NRPM: Standards for Privacy of Individually Identifiable Health Information. a. Right to a written notice of information procedures.


We are proposing that individuals have a right to an adequate notice of the information practices of covered plans and providers. The notice would be intended to inform individuals about what is done with their protected health information and about any rights they may have with respect to that information. Federal agencies must adhere to a similar notice requirement pursuant to the Privacy Act of 1974 (5 U.S.C. 552a(e)(3)).

We are not proposing that business partners (including health care clearinghouses) be required to develop a notice of information practices because, under this proposed rule, they would be bound by the information practices of the health plan or health care provider with whom they are contracting.

We considered requiring covered plans or providers to obtain a signed copy of the notice form (or some other signed indication of receipt) when they give the form to individuals. There are advantages to including such a requirement. A signed acknowledgment would provide evidence that the notice form has been provided to the individual. Further, the request to the individual to formally acknowledgment receipt would highlight the importance of the notice, providing additional encouragement for the individual to read it and ask questions about its content.

We are concerned, however, that requiring a signed acknowledgment would significantly increase the administrative and paperwork burden of this provision. We also are unsure of the best way for health plans to obtain a signed acknowledgment because plans often do not have face-to-face contact with enrollees. It may be possible to collect an acknowledgment at initial enrollment, for example by adding an additional acknowledgment to the enrollment form, but it is less clear how to obtain it when the form is revised. We solicit comment on whether we should require a signed acknowledgment. Comments that address the relative advantages and burdens of such a provision would be most useful. We also solicit comment on the best way to obtain signed acknowledgments from health plans if such a provision is included in the final rule. We also solicit comments on other strategies, not involving signed acknowledgments, to ensure that individuals are effectively informed about the information practices of covered plans or providers.