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

ICR 202401-0945-002

OMB: 0945-0003

Federal Form Document

Forms and Documents

Document Name	Status
2024_04_30_HIPAA RHC Privacy FR_ICR_Supporting_Statement CLEAN.docx Supporting Statement A	2024-04-30

IC Document Collections

IC ID	Document Title	Status
264566	Attestations requiring additional action	New
264565	Attestations requiring investigation review	New
264564	Notice of Privacy Practices for Protected Health Information―Mailing notice to 10% of subscribers at a rate of 240 notices/hour	New
259737	164.509 Disclosures for which attestation is required	Modified
259736	164.530 Administrative Requirements―Training― 164.525 Update training content	Unchanged
259735	164.530 Administrative Requirements-Policies & Procedures (new and updated)	Unchanged
259734	164.520 Notice of Privacy Practices for Protected Health Information― Post updated notice online	Modified
259733	164.520 Notice of Privacy Practices for Protected Health Information―Updating	Modified
259732	164.509 Uses and Disclosures for which an Attestation is Required―Creating New Form	Removed
259731	164.504 Revising Business Associate Agreements	Unchanged
237898	Business Associate Notice to Covered Entity – Less than 500 affected individuals	Unchanged
237897	Business Associate Notice to Covered Entity – 500 or more affected individuals	Unchanged
221884	Less than 500 Affected Individuals (investigating and documenting breach) breaches affecting	Modified
221883	Less than 500 Affected Individuals (investigating and documenting breach)	Modified
221882	500 or More Affected Individuals (investigating and documenting breach)	Modified
221881	Notice to Secretary (notice for breaches affecting fewer than 500 individuals)	Modified
221880	Notice to Secretary (notice for breaches affecting 500 or more individuals)	Modified
221879	Media Notice	Modified
221878	Individual Notice-Substitute Notice (individuals' voluntary burden to call toll-free number for information)	Modified
221877	Individual Notice-Substitute Notice (staffing toll-free number)	Modified
221876	Individual Notice- Substitute Notice (posting or publishing)	Modified
221875	Individual Notice-Written and E-mail Notice(processing and sending)	Modified
221874	Individual Notice-Written and E-mail Notice (preparing and documenting notification)	Modified
221872	Individual Notice- Written and E-mail Notice (drafting)	Modified
221871	Documentation - Review and Update	Unchanged
221870	Security Incidents- Business Associate reporting of incidents (other than breach) to Covered Entities	Unchanged
221869	Maintenance Records	Unchanged
221868	Contingency Plan- Criticality Analysis	Unchanged
221866	Contingency Plan- Testing and Revision	Unchanged
221862	Security Incidents (other than breaches)- Documentation	Unchanged
221861	Security Reminders- Periodic Updates	Unchanged
221860	Information System Activity Review- Documentation	Unchanged
221859	Risk Analysis-Documentation	Unchanged
208573	Rights to request privacy protection for protected health information	Unchanged
190153	Accounting for Disclosures of Protected Health Information	Unchanged
190152	Amendment of Protected Health Information (denials)	Unchanged
190151	Amendment of Protected Health Information (requests)	Unchanged
190150	Access of Individuals to Protected Health Information (copies of PHI)	Modified
190149	Notice of Privacy Practice for Protected Health Information (Health plans- periodic distribution of NPPs by electronic mail)	Unchanged
190147	Notice of Privacy Practices for Protected Health Information (health care providers - dissemination/acknowledgement	Unchanged
190146	Notice of Privacy Practices for Protected Health Information/health plan distribution paper mail	Modified
190145	Uses and Disclosures for Research Purposes	Modified
190144	Uses and Disclosures for which Individual authorization is required	Modified
190143	Uses and Disclosures-Organizational Requirement	Unchanged
10428	Process for Requesting Exception Determinations (states or persons)	Unchanged