; and (iii) providers of services and suppliers participating under this title have near real-time online access to the advance directive of an eligible beneficiary who has adopted an advance directive with such vendor or entity, including communication of the advance directive and corresponding beneficiary’s wishes through secure email and messaging technologies and nationally recognized health care information technology standards specified by the Secretary to improve the accessibility and interoperability of such directives. (E) Privacy protections (i) In general The advance directive vendor or other entity providing an advance directive shall comply with the Federal regulations (concerning the privacy of individually identifiable health information) promulgated under section 264(c) of the Health Insurance Portability and Accountability Act of 1996 ( 42 U.S.C. 1320d–2 note), subject to the access authorized under subparagraph (D) and subsection (a)(8). (ii) Access Such vendor or entity shall utilize standardized data protections and privacy standards, including the Federal regulations described in clause (i), to ensure that the content of an eligible beneficiary’s advance directive is owned and maintained by the beneficiary and can only be accessed by those authorized to access the advance directive under subparagraph (D) and subsection (a)(8). (F) Security and testing The advance directive vendor or other entity providing an advance directive shall certify that— (i) all data management and data transfer elements involved in adopting, maintaining, and accessing the advance directive have successfully passed rigorous independent testing regarding standards of timeliness, accuracy, and efficiency; (ii) the data management and data transfer elements involved in adopting, maintaining, and accessing the advance directive meet widely accepted industry security standards