[Federal Register Volume 74, Number 120 (Wednesday, June 24, 2009)]
[Notices]
[Pages 30095-30096]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: E9-14841]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Indian Health Service


Request for Public Comment: 60-Day Proposed Information 
Collection: Indian Health Service Forms

AGENCY: Indian Health Service, HHS.

ACTION: Request for Public Comment: 60-Day Proposed Information 
Collection: Indian Health Service Forms to Implement the Privacy Rule 
(45 CFR Parts 160 & 164).

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SUMMARY: The Indian Health Service (IHS), as part of its continuing 
effort to reduce paperwork and respondent burden, conducts a pre-
clearance consultation program to provide the general public and 
Federal agencies with an opportunity to comment on proposed and/or 
continuing collections of information in accordance with the Paperwork 
Reduction Act of 1995 (PRA95) (44 U.S.C. 3506(c)(2)(A)). This program 
helps to ensure that requested data can be provided in the desired 
format, reporting burden (time and financial resources) is minimized, 
collection instruments are clearly understood, and the impact of 
collection requirements on respondents can be properly assessed. 
Currently, the IHS is providing a 60-day advance opportunity for public 
comment on a proposed extension on collection of information to be 
submitted to the Office of Management and Budget for review.
    Proposed Collection: Title: 0917-0030, ``IHS Forms to Implement the 
Privacy Rule (45 CFR Parts 160 & 164)''. Type of Information Collection 
Request: Extension, with 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 Information Portability and Accountability Act of 1996 and 
creates national standards to protect an individual's personal health 
information and gives patients increased access to their medical 
records. 45 CFR 164.508, 522, 526 and 528 of the Rule require the 
collection of information to implement these protection standards and 
access requirements. The IHS will use the following data collection 
instruments to continue the implementation of 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'' 
will be 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 Restriction(s)'' will be 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)(1) 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)'' will be 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'' will be 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 and obtain the individual's identification of 
an agreement to have the covered entity notify the relevant persons 
with which the amendment needs to be shared. 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 IRS 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:

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                                                                                    Burden per
             45 CFR section/IHS form                 Number of     Responses per     response*     Total annual
                                                    respondents     respondent        (mins)          burden
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164.506, IHS-810................................         500,000               1              20         166,667
164.522(a)(1), IHS-912-1........................          15,000               1              10           2,500
164.522(a)(2), IHS-912-2........................           5,000               1              10             833
164.528 IHS-913.................................          15,000               1              10           2,500
164.526, IHS-917................................           7,500               1              15           1,875
                                                 ---------------------------------------------------------------

[[Page 30096]]

 
    Total Annual Burden.........................  ..............               5  ..............         174,375
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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 
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.
    Send Comments and Requests for Further Information: Send your 
written comments and requests for more information on the proposed 
collection or requests to obtain a copy of the data collection 
instrument(s) and instructions to: Ms. Betty Gould, Acting IHS Reports 
Clearance Officer, 801 Thompson Avenue, TMP, Suite 450, Rockville, MD 
20852, call non-toll free (301) 443-7899, send via facsimile to (301) 
443-9879, or send your e-mail requests, comments, and return address 
to: <a href="/cdn-cgi/l/email-protection#2b494e5f5f52054c445e474f6b424358054c445d"><span class="__cf_email__" data-cfemail="04666170707d2a636b716860446d6c772a636b72">[email protected]</span></a>.
    Comment Due Date: Your comments regarding this information 
collection are best assured of having full effect if received within 60 
days of the date of this publication.

    Dated: June 17, 2009.
Robert G. McSwain,
Deputy Director for Management Operations, Indian Health Service.
[FR Doc. E9-14841 Filed 6-23-09; 8:45 am]
BILLING CODE 4165-16-M


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