83 FR 2762 - Consent for Release of VA Medical Records
DEPARTMENT OF VETERANS AFFAIRS Federal Register Volume 83, Issue 13 (January 19, 2018)
Federal Register Volume 83, Issue 13 (January 19, 2018)
| Page Range | 2762-2765 | |
| FR Document | 2018-00758 |
[Federal Register Volume 83, Number 13 (Friday, January 19, 2018)] [Proposed Rules] [Pages 2762-2765] From the Federal Register Online [www.thefederalregister.org] [FR Doc No: 2018-00758] ======================================================================= ----------------------------------------------------------------------- DEPARTMENT OF VETERANS AFFAIRS 38 CFR Part 1 RIN 2900-AP90 Consent for Release of VA Medical Records AGENCY: Department of Veterans Affairs. ACTION: Proposed rule. ----------------------------------------------------------------------- SUMMARY: The Department of Veterans Affairs (VA) proposes to amend its regulations to clarify that a valid consent authorizing the Department to release the patient's confidential VA medical records to a health information exchange (HIE) community partner may be established not only by VA's physical possession of the written consent form, but also by the HIE community partner's written (electronic) attestation that the patient has, in fact, provided such consent. This proposed rule would be a reinterpretation of an existing, long-standing regulation and is necessary to facilitate modern requirements for the sharing of patient records with community health care providers, health plans, governmental agencies, and other entities participating in electronic HIEs. This revision would ensure that more community health care providers and other HIE community partners can deliver informed medical care to patients by having access to the patient's VA medical records at the point of care. DATES: Comment Date: Comments must be received on or before March 20, 2018. ADDRESSES: Written comments may be submitted through www.Regulations.gov; by mail or hand-delivery to Director, Regulation Policy and Management (00REG), Department of Veterans Affairs, 810 Vermont Avenue NW, Room 1063B, Washington, DC 20420; or by fax to (202) 273-9026. Comments should indicate that they are submitted in response to ``RIN 2900-AP90 Consent for Release of VA Medical Records.'' Copies of comments received will be available for public inspection in the Office of Regulation Policy and Management, Room 1063B, between the hours of 8:00 a.m. and 4:30 p.m., Monday through Friday (except holidays). Please call (202) 461-4902 for an appointment. (This is not a toll-free number.) In addition, during the comment period, comments may be viewed online through the Federal Docket Management System (FDMS) at www.Regulations.gov. FOR FURTHER INFORMATION CONTACT: Stephania Griffin, Director, Veterans Health Administration Information Access and Privacy Office, Department of Veterans Affairs, 810 Vermont Avenue NW, Washington, DC 20420; [email protected], (704) 245-2492 (This is not a toll-free number.) SUPPLEMENTARY INFORMATION: Under 38 U.S.C. 7332, VA must keep confidential all records of identity, diagnosis, prognosis, or treatment of a patient in connection with any program or activity carried out by VA related to drug abuse, alcoholism or alcohol abuse, infection with human immunodeficiency virus, or sickle cell anemia, and must obtain patients' written consent before VA may disclose the protected information unless authorized by the statute. This requirement applies to communications between VA and community health care providers for the purposes of treatment, except in certain situations, for instance in medical emergencies and when the records are sent to a non-Department entity that provides hospital care to patients as authorized by the Secretary. 38 U.S.C. 7332(b)(2)(A) and (H); Public Law 115-26 (April 19, 2017). Although section 7332 does not explicitly require that the written consent physically be in VA's possession at the time of the disclosure, VA had interpreted the statute to require such possession, and therefore applied 38 CFR 1.475 consistent with that interpretation. VA has reexamined that statutory interpretation in light of contemporary [[Page 2763]] healthcare industry standards and proposes to revise Sec. 1.475 to reflect this updated reading of section 7332. This proposed rule would revise 38 CFR 1.475 to permit VA to release section 7332-protected medical records to eligible community partners, even if VA does not physically have the patient's written consent, provided that specified criteria are met. The ability to quickly release section 7332-protected information has become increasingly important as VA strives to support veterans' choice to seek care in the community and create innovative ways to provide effective and timely care to veterans. In this regard, VA has entered into an agreement to participate in an HIE to help facilitate the transfer of information between different organizations. An HIE is the electronic transfer of health information among organizations according to nationally recognized standards. The organizations that participate (HIE community partners) range from community health care providers and health plans to governmental agencies providing benefits, such as the Social Security Administration (SSA). The interpretation that valid consent may be established only by VA's physical possession of the written consent has left many HIE community partners unable to access veterans' VA medical records at the point of care. While an estimated three out of four veterans enrolled in VA's health care system also seek medical care in the community, HIE community partners' requests for their VA health records must frequently be denied because VA does not have a consent on file, and many HIE community partners therefore either must delay care to veterans or provide treatment to veterans without having the benefit of reviewing the veteran's full medical history. The reason for the low rate of consent is not because veterans object to providing consent; veteran participation is almost always favorable when asked to provide consent. The primary obstacle is that veterans will often seek care in the community prior to having the opportunity to provide the consent form to VA and are then left without any means of getting the consent into VA's physical possession promptly once they are at the community health care facility. By allowing HIE community partners to attest that they have, in fact, obtained a valid consent, VA would be able to collect consent in a broader array of circumstances. Most importantly, this would allow VA to release a veteran's medical records to an HIE community partner, such as a community health care provider or SSA, once the partner attests that they have collected valid consent, without VA having to wait for the document to be furnished. This would allow for HIE community partners to provide veterans with the most informed care, would allow VA to more expediently provide veterans' records for the adjudication of their SSA disability claims, and would also allow for VA to continue innovating and creating new ways for veterans to receive timely and high quality health care. VA believes that this new interpretation of section 7332--to permit disclosure to an HIE community partner pursuant to the partner's attestation regarding written consent, would uphold veterans' right to privacy. As explained in greater detail below, such disclosure would still require a legally sufficient written consent. We clarify that the only change would be that a valid consent authorizing disclosure may be established not only by VA's physical possession of the written consent form but also by the HIE community partner's attestation that the veteran has submitted legally sufficient consent. Moreover, in the private sector under the Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule, health care providers are able to release a patient's confidential medical records to another one of the patient's treating providers without written consent. Therefore, VA's privacy protections would remain more robust than those of the private sector generally and greater than those required by the HIPAA Privacy Rule. This proposed rule would revise 38 CFR 1.460 to include definitions for ``health information exchange'' and ``health information exchange community partner'' as described above. Further, the rule would revise 1.475 as follows. Current paragraph (d) would be redesignated as paragraph (e) and would be revised as explained below. New paragraph (d) would provide the criteria to establish written consent that would authorize the disclosure of confidential VA medical records. Specifically, it would establish that, in addition to physical possession of a patient's written consent, VA may release the patient's protected medical information to an HIE community partner pursuant to that partner's attestation that valid consent has been obtained. To clarify, this paragraph would not require VA to provide the records to HIE community partners just because the partner submitted an attestation; instead, VA would have the discretion to send the records. Proposed paragraph (d)(1) states that written consent may be established by VA's physical possession of the patient's written consent that meets the criteria in paragraph (a) of this section. This is how VA traditionally collected consent forms. Paragraph (d)(2) would provide an alternative for disclosure of section 7332-protected information. VA would also be able to disclose the protected information to an HIE community partner as long as two criteria are met. Initially, we note that this alternative for disclosure would be limited to VA's partners in the HIE because the partners have all signed an agreement to comply with certain standards of practice. Additionally, all partners would be required to have the technological capabilities to provide the requisite attestation. The first proposed criterion is that the HIE community partner must provide written attestation that the patient has submitted legally sufficient consent to them. This requirement is necessary because 38 U.S.C. 7332 and 38 CFR 1.475 still require the veteran provide legally sufficient written consent to release section 7332-protected information. Therefore, in order for VA to release the records to the HIE community partner, VA must have an attestation or some documentation that the patient provided legally sufficient written consent. To clarify, ``written attestation'' would not require a physical document and a wet signature; electronic attestations satisfy this requirement and are the expected form of attestation from the HIE community partner. VA would not specifically require the attestation to be electronic in order to provide for flexibility if there are changes in technology and best practices. However, VA envisions the vast majority, if not all, of the attestations would be electronic through approved messaging with the HIE community partners. This proposed rule would allow for VA's community partners to electronically attest, through the computer software, that the veteran submitted legally sufficient written consent. At that time, VA would be able to release the veteran's medical records electronically to the HIE community partner. In addition to the written attestation, paragraph (d)(2) would require that VA have the ability to retrieve or obtain the written consent. There are two ways in which VA can obtain the records. First, proposed paragraph (d)(2)(i) provides that a .HIE community partner can make the consent form available to VA within 10 business days of its attestation. This can be accomplished either by storing [[Page 2764]] the written consent form electronically for access by VA or by sending the written consent form to VA. Second, paragraph (d)(2)(ii) would provide that the HIE community partner can maintain the patient's written consent form in accordance with a memorandum of understanding (MOU) that is drafted and signed by VA and the HIE community partner. The MOU would ensure that the patient's records are retained in accordance with VA record retention requirements set forth in VHA Records Control Schedule (RCS) 10-1. Even though VA would not require the written consent to be physically in VA's possession since it is a VA record, the HIE would have to retain the consent form according to VA's record retention requirements. Paragraph (d)(2)(ii) would also require that the MOU outline how VA can request the consent form from the HIE community partner and how the HIE community partner can make the consent form available to VA. In this regard, VA and the partner would determine a mutually agreeable timeframe to comply with a request by VA for a copy of the consent form. As explained above current paragraph (d) would be redesignated as new paragraph (e). This paragraph would be revised to update the name of VA Form 10-5345. Specifically, current paragraph (d) provides that it was not necessary to use any particular form to establish a consent referred to in paragraph (a) of this section, however, VA Form 10-5345, titled Request for and Consent to Release of Medical Records Protected by 38 U.S.C. 7332, may be used for such purpose. VA Form 10-5345 has been updated and renamed Request for and Authorization to Release Medical Records or Health Information. Accordingly, VA would revise the paragraph to reflect the new name of VA Form 10-5345. Effect of Rulemaking The Code of Federal Regulations, as proposed to be revised by this proposed rulemaking, would represent the exclusive legal authority on this subject. No contrary rules or procedures would be authorized. All VA guidance would be read to conform with this proposed rulemaking if possible or, if not possible, such guidance would be superseded by this rulemaking. Paperwork Reduction Act This proposed rule contains no provisions constituting a collection of information under the Paperwork Reduction Act of 1995 (44 U.S.C. 3501-3521). Regulatory Flexibility Act The Secretary hereby certifies that this proposed rule would not have a significant economic impact on a substantial number of small entities as they are defined in the Regulatory Flexibility Act (5 U.S.C. 601-612). The overall impact of the proposed rule on small entities would be minimal as the proposed rule would only require that entities attest that they received the veteran's consent and make the written consent available to VA. These administrative burdens are similar to current burdens related to medical privacy and will not have a significant economic impact on these entities. On this basis, the Secretary certifies that the adoption of this proposed rule would not have a significant economic impact on a substantial number of small entities as they are defined in the Regulatory Flexibility Act, 5 U.S.C. 601-612. Therefore, under 5 U.S.C. 605(b), this rulemaking is exempt from the initial and final regulatory flexibility analysis requirements of sections 603 and 604. Executive Orders 12866, 13563 and 13771 Executive Orders (E.O.s) 12866 and 13563 direct agencies to assess all costs and benefits of available regulatory alternatives and, if regulation is necessary, to select regulatory approaches that maximize net benefits (including potential economic, environmental, public health and safety effects, distributive impacts, and equity). E.O. 13563 emphasizes the importance of quantifying both costs and benefits of reducing costs, of harmonizing rules, and of promoting flexibility. E.O. 12866, Regulatory Planning and Review, defines ``significant regulatory action'' to mean any regulatory action that is likely to result in a rule that may: ``(1) Have an annual effect on the economy of $100 million or more or adversely affect in a material way the economy, a sector of the economy, productivity, competition, jobs, the environment, public health or safety, or State, local, or tribal governments or communities; (2) Create a serious inconsistency or otherwise interfere with an action taken or planned by another agency; (3) Materially alter the budgetary impact of entitlements, grants, user fees, or loan programs or the rights and obligations of recipients thereof; or (4) Raise novel legal or policy issues arising out of legal mandates, the President's priorities, or the principles set forth in this Executive order.'' VA has examined the economic, interagency, budgetary, legal, and policy implications of this regulatory action, and it has been determined not to be a significant regulatory action under E.O. 12866. This proposed rule is not expected to be an E.O. 13771 regulatory action because this proposed rule is not significant under E.O. 12866. Unfunded Mandates The Unfunded Mandates Reform Act of 1995 requires, at 2 U.S.C. 1532, that agencies prepare an assessment of anticipated costs and benefits before issuing any rule that may result in the expenditure by State, local, and tribal governments, in the aggregate, or by the private sector, of $100 million or more (adjusted annually for inflation) in any one year. This proposed rule would have no such effect on State, local, and tribal governments, or on the private sector. Catalog of Federal Domestic Assistance The Catalog of Federal Domestic Assistance numbers and titles for the programs affected by this document are 64.008--Veterans Domiciliary Care; 64.011--Veterans Dental Care; 64.012--Veterans Prescription Service; 64.013--Veterans Prosthetic Appliances; 64.014--Veterans State Domiciliary Care; 64.015--Veterans State Nursing Home Care; 64.024--VA Homeless Providers Grant and Per Diem Program; 64.026--Veterans State Adult Day Health Care; 64.029--Purchase Care Program; 64.033--VA Supportive Services for Veteran Families Program; 64.039--CHAMPVA; 64.040--VHA Inpatient Medicine; 64.041--VHA Outpatient Specialty Care; 64.042--VHA Inpatient Surgery; 64.043--VHA Mental Health Residential; 64.044--VHA Home Care; 64.045--VHA Outpatient Ancillary Services; 64.046--VHA Inpatient Psychiatry; 64.047--VHA Primary Care; 64.048--VHA Mental Health clinics; 64.049--VHA Community Living Center; 64.050--VHA Diagnostic Care; 64.054--Research and Development. Signing Authority The Secretary of Veterans Affairs, or designee, approved this document and authorized the undersigned to sign and submit the document to the Office of the Federal Register for publication electronically as an official document of the Department of Veterans Affairs. Gina S. Farrisee, Deputy Chief of Staff, Department of Veterans Affairs, approved this document on December 8, 2017, for publication. List of Subjects in 38 CFR Part 1 Administrative practice and procedure, Archives and records, [[Page 2765]] Cemeteries, Claims, Courts, Crime, Flags, Freedom of information, Government contracts, Government employees, Government property, Infants and children, Inventions and patents, Parking, Penalties, Privacy, Reporting and recordkeeping requirements, Seals and insignia, Security measures, Wages. Dated: January 12, 2018. Janet Coleman, Chief, Office of Regulation Policy & Management, Office of the Secretary, Department of Veterans Affairs. For the reasons set out in the preamble, Department of Veterans Affairs proposes to amend 38 CFR part 1 as follows: PART 1--GENERAL PROVISIONS 0 1. The authority citation for part 1 continues to read as follows: Authority: 38 U.S.C. 501, and as noted in specific sections. 0 2. Amend Sec. 1.460 by adding, in alphabetical order, definitions for ``health information exchange'' and ``health information exchange community partner.'' Sec. 1.460 Definitions. * * * * * Health information exchange. The term ``health information exchange'' means the electronic transfer of health information among health care professionals, health plans, governmental agencies providing benefits, and other persons and entities according to nationally recognized standards that allow the participants to appropriately access and securely share patients' vital medical information to improve the quality, safety, and efficiency of health care delivery. Health information exchange community partner. The term ``health information exchange community partner'' means a health care provider, health plan, governmental agency providing benefits, or other person or entity with whom VA shares patients' vital medical information according to nationally recognized standards. * * * * * 0 3. Amend Sec. 1.475 by redesignating paragraph (d) as paragraph (e), adding a new paragraph (d) and revising newly redesignated paragraph (e) to read as follows: Sec. 1.475 Form of written consent. * * * * * (d) Establishing written consent. A written consent authorizing the disclosure may be demonstrated by: (1) A written consent meeting the criteria set forth in paragraph (a) of this section that is presented to VA in physical form; or (2) A written attestation by a health information exchange community partner that the patient submitted legally sufficient consent meeting the criteria set forth in paragraph (a), provided that: (i) Within 10 business days of the health information exchange community partner's attestation, the partner either makes the written consent form available for electronic retrieval by VA or produces the written consent form to VA; or (ii) The health information exchange community partner complies with a memorandum of understanding signed by the partner and VA that outlines: (A) How the written consent will be retained in accordance with VHA Records Control Schedule (RCS) 10-1; (B) How VA can request the consent form from the partner; and (C) How the partner can send the consent form to VA. (e) Required Form. It is not necessary to use any particular form to establish a consent referred to in paragraph (a) of this section, however, VA Form 10-5345, titled Request for and Authorization to Release Medical Records or Health Information, complies with all applicable legal requirements and may be used for such purpose. [FR Doc. 2018-00758 Filed 1-18-18; 8:45 am] BILLING CODE 8320-01-P
![2762 Federal Register / Vol. 83, No. 13 / Friday, January 19, 2018 / Proposed Rules
necessary under the provisions of the § 1.351 [Removed and reserved] care to patients by having access to the
Unfunded Mandates Reform Act of ■ 4. Section 1.351 is removed and patient’s VA medical records at the
1995. See 2 U.S.C. 1501 et seq. reserved. point of care.
N. National Environmental Policy DATES: Comment Date: Comments must
Act: This rulemaking will not have any PART 42—TRIAL PRACTICE BEFORE be received on or before March 20, 2018.
effect on the quality of the environment THE PATENT TRIAL AND APPEAL ADDRESSES: Written comments may be
and is thus categorically excluded from BOARD submitted through
review under the National www.Regulations.gov; by mail or hand-
Environmental Policy Act of 1969. See ■ 5. The authority citation for part 42
continues to read as follows: delivery to Director, Regulation Policy
42 U.S.C. 4321 et seq. and Management (00REG), Department
O. National Technology Transfer and Authority: 35 U.S.C. 2(b)(2), 6, 21, 23, 41, of Veterans Affairs, 810 Vermont
Advancement Act: The requirements of 135, 311, 312, 316, 321–326 and Public Law
Avenue NW, Room 1063B, Washington,
section 12(d) of the National 112–29, 125 Stat. 284; and Pub. L. 112–274,
126 Stat. 2456. DC 20420; or by fax to (202) 273–9026.
Technology Transfer and Advancement Comments should indicate that they are
Act of 1995 (15 U.S.C. 272 note) are not § 42.102 [Amended] submitted in response to ‘‘RIN 2900–
applicable because this rulemaking does AP90 Consent for Release of VA
■ 6. Amend § 42.102 by removing and
not contain provisions that involve the Medical Records.’’ Copies of comments
reserving paragraph (b).
use of technical standards. received will be available for public
P. Paperwork Reduction Act: The § 42.202 [Amended] inspection in the Office of Regulation
Paperwork Reduction Act of 1995 (44 ■ 7. Amend § 42.202 by removing and Policy and Management, Room 1063B,
U.S.C. 3501 et seq.) requires that the reserving paragraph (b). between the hours of 8:00 a.m. and 4:30
Office consider the impact of paperwork p.m., Monday through Friday (except
and other information collection Dated: January 11, 2018.
holidays). Please call (202) 461–4902 for
burdens imposed on the public. This Joseph Matal,
an appointment. (This is not a toll-free
rulemaking does not involve an Associate Solicitor, performing the functions
number.) In addition, during the
information collection that is subject to and duties of the Under Secretary of
Commerce for Intellectual Property and comment period, comments may be
review by the Office of Management and viewed online through the Federal
Director of the United States Patent and
Budget (OMB) under the Paperwork Trademark Office. Docket Management System (FDMS) at
Reduction Act of 1995 (44 U.S.C. 3501– www.Regulations.gov.
[FR Doc. 2018–00769 Filed 1–18–18; 8:45 am]
3549). FOR FURTHER INFORMATION CONTACT:
Notwithstanding any other provision BILLING CODE 3510–16–P
Stephania Griffin, Director, Veterans
of law, no person is required to respond Health Administration Information
to nor shall a person be subject to a Access and Privacy Office, Department
penalty for failure to comply with a DEPARTMENT OF VETERANS
of Veterans Affairs, 810 Vermont
collection of information subject to the AFFAIRS
Avenue NW, Washington, DC 20420;
requirements of the Paperwork Stephania.griffin@va.gov, (704) 245–
Reduction Act unless that collection of 38 CFR Part 1
2492 (This is not a toll-free number.)
information displays a currently valid RIN 2900–AP90 SUPPLEMENTARY INFORMATION: Under 38
OMB control number.
U.S.C. 7332, VA must keep confidential
Consent for Release of VA Medical
List of Subjects all records of identity, diagnosis,
Records
prognosis, or treatment of a patient in
37 CFR Part 1
AGENCY: Department of Veterans Affairs. connection with any program or activity
Administrative practice and carried out by VA related to drug abuse,
ACTION: Proposed rule.
procedure, Courts, Freedom of alcoholism or alcohol abuse, infection
Information, Inventions and patents, SUMMARY: The Department of Veterans with human immunodeficiency virus, or
Reporting and recordkeeping Affairs (VA) proposes to amend its sickle cell anemia, and must obtain
requirements, Small businesses. regulations to clarify that a valid patients’ written consent before VA may
37 CFR Part 42 consent authorizing the Department to disclose the protected information
release the patient’s confidential VA unless authorized by the statute. This
Administrative practice and medical records to a health information requirement applies to communications
procedure, Inventions and patents. exchange (HIE) community partner may between VA and community health care
For the reasons stated in the be established not only by VA’s physical providers for the purposes of treatment,
preamble, the Office proposes to amend possession of the written consent form, except in certain situations, for instance
parts 1 and 42 of title 37 as follows: but also by the HIE community partner’s in medical emergencies and when the
written (electronic) attestation that the records are sent to a non-Department
PART 1—RULES OF PRACTICE IN
patient has, in fact, provided such entity that provides hospital care to
PATENT CASES
consent. This proposed rule would be a patients as authorized by the Secretary.
■ 1. The authority citation for part 1 reinterpretation of an existing, long- 38 U.S.C. 7332(b)(2)(A) and (H); Public
continues to read as follows: standing regulation and is necessary to Law 115–26 (April 19, 2017). Although
facilitate modern requirements for the section 7332 does not explicitly require
daltland on DSKBBV9HB2PROD with PROPOSALS
Authority: 35 U.S.C. 2(b)(2).
sharing of patient records with that the written consent physically be in
§ 1.79 [Removed and reserved] community health care providers, VA’s possession at the time of the
■ 2. Section 1.79 is removed and health plans, governmental agencies, disclosure, VA had interpreted the
reserved. and other entities participating in statute to require such possession, and
electronic HIEs. This revision would therefore applied 38 CFR 1.475
§ 1.127 [Removed and reserved] ensure that more community health care consistent with that interpretation. VA
■ 3. Section 1.127 is removed and providers and other HIE community has reexamined that statutory
reserved. partners can deliver informed medical interpretation in light of contemporary
VerDate Sep<11>2014 16:20 Jan 18, 2018 Jkt 244001 PO 00000 Frm 00016 Fmt 4702 Sfmt 4702 E:\FR\FM\19JAP1.SGM 19JAP1](https://thefederalregister.org/doc/83_FR_2775/page/1.svg)
![Federal Register / Vol. 83, No. 13 / Friday, January 19, 2018 / Proposed Rules 2765
Cemeteries, Claims, Courts, Crime, section that is presented to VA in Additional requests for extension of the
Flags, Freedom of information, physical form; or comment period have been received.
Government contracts, Government (2) A written attestation by a health The Agency extends the January 19,
employees, Government property, information exchange community 2018, deadline for the submission of
Infants and children, Inventions and partner that the patient submitted public comments to February 20, 2018.
patents, Parking, Penalties, Privacy, legally sufficient consent meeting the DATES: FMCSA extends the comment
Reporting and recordkeeping criteria set forth in paragraph (a), period for the notice of proposed
requirements, Seals and insignia, provided that: regulatory guidance published on
Security measures, Wages. (i) Within 10 business days of the December 20, 2017 at 82 FR 60360. You
Dated: January 12, 2018. health information exchange must submit comments on or before
Janet Coleman, community partner’s attestation, the February 20, 2018.
Chief, Office of Regulation Policy & partner either makes the written consent ADDRESSES: You may insert comments
Management, Office of the Secretary, form available for electronic retrieval by identified by Federal Docket
Department of Veterans Affairs. VA or produces the written consent Management System Number FMCSA–
For the reasons set out in the form to VA; or 2017–0360 by any of the following
preamble, Department of Veterans (ii) The health information exchange methods:
Affairs proposes to amend 38 CFR part community partner complies with a • Federal eRulemaking Portal: http://
1 as follows: memorandum of understanding signed www.regulations.gov. Follow the online
by the partner and VA that outlines: instructions for submitting comments.
PART 1—GENERAL PROVISIONS (A) How the written consent will be • Mail: Docket Management Facility,
retained in accordance with VHA U.S. Department of Transportation, 1200
■ 1. The authority citation for part 1 Records Control Schedule (RCS) 10–1;
continues to read as follows: New Jersey Avenue SE, West Building,
(B) How VA can request the consent Ground Floor, Room W12–140,
Authority: 38 U.S.C. 501, and as noted in form from the partner; and
specific sections. Washington, DC 20590–0001.
(C) How the partner can send the • Hand Delivery or Courier: West
■ 2. Amend § 1.460 by adding, in consent form to VA. Building, Ground Floor, Room W12–
alphabetical order, definitions for (e) Required Form. It is not necessary 140, 1200 New Jersey Avenue SE,
‘‘health information exchange’’ and to use any particular form to establish Washington, DC, between 9 a.m. and 5
‘‘health information exchange a consent referred to in paragraph (a) of p.m., Monday through Friday, except
community partner.’’ this section, however, VA Form 10– Federal holidays.
5345, titled Request for and • Fax: (202) 493–2251.
§ 1.460 Definitions. Authorization to Release Medical
* * * * * To avoid duplication, please use only
Records or Health Information, complies one of these four methods. See the
Health information exchange. The with all applicable legal requirements
term ‘‘health information exchange’’ ‘‘Public Participation and Request for
and may be used for such purpose. Comments’’ portion of the
means the electronic transfer of health
[FR Doc. 2018–00758 Filed 1–18–18; 8:45 am] SUPPLEMENTARY INFORMATION section for
information among health care
professionals, health plans, BILLING CODE 8320–01–P instructions on submitting comments.
governmental agencies providing FOR FURTHER INFORMATION CONTACT: Mr.
benefits, and other persons and entities Thomas Yager, Chief, Driver and Carrier
according to nationally recognized DEPARTMENT OF TRANSPORTATION Operations Division, Federal Motor
standards that allow the participants to Carrier Safety Administration, U.S.
appropriately access and securely share Federal Motor Carrier Safety Department of Transportation, 1200
patients’ vital medical information to Administration New Jersey Avenue SE, Washington, DC
improve the quality, safety, and 20590, phone (614) 942–6477, email
efficiency of health care delivery. 49 CFR Part 395 MCPSD@dot.gov.
Health information exchange [Docket No. FMCSA–2017–0360] SUPPLEMENTARY INFORMATION:
community partner. The term ‘‘health
information exchange community Hours of Service of Drivers of I. Public Participation and Request for
partner’’ means a health care provider, Commercial Motor Vehicles; Proposed Comments
health plan, governmental agency Regulatory Guidance Concerning the A. Submitting Comments
providing benefits, or other person or Transportation of Agricultural
entity with whom VA shares patients’ If you submit a comment, please
Commodities; Extension of Comment
vital medical information according to include the docket number listed above,
Period
nationally recognized standards. indicate the specific section of this
AGENCY: Federal Motor Carrier Safety document to which your comment
* * * * *
■ 3. Amend § 1.475 by redesignating Administration (FMCSA), DOT applies, and provide a reason for each
paragraph (d) as paragraph (e), adding a ACTION: Proposed regulatory guidance; suggestion or recommendation. You
new paragraph (d) and revising newly extension of comment period. may submit your comments and
redesignated paragraph (e) to read as material online or by fax, mail, or hand
follows: SUMMARY: FMCSA extends the public delivery. FMCSA recommends that you
daltland on DSKBBV9HB2PROD with PROPOSALS
comment period for the Agency’s include your name and a mailing
§ 1.475 Form of written consent. December 20, 2017, notice announcing address, an email address, or a phone
* * * * * the proposed regulatory guidance number in the body of your document
(d) Establishing written consent. A concerning the transportation of so that FMCSA can contact you if there
written consent authorizing the agricultural commodities. On December are questions regarding your
disclosure may be demonstrated by: 22, 2017, the American Trucking submission.
(1) A written consent meeting the Associations, Inc. (ATA) requested a 30- To submit your comment online, go to
criteria set forth in paragraph (a) of this day extension of the comment period. http://www.regulations.gov, put the
VerDate Sep<11>2014 16:20 Jan 18, 2018 Jkt 244001 PO 00000 Frm 00019 Fmt 4702 Sfmt 4702 E:\FR\FM\19JAP1.SGM 19JAP1](https://thefederalregister.org/doc/83_FR_2775/page/4.svg)
Document Created: 2018-01-19 02:42:44
Document Modified: 2018-01-19 02:42:44
| Category | Regulatory Information | |
| Collection | Federal Register | |
| sudoc Class | AE 2.7: GS 4.107: AE 2.106: | |
| Publisher | Office of the Federal Register, National Archives and Records Administration | |
| Section | Proposed Rules | |
| Action | Proposed rule. | |
| Dates | Comment Date: Comments must be received on or before March 20, 2018. | |
| Contact | Stephania Griffin, Director, Veterans Health Administration Information Access and Privacy Office, Department of Veterans Affairs, 810 Vermont Avenue NW, Washington, DC 20420; [email protected], (704) 245-2492 (This is not a toll-free number.) | |
| FR Citation | 83 FR 2762 | |
| RIN Number | 2900-AP90 | |
| CFR Associated | Administrative Practice and Procedure; Archives and Records; Cemeteries; Claims; Courts; Crime; Flags; Freedom of Information; Government Contracts; Government Employees; Government Property; Infants and Children; Inventions and Patents; Parking; Penalties; Privacy; Reporting and Recordkeeping Requirements; Seals and Insignia; Security Measures and Wages |
2025 Federal Register | Disclaimer | Privacy Policy
USC | CFR | eCFR