Information Collection Request

Standards for Privacy of Individually Identifiable Health Information and Supporting Regulations at 45 CFR Parts 160 and 164

ICR 201309-0945-001 · OMB 0945-0003 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
20296_ID 0945-0003 Supporting Statement Omnibus HITECH GINA.docx Supporting Statement A Uploaded 2013-09-06 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
208577 Revison of Notice of Privacy Practices (providers) New
208576 Revision of Notice of Privacy Practices for Protected Health Information (drafting revised language health plan New
208575 Business Associates Needing to establish or Modify Business Associate Agreements with Subcontrractors New
208574 Dissemination of Notice of Privacy Practices for Protected Health Information(health Plans) New
208573 Rights to request privacy protection for protected health information New
208572 Documentation of Security Rule Policies and Procedures and Administrative safeguards business associates New
190153 Accounting for Disclosures of Protected Health Information Modified
190152 Amendment of Protected Health Information (denials) Modified
190151 Amendment of Protected Health Information (requests) Modified
190150 Access of Individuals to Protected Health Information (disclosures) Modified
190149 Rights to Request Privacy Protection for Protected Health Information/distribution by electronic mail Modified
190148 Notice of Privacy Practices for Protected Health Information (health care providers - acknowledgement) Removed
190147 Notice of Privacy Practices for Protected Health Information (health care providers - dissemination/acknowledgement Modified
190146 Notice of privacy Practices for Protected Health Information/health plan by distibution by paper mail Modified
190145 Uses and Disclosures for which consent individual authorization or opportunity to agree or Object is not required Modified
190144 Uses and Disclosures for which Individual authorization is required Modified
190143 Uses and Disclosures-Organizational Requirement Modified
10428 Process for Requesting Exception Determinations (states or persons) Modified

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
01/31/2017 36 Months From Approved 12/31/2015
836,457,025 0 1,229,233,732
32,762,920 0 62,254,161
0 0 0





Reginfo record details
17
table that charts list of burden
IC Title Form No. Form Name
Business Associates Needing to establish or Modify Business Associate Agreements with Subcontrractors
Revision of Notice of Privacy Practices for Protected Health Information (drafting revised language health plan
Process for Requesting Exception Determinations (states or persons)
Uses and Disclosures-Organizational Requirement
Uses and Disclosures for which Individual authorization is required
Uses and Disclosures for which consent individual authorization or opportunity to agree or Object is not required
Notice of privacy Practices for Protected Health Information/health plan by distibution by paper mail
Notice of Privacy Practices for Protected Health Information (health care providers - dissemination/acknowledgement
Rights to Request Privacy Protection for Protected Health Information/distribution by electronic mail
Access of Individuals to Protected Health Information (disclosures)
Amendment of Protected Health Information (requests)
Amendment of Protected Health Information (denials)
Accounting for Disclosures of Protected Health Information
Documentation of Security Rule Policies and Procedures and Administrative safeguards business associates
Rights to request privacy protection for protected health information
Dissemination of Notice of Privacy Practices for Protected Health Information(health Plans)
Revison of Notice of Privacy Practices (providers)
Notice of Privacy Practices for Protected Health Information (health care providers - acknowledgement)

table that charts list of burden
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 836,457,025 1,229,233,732 0 220,223,293 -613,000,000 0
Annual Time Burden (Hours) 32,762,920 62,254,161 0 1,158,759 -30,650,000 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No