indian Health
Programs; Announcement Type:
Meeting Notice
Indian Health Service, HHS.
Meeting Notice.
AGENCY:
ACTION:
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11JAN1
Agencies
[Federal Register Volume 78, Number 8 (Friday, January 11, 2013)]
[Notices]
[Pages 2412-2413]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2013-00363]
-----------------------------------------------------------------------
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Indian Health Service
Request for Public Comment: 30-Day Proposed Information
Collection: Indian Health Service Forms To Implement the Privacy Rule
AGENCY: Indian Health Service, HHS.
ACTION: Notice.
-----------------------------------------------------------------------
SUMMARY: In compliance with Section 3507(a)(1)(D) of the Paperwork
Reduction Act of 1995 which requires 30 days for public comment on
proposed information collection projects, the Indian Health Service
(IHS) is publishing for comment a summary of a proposed information
collection to be submitted to the Office of Management and Budget (0MB)
for review. This proposed information collection project was previously
published in the Federal Register (77 FR 60219) on October 2, 2012, and
allowed 60 days for public comment, as required by 3506(c)(2)(A). No
public comment was received in response to the notice. The purpose of
this notice is to allow 30 days for public comment to be submitted
directly to OMB.
Proposed Collection: Title: 0917-0030, ``IHS Forms to Implement the
Privacy Rule (45 CFR parts 160 & 164).'' Type of Information Collection
Request: Extension, without revisions, of currently approved
information collection, 0917-0030, ``IHS Forms to Implement the Privacy
Rule (45 CFR parts 160 & 164).'' Form Number(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 individuals' 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 for 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
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
[[Page 2413]]
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 the
estimated burden hours for this information collection:
----------------------------------------------------------------------------------------------------------------
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 500,000 1 20/60 166,667
Health Information (OMB Form No. 0917-0030, IHS-
810)...........................................
Request for Restriction(s) (OMB Form No. 0917- 15,000 1 10/60 2,500
0030, IHS-912-1)...............................
Request for Revocation of Restriction(s) (OMB 5,000 1 10/60 833
Form No. 0917-0030, IHS-912-2).................
Request for Accounting of Disclosures (OMB Form 15,000 1 10/60 2,500
No. 0917-0030, IHS-913)........................
Request for Correction/Amendment of Protected 7,500 1 15/60 1,875
Health Information (OMB Form No. 0917-0030, IHS-
917)...........................................
---------------------------------------------------------------
Total Annual Burden......................... .............. 5 .............. 174,375
----------------------------------------------------------------------------------------------------------------
* For ease of understanding, burden hours are provided in actual minutes.
The total estimated burden for this collection of information is
174,375 hours. There are no capital costs, operating costs and/or
maintenance costs to respondents.
Request 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 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 estimate 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.
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.
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, Reports Clearance Officer, 801 Thompson Avenue,
TMP, Suite 450, Rockville, MD 20852, call non-toll free (301) 443-4750,
send via facsimile to (301) 443-2316, or send your email requests,
comments, and return address to: Tamara.Clay@ihs.gov.
Comment Due Date: February 11, 2013. Your comments regarding this
information collection are best assured of having full effect if
received within 30 days of the date of this publication.
Dated: December 27, 2012.
Yvette Roubideaux,
Director, Indian Health Service.
[FR Doc. 2013-00363 Filed 1-10-13; 8:45 am]
BILLING CODE 4165-16-P