View Information Collection Request (ICR) Package
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View Information Collection (IC) List
View Supporting Statement and Other Documents
Please note that the OMB number and expiration date may not have been determined when this Information Collection Request and associated Information Collection forms were submitted to OMB. The approved OMB number and expiration date may be found by clicking on the Notice of Action link below.
View ICR - OIRA Conclusion
OMB Control No:
0938-0948
ICR Reference No:
200703-0938-009
Status:
Historical Active
Previous ICR Reference No:
200612-0938-002
Agency/Subagency:
HHS/CMS
Agency Tracking No:
Title:
HIPAA Administrative Simplification Non-Privacy Enforcement
Type of Information Collection:
Revision of a currently approved collection
Common Form ICR:
No
Type of Review Request:
Regular
OIRA Conclusion Action:
Approved without change
Conclusion Date:
06/06/2007
Retrieve Notice of Action (NOA)
Date Received in OIRA:
03/16/2007
Terms of Clearance:
Inventory as of this Action
Requested
Previously Approved
Expiration Date
06/30/2010
36 Months From Approved
12/31/2008
Responses
500
0
500
Time Burden (Hours)
500
0
500
Cost Burden (Dollars)
0
0
0
Abstract:
HIPAA became law in 1996 (Public Law 104-191). Subtitle F of Title II of HIPAA, entitled #Administrative Simplification,# (A.S.) requires the Secretary of HHS to adopt national standards for certain information-related activities of the health care industry. The HIPAA provisions, by statute, apply only to covered entities referred to in section 1320d 2(a)(1) of this title. Responsibility for administering and enforcing the HIPAA A.S. Transactions, Code Sets, Identifiers and Security Rules has been delegated to the Centers for Medicare & Medicaid Services.
Authorizing Statute(s):
PL:
Pub.L. 104 - 191 1300d
Name of Law: Health Insurance Portability and Accountability Act
Citations for New Statutory Requirements:
None
Associated Rulemaking Information
RIN:
Stage of Rulemaking:
Federal Register Citation:
Date:
Not associated with rulemaking
Federal Register Notices & Comments
60-day Notice:
Federal Register Citation:
Citation Date:
71 FR 71178
12/08/2006
30-day Notice:
Federal Register Citation:
Citation Date:
72 FR 8168
02/23/2007
Did the Agency receive public comments on this ICR?
No
Number of Information Collection (IC) in this ICR:
3
IC Title
Form No.
Form Name
HIPAA Administrative Simplification Non-Privacy Enforcement
CMS-10148
CMS-10148 - HIPAA Non-Privacy Complaint Form
HIPAA Administrative Simplification Non-Privacy Enforcement
CMS-10148
CMS-10148 - HIPAA Non-Privacy Complaint Form
HIPAA Administrative Simplification Non-Privacy Enforcement
CMS-10148
CMS-10148 - HIPAA Non-Privacy Complaint Form
ICR Summary 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
500
500
0
0
0
0
Annual Time Burden (Hours)
500
500
0
0
0
0
Annual Cost Burden (Dollars)
0
0
0
0
0
0
Burden increases because of Program Change due to Agency Discretion:
Yes
Burden Increase Due to:
Miscellaneous Actions
Burden decreases because of Program Change due to Agency Discretion:
Yes
Burden Reduction Due to:
Miscellaneous Actions
Short Statement:
This information collection change clarifies the "Identify the HIPAA Non-Privacy complaint category" section of the complaint form. In this section, complainants are given an opportunity to check the "Unique Identifiers" option to categorize the type of HIPAA complaint being filed. The revised form now includes a "For a Unique Identifier Complaint" section, that allows a complaint to further categorize their identifier complaint as either a "National Provider Identifier (NPI)" or an "Employer Identification Number (EIN)" complaint. This change does not have an additional burden impact.
Annual Cost to Federal Government:
$0
Does this IC contain surveys, censuses, or employ statistical methods?
No
Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002?
No
Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]?
Uncollected
Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]?
Uncollected
Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)?
Uncollected
Is this ICR related to the Pandemic Response?
Uncollected
Agency Contact:
Saleda Perryman
Common Form ICR:
No
On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
(a) It is necessary for the proper performance of agency functions;
(b) It avoids unnecessary duplication;
(c) It reduces burden on small entities;
(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;
(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;
(f) It indicates the retention periods for recordkeeping requirements;
(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:
(i) Why the information is being collected;
(ii) Use of information;
(iii) Burden estimate;
(iv) Nature of response (voluntary, required for a benefit, or mandatory);
(v) Nature and extent of confidentiality; and
(vi) Need to display currently valid OMB control number;
(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.
(i) It uses effective and efficient statistical survey methodology (if applicable); and
(j) It makes appropriate use of information technology.
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
Certification Date:
03/14/2007
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