HIPAA Privacy Rule Policies

Save this PDF as:
 WORD  PNG  TXT  JPG

Size: px
Start display at page:

Download "HIPAA Privacy Rule Policies"

Transcription

1 DRAFT - Policies and Procedures PRIVACY OFFICE ASSIGNMENT AND RESPONSIBILITIES APPROVED BY: SUPERCEDES POLICY: Policy #1 ADOPTED: REVISED: REVIEWED: Purpose This policy is designed to assure the establishment of a Privacy Office for the purpose of overseeing [YOUR COMPANY NAME] s obligations to maintain the privacy of protected health information (PHI) consistent with state and federal privacy laws in accordance with 45 CFR Administrative Requirements. Policy It is [YOUR COMPANY NAME] policy to maintain a Privacy Office headed by the Privacy Officer responsible for all [YOUR COMPANY NAME] s privacy matters including policies and procedures and for assuring that all for [YOUR COMPANY NAME] s workforce members comply with such requirements. Definitions Refer to HIPAA-HITECH Privacy and Security Glossary. Procedures: 1. Appointment of Privacy Officer. [YOUR COMPANY NAME] will maintain a Privacy Office and appoint a Privacy Officer to be responsible for ensuring compliance with privacy requirements throughout [YOUR COMPANY NAME]. 2. Responsibilities of Privacy Officer. The Privacy Officer will lead the Privacy Office and have the responsibilities set forth in Exhibit A which will include receiving complaints related to privacy. 1 Clearwater Compliance LLC All Rights Reserved

2 3. Contacting the Privacy Officer. The Privacy Office can be contacted via [YOUR COMPANY NAME] secure at COMPANY NAME] address twenty-four (24) hours a day, seven (7) days a week. Incident and disclosure reports must be immediately completed in the online form located at 4. Documentation and Retention. This version of the policy, together with any forms and other documentation created or obtained in accordance with the policy, will be retained by [YOUR COMPANY NAME] for at least seven (7) years from the date of creation or last use, whichever is later. 2 Clearwater Compliance LLC All Rights Reserved

3 Exhibit A: Responsibilities of the Privacy Office Purpose. The Privacy Office is responsible for [YOUR COMPANY NAME] s compliance with state and federal privacy and breach notification laws. Qualifications. The Privacy Office collectively will have experience in information management and be familiar with the day-to-day operations of [YOUR COMPANY NAME]. The Privacy Office collectively will have the ability to work well with [YOUR COMPANY NAME] s management including Information Security Office, Legal Counsel, Human Resources, Customers, Subcontractors, regulatory agencies and law officials. The Privacy Office will have a strong practical working knowledge of [YOUR COMPANY NAME] s operations and of state and federal privacy and breach notification regulations. Responsibilities: Under the leadership of the Privacy Officer, the Privacy Office will be responsible for: 1. Developing [YOUR COMPANY NAME] s privacy and breach notification policies and procedures in coordination with [YOUR COMPANY NAME] s management and legal counsel. 2. Investigating and maintaining a log of all reported incidences and follow-up activities related to [YOUR COMPANY NAME] and/or [YOUR COMPANY NAME] s Business Associates [see Privacy Policy #4 Reporting Violations, Sanctions and Mitigation and Privacy Policy # 15 Reporting Impermissible Uses and Disclosures]. 3. Monitoring and communicating changes in privacy laws and regulations and assuring that any necessary revisions are made to [YOUR COMPANY NAME] s privacy and breach notification policies and procedures in a timely manner. 4. Conducting periodic assessments of compliance with [YOUR COMPANY NAME] privacy and breach notification policies and procedures, and making [YOUR 3 Clearwater Compliance LLC All Rights Reserved

4 COMPANY NAME] management aware of any known or potential problems that will be addressed. 5. Participating in the identification of subcontractors that handle PHI on behalf of [YOUR COMPANY NAME] and ensuring that appropriate agreements and safeguards are implemented and maintained between [YOUR COMPANY NAME] and its vendors and subcontractors [see Privacy Policy #10 Uses By and Disclosures to Subcontractors and Third Parties]. 6. Investigating and following up, as appropriate, on requests and disclosures of PHI assigned to the Privacy Office [see Privacy Policy #5 Required Disclosures, Privacy Policy #6 Request for Health Record, Privacy Policy #7 Amendment of Health Information, Privacy Policy #8 Accounting of Disclosures, and Privacy Policy #9 Authorization to Use or Disclose PHI]. 7. Determining whether a charge for an accounting of disclosures is appropriate, and, if so, the amount of such charge [see Privacy Policy #8 Accounting of Disclosures]. 8. Maintaining, or ensuring the maintenance of, all documentation required by the Privacy and Breach Notification Rules as outlined in {YOUR COMPANY NAME} s Privacy and Breach Notification Policies and Procedures. 9. Ensuring the development and provision of [YOUR COMPANY NAME] s initial and ongoing privacy training for workforce members, including orientation for new workforce members and updates for current workforce members periodically and when necessary [see Privacy Policy #2 Privacy Training Requirements]. 10. Responding to Individual s concerns and complaints regarding [YOUR COMPANY NAME] privacy policies and procedures [see Privacy Policy # 16 Reporting and Responding to Privacy Complaints]. 11. Responding to and coordinating [YOUR COMPANY NAME] s response to privacy audits by Customers and regulatory agencies, and working with [YOUR 4 Clearwater Compliance LLC All Rights Reserved

5 COMPANY NAME] Management to assure that appropriate actions are taken to resolve any problems. 12. Collaborating with [YOUR COMPANY NAME] Information Security and Facilities Departments, and assisting in the development of appropriate administrative, physical and technical safeguards for the protection of PHI in [YOUR COMPANY NAME] s care [see Privacy Policy # 18 Data Safeguards] 13. Assisting [YOUR COMPANY NAME] s Human Resources department in developing appropriate disciplinary measures when workforce members violate [YOUR COMPANY NAME] privacy policies and procedures [see Privacy Policy #4 Reporting Violations, Sanctions and Mitigation]. 14. Cooperating with Customers and state and federal agencies, including the Department of Health and Human Services and the Office for Civil Rights, in any and all compliance reviews or investigations. Documentation This version of the policy, together with any forms and other documentation created or obtained in accordance with the policy, will be retained by [YOUR COMPANY NAME] for at least seven (7) years or from the date of creation or data of last use, whichever is later. Regulatory Authority Administrative requirements. (a) (1) Standard: Personnel designations. (i) A covered entity must designate a privacy official who is responsible for the development and implementation of the policies and procedures of the entity. 5 Clearwater Compliance LLC All Rights Reserved

6 (ii) A covered entity must designate a contact person or office who is responsible for receiving complaints under this section and who is able to provide further information about matters covered by the notice required by (2) Implementation specification: Personnel designations. A covered entity must document the personnel designations in paragraph (a)(1) of this section as required by paragraph (j) of this section. 6 Clearwater Compliance LLC All Rights Reserved

Exhibit 2. Business Associate Addendum

Exhibit 2. Business Associate Addendum Exhibit 2 Business Associate Addendum This Business Associate Addendum ( Addendum ) governs the use and disclosure of Protected Health Information by EOHHS when functioning as a Business Associate in performing

More information

HIPAA Business Associate Contract. Definitions

HIPAA Business Associate Contract. Definitions HIPAA Business Associate Contract Definitions Terms used, but not otherwise defined, in this Agreement shall have the same meaning as those terms in the Privacy Rule. Examples of specific definitions:

More information

Sample Business Associate Agreement Provisions

Sample Business Associate Agreement Provisions Sample Business Associate Agreement Provisions Words or phrases contained in brackets are intended as either optional language or as instructions to the users of these sample provisions. Definitions Catch-all

More information

BUSINESS ASSOCIATE AGREEMENT. Recitals

BUSINESS ASSOCIATE AGREEMENT. Recitals BUSINESS ASSOCIATE AGREEMENT This Agreement is executed this 8 th day of February, 2013, by BETA Healthcare Group. Recitals BETA Healthcare Group consists of BETA Risk Management Authority (BETARMA) and

More information

Business Associate Agreement

Business Associate Agreement Business Associate Agreement This Business Associate Agreement (the Agreement ) is made by and between Business Associate, [Name of Business Associate], and Covered Entity, The Connecticut Center for Health,

More information

BUSINESS ASSOCIATE AGREEMENT

BUSINESS ASSOCIATE AGREEMENT BUSINESS ASSOCIATE AGREEMENT This Agreement ( Agreement ) is made and entered into this day of [Month], [Year] by and between [Business Name] ( Covered Entity ), [Type of Entity], whose business address

More information

BUSINESS ASSOCIATE AGREEMENT HIPAA Omnibus Rule (Final Rule)

BUSINESS ASSOCIATE AGREEMENT HIPAA Omnibus Rule (Final Rule) BUSINESS ASSOCIATE AGREEMENT HIPAA Omnibus Rule (Final Rule) This Business Associate Agreement (the Agreement ), dated September 9, 2013, is entered into by and between ( Covered Entity ) and Schuster

More information

SAMPLE BUSINESS ASSOCIATE AGREEMENT

SAMPLE BUSINESS ASSOCIATE AGREEMENT SAMPLE BUSINESS ASSOCIATE AGREEMENT This is a draft business associate agreement based on the template provided by HHS. It is not intended to be used as is and you should only use the agreement after you

More information

BUSINESS ASSOCIATE ADDENDUM

BUSINESS ASSOCIATE ADDENDUM BUSINESS ASSOCIATE ADDENDUM This Business Associate Addendum ( Addendum ) adds to and is made a part of the Q- global Subscription and License Agreement by and between NCS Pearson, Inc. ( Business Associate

More information

Business Associate Agreement (BAA) Guidance

Business Associate Agreement (BAA) Guidance Business Associate Agreement (BAA) Guidance Introduction The purpose of this document is to provide guidance for creating or updating business associate agreements between your Practice ( Covered Entity

More information

STATE OF NEVADA DEPARTMENT OF HEALTH AND HUMAN SERVICES BUSINESS ASSOCIATE ADDENDUM

STATE OF NEVADA DEPARTMENT OF HEALTH AND HUMAN SERVICES BUSINESS ASSOCIATE ADDENDUM STATE OF NEVADA DEPARTMENT OF HEALTH AND HUMAN SERVICES BUSINESS ASSOCIATE ADDENDUM BETWEEN The Division of Health Care Financing and Policy Herein after referred to as the Covered Entity and (Enter Business

More information

It s a New Regulatory Landscape: Do You Know Where Your Business Associates are and What They are Doing?

It s a New Regulatory Landscape: Do You Know Where Your Business Associates are and What They are Doing? It s a New Regulatory Landscape: Do You Know Where Your Business Associates are and What They are Doing? The AMC Privacy & Security Conference Series Securely Connecting Communities for Improved Health

More information

BUSINESS ASSOCIATE AGREEMENT

BUSINESS ASSOCIATE AGREEMENT BUSINESS ASSOCIATE AGREEMENT This Addendum is made part of the agreement between Boston Medical Center ("Covered Entity ) and ( Business Associate"), dated [the Underlying Agreement ]. In connection with

More information

BREVIUM HIPAA BUSINESS ASSOCIATE TERMS AND CONDITIONS

BREVIUM HIPAA BUSINESS ASSOCIATE TERMS AND CONDITIONS BREVIUM HIPAA BUSINESS ASSOCIATE TERMS AND CONDITIONS The following HIPAA Business Associate Terms and Conditions (referred to hereafter as the HIPAA Agreement ) are part of the Brevium Software License

More information

BUSINESS ASSOCIATE AGREEMENT

BUSINESS ASSOCIATE AGREEMENT BUSINESS ASSOCIATE AGREEMENT This Business Associate Agreement ( Agreement ) is effective as of, 200 ( Effective Date ), and entered into by and between, whose address is ( Business Associate ) and THE

More information

HIPAA Business Associate Agreement

HIPAA Business Associate Agreement HIPAA Business Associate Agreement This HIPAA Business Associate Agreement ( BAA ), effective as of, ( Effective Date ), is made by and between ( Covered Entity ) and da Vinci Motion Graphics, Inc. d/b/a

More information

OFFICE OF CONTRACT ADMINISTRATION 60400 PURCHASING DIVISION. Appendix A HEALTHCARE INSURANCE PORTABILITY AND ACCOUNTABILITY ACT (HIPPA)

OFFICE OF CONTRACT ADMINISTRATION 60400 PURCHASING DIVISION. Appendix A HEALTHCARE INSURANCE PORTABILITY AND ACCOUNTABILITY ACT (HIPPA) Appendix A HEALTHCARE INSURANCE PORTABILITY AND ACCOUNTABILITY ACT (HIPPA) BUSINESS ASSOCIATE ADDENDUM This Business Associate Addendum ( Addendum ) supplements and is made a part of the contract ( Contract

More information

Business Associate Agreement

Business Associate Agreement Business Associate Agreement I. Definitions Catch-all definition: The following terms used in this Agreement shall have the same meaning as those terms in the HIPAA Rules: Breach, Data Aggregation, Designated

More information

Business Associate Agreement

Business Associate Agreement Business Associate Agreement This BUSINESS ASSOCIATE AGREEMENT (the "Agreement") is entered into by and between the Board of Regents of the University of Wisconsin System on behalf of the [insert name

More information

SaaS. Business Associate Agreement

SaaS. Business Associate Agreement SaaS Business Associate Agreement This Business Associate Agreement ( BA Agreement ) becomes effective pursuant to the terms of Section 5 of the End User Service Agreement ( EUSA ) between Customer ( Covered

More information

Appendix : Business Associate Agreement

Appendix : Business Associate Agreement I. Authority: Pursuant to 45 C.F.R. 164.502(e), the Indian Health Service (IHS), as a covered entity, is required to enter into an agreement with a business associate, as defined by 45 C.F.R. 160.103,

More information

INDIANA UNIVERSITY SCHOOL OF OPTOMETRY HIPAA COMPLIANCE PLAN TABLE OF CONTENTS. I. Introduction 2. II. Definitions 3

INDIANA UNIVERSITY SCHOOL OF OPTOMETRY HIPAA COMPLIANCE PLAN TABLE OF CONTENTS. I. Introduction 2. II. Definitions 3 INDIANA UNIVERSITY SCHOOL OF OPTOMETRY HIPAA COMPLIANCE PLAN TABLE OF CONTENTS I. Introduction 2 II. Definitions 3 III. Program Oversight and Responsibilities 4 A. Structure B. Compliance Committee C.

More information

Professional Solutions Insurance Company. Business Associate Agreement re HIPAA Rules

Professional Solutions Insurance Company. Business Associate Agreement re HIPAA Rules Professional Solutions Insurance Company Business Associate Agreement re HIPAA Rules I. Purpose of Agreement This Agreement reflects Professional Solutions Insurance Company s agreement to comply with

More information

BUSINESS ASSOCIATE AGREEMENT

BUSINESS ASSOCIATE AGREEMENT BUSINESS ASSOCIATE AGREEMENT 1. DEFINITIONS: 1.1 Undefined Terms: Terms used, but not otherwise defined, in this Agreement shall have the same meaning as those terms defined by the Health Insurance Portability

More information

DRAFT BUSINESS ASSOCIATES AGREEMENT

DRAFT BUSINESS ASSOCIATES AGREEMENT DRAFT BUSINESS ASSOCIATES AGREEMENT THIS AGREEMENT is made this day of, 20, by and among, a Corporation organized under the laws of the State of (hereinafter known as "Covered Entity") and organized under

More information

RUTGERS POLICY. Policy Name: Standards for Privacy of Individually Identifiable Health Information

RUTGERS POLICY. Policy Name: Standards for Privacy of Individually Identifiable Health Information RUTGERS POLICY Section: 100.1.9 Section Title: HIPAA Policies Policy Name: Standards for Privacy of Individually Identifiable Health Information Formerly Book: 00-01-15-05:00 Approval Authority: RBHS Chancellor

More information

HIPAA BUSINESS ASSOCIATE AGREEMENT

HIPAA BUSINESS ASSOCIATE AGREEMENT HIPAA BUSINESS ASSOCIATE AGREEMENT This HIPAA Business Associate Agreement ( Agreement ) is entered into as of the day of, 2013 by and between RUTGERS UNIVERSITY, a Hybrid Entity, on behalf and for the

More information

HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT (HIPAA) TERMS AND CONDITIONS FOR BUSINESS ASSOCIATES

HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT (HIPAA) TERMS AND CONDITIONS FOR BUSINESS ASSOCIATES HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT (HIPAA) TERMS AND CONDITIONS FOR BUSINESS ASSOCIATES I. Overview / Definitions The Health Insurance Portability and Accountability Act is a federal law

More information

ACTION COLLECTION SERVICES INC. BUSINESS ASSOCIATE AGREEMENT (FOR MEDICAL PROVIDERS)

ACTION COLLECTION SERVICES INC. BUSINESS ASSOCIATE AGREEMENT (FOR MEDICAL PROVIDERS) ACTION COLLECTION SERVICES INC. BUSINESS ASSOCIATE AGREEMENT (FOR MEDICAL PROVIDERS) THIS BUSINESS ASSOCIATE AGREEMENT (the Agreement ), is dated as of, by and between Action Collection Services Inc. (

More information

INTERMACS REGISTRY BUSINESS ASSOCIATE AGREEMENT

INTERMACS REGISTRY BUSINESS ASSOCIATE AGREEMENT INTERMACS REGISTRY BUSINESS ASSOCIATE AGREEMENT This Agreement dated as of is made by and between The Board of Trustees of the University of Alabama, on behalf of INTERMACS Registry ( Business Associate

More information

COVERMYMEDS BUSINESS ASSOCIATE AGREEMENT

COVERMYMEDS BUSINESS ASSOCIATE AGREEMENT COVERMYMEDS BUSINESS ASSOCIATE AGREEMENT THIS BUSINESS ASSOCIATE AGREEMENT (the Agreement ) is entered into between Covered Entity and CoverMyMeds LLC, a Delaware limited liability company ( Business Associate

More information

Snake River School District No. 52 HIPAA BUSINESS ASSOCIATE AGREEMENT (See also Policy No. 7436, HIPAA Privacy Rule)

Snake River School District No. 52 HIPAA BUSINESS ASSOCIATE AGREEMENT (See also Policy No. 7436, HIPAA Privacy Rule) 5450F1 (page 1 of 6) Snake River School District No. 52 HIPAA BUSINESS ASSOCIATE AGREEMENT (See also Policy No. 7436, HIPAA Privacy Rule) THIS AGREEMENT is entered into on this day of, 20 by and between

More information

ADDENDUM TO ADMINISTRATIVE SERVICES AGREEMENT FOR HIPAA PRIVACY/SECURITY RULES

ADDENDUM TO ADMINISTRATIVE SERVICES AGREEMENT FOR HIPAA PRIVACY/SECURITY RULES ADDENDUM TO ADMINISTRATIVE SERVICES AGREEMENT FOR HIPAA PRIVACY/SECURITY RULES This Addendum is entered into effective as of, by and among Delta Dental of Virginia ("Business Associate"), and ( Covered

More information

Definitions. Catch-all definition:

Definitions. Catch-all definition: BUSINESS ASSOCIATE AGREEMENT THESE PROVISIONS MAY STAND ALONE AS A BUSINESS ASSOCIATE AGREEMENT, OR MAY BE INCORPORATED INTO A LARGER, MORE COMPREHENSIVE CONTRACT WITH THE BUSINESS ASSOCIATE TO COVER OTHER

More information

MANUAL OF UNIVERSITY POLICIES PROCEDURES AND GUIDELINES. Applies to: faculty staff students student employees visitors contractors

MANUAL OF UNIVERSITY POLICIES PROCEDURES AND GUIDELINES. Applies to: faculty staff students student employees visitors contractors Page 1 of 5 Applies to: faculty staff students student employees visitors contractors Effective Date of This Revision: October 19, 2006 Contact for More Information: Chief Privacy Officer 1303 A West Campus

More information

Business Associate Agreement

Business Associate Agreement Business Associate Agreement This Business Associate Agreement (this "Agreement") is made as of, 201_ (the Effective Date ), and is entered into between ( Covered Entity ) and Delta Business System, Inc.

More information

MMA SAMPLE FORM *REVIEW CAREFULLY & ADAPT TO YOUR PRACTICE*

MMA SAMPLE FORM *REVIEW CAREFULLY & ADAPT TO YOUR PRACTICE* This is only sample language. The language should be changed to accurately reflect business arrangements between a covered entity and business associate or business associate and subcontractor. In addition,

More information

Please print the attached document, sign and return to privacy@covermymeds.com or contact Erica Van Treese, Account Manager, Provider Relations &

Please print the attached document, sign and return to privacy@covermymeds.com or contact Erica Van Treese, Account Manager, Provider Relations & Please print the attached document, sign and return to privacy@covermymeds.com or contact Erica Van Treese, Account Manager, Provider Relations & Solutions. Office: 866-452-5017, Fax: 615-379-2541, evantreese@covermymeds.com

More information

SCDA and SCDA Member Benefits Group

SCDA and SCDA Member Benefits Group SCDA and SCDA Member Benefits Group HIPAA Privacy Policy 1. PURPOSE The purpose of this policy is to protect personal health information (PHI) and other personally identifiable information for all individuals

More information

Receipt of the BAA constitutes acceptance thereof, provided that you do not provide a written objection within fourteen (14) days of receipt.

Receipt of the BAA constitutes acceptance thereof, provided that you do not provide a written objection within fourteen (14) days of receipt. Re: Notice of Business Associate Agreement This Notice concerns the mutual obligations arising from the COBRA Administration Contract ( Contract ) between your company ( Covered Entity ) and Small Business

More information

LCD SOLUTIONS and CLICKTATE.COM BUSINESS ASSOCIATE AGREEMENT and DISCLOSURE of RIGHTS to COVERED ENTITIES

LCD SOLUTIONS and CLICKTATE.COM BUSINESS ASSOCIATE AGREEMENT and DISCLOSURE of RIGHTS to COVERED ENTITIES LCD SOLUTIONS and CLICKTATE.COM BUSINESS ASSOCIATE AGREEMENT and DISCLOSURE of RIGHTS to COVERED ENTITIES DEFINTIONS Terms used, but not otherwise defined, in this Agreement shall have the same meaning

More information

BUSINESS ASSOCIATE AGREEMENT

BUSINESS ASSOCIATE AGREEMENT THIS IS A TEMPLATE ONLY. CERTAIN STATES MAY NOT PERMIT THE TYPES OF ACTIVITIES ALLOWED HEREUNDER RELATING TO PROTECTED HEALTH INFORMATION. THUS THIS AGREEMENT MAY NEED TO BE MODIFIED IN ORDER TO COMPLY

More information

CONTRACT ADDENDUM BUSINESS ASSOCIATE CONTRACT 1

CONTRACT ADDENDUM BUSINESS ASSOCIATE CONTRACT 1 CONTRACT ADDENDUM BUSINESS ASSOCIATE CONTRACT 1 THIS AGREEMENT is entered into on ( Effective Date ) by and between LaSalle County Health Department, hereinafter called Covered Entity and, hereinafter

More information

BUSINESS ASSOCIATE ADDENDUM. WHEREAS, Provider (as defined below) has a contractual relationship with FHCCP requiring this Addendum;

BUSINESS ASSOCIATE ADDENDUM. WHEREAS, Provider (as defined below) has a contractual relationship with FHCCP requiring this Addendum; BUSINESS ASSOCIATE ADDENDUM This BUSINESS ASSOCIATE ADDENDUM (this Addendum ) is made and entered into as of July 1, 2012, ( Effective Date ) and supplements and is made a part of the services agreement

More information

BUSINESS ASSOCIATE AGREEMENT ( BAA )

BUSINESS ASSOCIATE AGREEMENT ( BAA ) BUSINESS ASSOCIATE AGREEMENT ( BAA ) Pursuant to the terms and conditions specified in Exhibit B of the Agreement (as defined in Section 1.1 below) between EMC (as defined in the Agreement) and Subcontractor

More information

TABLE OF CONTENTS. University of Northern Colorado

TABLE OF CONTENTS. University of Northern Colorado TABLE OF CONTENTS University of Northern Colorado HIPAA Policies and Procedures Page # Development and Maintenance of HIPAA Policies and Procedures... 1 Procedures for Updating HIPAA Policies and Procedures...

More information

HIPAA Privacy and Business Associate Agreement

HIPAA Privacy and Business Associate Agreement HR 2011-07 ATTACHMENT D HIPAA Privacy and Business Associate Agreement This Agreement is entered into this day of,, between [Employer] ( Employer ), acting on behalf of [Name of covered entity/plan(s)

More information

Sample Business Associate Agreement (4. Other Bus. Assoc., Version 6-06-05)

Sample Business Associate Agreement (4. Other Bus. Assoc., Version 6-06-05) Sample Business Associate Agreement (4. Other Bus. Assoc., Version 6-06-05) This Business Associate Agreement (the Agreement ) is entered into as of, 20, (the Effective Date ) by and between, (the Covered

More information

UNIVERSITY OF WYOMING HIPAA POLICY 3.6 BREACH

UNIVERSITY OF WYOMING HIPAA POLICY 3.6 BREACH UNIVERSITY OF WYOMING HIPAA POLICY 3.6 BREACH I. PURPOSE: The purpose of this policy is to outline the processes and procedures for determining whether the security or privacy of PHI has been compromised

More information

BUSINESS ASSOCIATE AGREEMENT

BUSINESS ASSOCIATE AGREEMENT BUSINESS ASSOCIATE AGREEMENT This Business Associate Agreement (the "Agreement") is made and entered into this day of,, by and between Quicktate and idictate ("Business Associate") and ("Covered Entity").

More information

HIPAA BUSINESS ASSOCIATE ADDENDUM

HIPAA BUSINESS ASSOCIATE ADDENDUM HIPAA BUSINESS ASSOCIATE ADDENDUM This Addendum, dated as of, 2007 ( Addendum ), supplements and is made a part of the Services Agreement (as defined below) by and between ( Covered Entity ) and FUJIFILM

More information

HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT (HIPAA) BUSINESS ASSOCIATE AGREEMENT

HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT (HIPAA) BUSINESS ASSOCIATE AGREEMENT HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT (HIPAA) BUSINESS ASSOCIATE AGREEMENT This HIPAA Business Associate Agreement ( BAA ) is by and between the National Association of Boards of Pharmacy

More information

BUSINESS ASSOCIATE AGREEMENT

BUSINESS ASSOCIATE AGREEMENT BUSINESS ASSOCIATE AGREEMENT This Business Associate Agreement ( Agreement ) between Inphonite, LLC ( Business Associate and you, as our Customer ( Covered Entity ) (each individually, a Party, and collectively,

More information

Business Associate and Other Agreements

Business Associate and Other Agreements Section 4.3 Implement Business Associate and Other Agreements This tool identifies the types of agreements that may be necessary for a community-based care coordination (CCC) program to have in place in

More information

BUSINESS ASSOCIATE AGREEMENT RECITALS

BUSINESS ASSOCIATE AGREEMENT RECITALS BUSINESS ASSOCIATE AGREEMENT This HIPAA Business Associate Agreement ( Agreement ) is entered into and made this day of, 201_, ( Effective Date ) by and among Interpra, Inc., S & S Health Products, Inc.

More information

HIPAA BUSINESS ASSOCIATE ADDENDUM (Privacy & Security) I. Definitions

HIPAA BUSINESS ASSOCIATE ADDENDUM (Privacy & Security) I. Definitions HIPAA BUSINESS ASSOCIATE ADDENDUM (Privacy & Security) I. Definitions A. Business Associate. Business Associate shall have the meaning given to such term under the Privacy and Security Rules, including,

More information

HIPAA BUSINESS ASSOCIATE AGREEMENT

HIPAA BUSINESS ASSOCIATE AGREEMENT HIPAA BUSINESS ASSOCIATE AGREEMENT This HIPAA Business Associate Agreement ( Agreement ) is by and between ( Covered Entity ) and Xelex Digital, LLC ( Business Associate ), and is effective as of. WHEREAS,

More information

BUSINESS ASSOCIATE AGREEMENT

BUSINESS ASSOCIATE AGREEMENT BUSINESS ASSOCIATE AGREEMENT This Business Associate Agreement ( Agreement ) is between you, a healthcare provider, its employees and agents ( Covered Entity ) and Doc Halo, LLC ( Business Associate ).

More information

ALLINA HOSPITALS & CLINICS System-wide Policy

ALLINA HOSPITALS & CLINICS System-wide Policy ALLINA HOSPITALS & CLINICS System-wide Policy Department: Allina Hospitals & Clinics Corporate Compliance Privacy & Security Compliance Page: 1 of 6 Approved by: Ethics & Compliance Oversight Committee

More information

BUSINESS ASSOCIATE AGREEMENT. Business Associate. Business Associate shall mean.

BUSINESS ASSOCIATE AGREEMENT. Business Associate. Business Associate shall mean. BUSINESS ASSOCIATE AGREEMENT This Business Associate Agreement is made as of the day of, 2010, by and between Methodist Lebonheur Healthcare, on behalf of itself and all of its affiliates ( Covered Entity

More information

Health Care Information Privacy The HIPAA Regulations What Has Changed and What You Need to Know

Health Care Information Privacy The HIPAA Regulations What Has Changed and What You Need to Know Health Care Information Privacy The HIPAA Regulations What Has Changed and What You Need to Know Note: Information provided to NCRA by Melodi Gates, Associate with Patton Boggs, LLC Privacy and data protection

More information

BUSINESS ASSOCIATE AGREEMENT

BUSINESS ASSOCIATE AGREEMENT BUSINESS ASSOCIATE AGREEMENT This Business Associate Agreement (the Agreement ) is entered into by and between Professional Office Services, Inc., with principal place of business at PO Box 450, Waterloo,

More information

HIPAA BUSINESS ASSOCIATE AGREEMENT

HIPAA BUSINESS ASSOCIATE AGREEMENT HIPAA BUSINESS ASSOCIATE AGREEMENT THIS HIPAA BUSINESS ASSOCIATE AGREEMENT ( BAA ) is entered into effective the day of, 20 ( Effective Date ), by and between the Regents of the University of Michigan,

More information

BUSINESS ASSOCIATE AGREEMENT. (Contractor name and address), hereinafter referred to as Business Associate;

BUSINESS ASSOCIATE AGREEMENT. (Contractor name and address), hereinafter referred to as Business Associate; BUSINESS ASSOCIATE AGREEMENT (Agreement #) THIS DOCUMENT CONSTITUTES AN AGREEMENT BETWEEN: AND (Contractor name and address), hereinafter referred to as Business Associate; The Department of Behavioral

More information

CHAPTER 7 BUSINESS ASSOCIATES

CHAPTER 7 BUSINESS ASSOCIATES CHAPTER 7 BUSINESS ASSOCIATES I. GENERAL RULE DMH may disclose Protected Health Information (PHI) to a Business Associate or allow it to create or receive PHI on DMH's behalf only if DMH obtains satisfactory

More information

HIPAA PRIVACY FOR EMPLOYERS A Comprehensive Introduction. HIPAA Privacy Regulations-General

HIPAA PRIVACY FOR EMPLOYERS A Comprehensive Introduction. HIPAA Privacy Regulations-General HIPAA PRIVACY FOR EMPLOYERS A Comprehensive Introduction HIPAA Privacy Regulations-General The final HIPAA Privacy regulation was released on December 20, 2000 and was effective for compliance on April

More information

Cybersecurity in the Health Care Sector: HIPAA Responsibilities from a Legal and Compliance Perspective

Cybersecurity in the Health Care Sector: HIPAA Responsibilities from a Legal and Compliance Perspective Cybersecurity in the Health Care Sector: HIPAA Responsibilities from a Legal and Compliance Perspective July 23, 2013 Gerry Hinkley, Pillsbury Allen Briskin, Pillsbury Pillsbury Winthrop Shaw Pittman LLP

More information

Business Associates Agreement

Business Associates Agreement Business Associates Agreement This Business Associate Agreement (the Agreement ) between Customer,( Covered Entity ) and Kareo ( Business Associate ) will be in effect during any such time period that

More information

Disclaimer: Template Business Associate Agreement (45 C.F.R. 164.308)

Disclaimer: Template Business Associate Agreement (45 C.F.R. 164.308) HIPAA Business Associate Agreement Sample Notice Disclaimer: Template Business Associate Agreement (45 C.F.R. 164.308) The information provided in this document does not constitute, and is no substitute

More information

Definitions: Policy: Duties and Responsibilities: The Privacy Officer will have the following responsibilities and duties:

Definitions: Policy: Duties and Responsibilities: The Privacy Officer will have the following responsibilities and duties: PRIVACY 1.0 FACILITY PRIVACY OFFICER Scope: Purpose: All subsidiaries of Universal Health Services, Inc., including facilities and UHS of Delaware Inc. (collectively, UHS ), including UHS covered entities

More information

BUSINESS ASSOCIATE AGREEMENT

BUSINESS ASSOCIATE AGREEMENT BUSINESS ASSOCIATE AGREEMENT THIS BUSINESS ASSOCIATE AGREEMENT is made and entered into as of the day of, 2013 ( Effective Date ), by and between [Physician Practice] on behalf of itself and each of its

More information

BUSINESS ASSOCIATE AGREEMENT

BUSINESS ASSOCIATE AGREEMENT BUSINESS ASSOCIATE AGREEMENT This Business Associate Agreement ( Agreement ) is entered into on [Month], [Day] 2014 (the effective Date ), by and between Accreditation Association for Ambulatory Health

More information

Use & Disclosure of Protected Health Information by Business Associates

Use & Disclosure of Protected Health Information by Business Associates Applicability: Policy Title: Policy Number: Use & Disclosure of Protected Health Information by Business Associates PP-12 Superseded Policy(ies) or Entity Policy: N/A Date Established: January 31, 2003

More information

BUSINESS ASSOCIATE AGREEMENT

BUSINESS ASSOCIATE AGREEMENT BUSINESS ASSOCIATE AGREEMENT THIS BUSINESS ASSOCIATE AGREEMENT (this Agreement ), effective as of May 1, 2014 (the Effective Date ), by and between ( Covered Entity ) and Orchard Software Corporation,

More information

Louisiana State University System

Louisiana State University System PM-36: Attachment 4 Business Associate Contract Addendum On this day of, 20, the undersigned, [Name of Covered Entity] ("Covered Entity") and [Name of Business Associate] ("Business Associate") have entered

More information

Enclosure. Dear Vendor,

Enclosure. Dear Vendor, Dear Vendor, As you may be aware, the Omnibus Rule was finalized on January 25, 2013 and took effect on March 26, 2013. Under the Health Insurance Portability & Accountability Act (HIPAA) and the Omnibus

More information

Information for Agents and Brokers Regarding the HIPAA Business Associate Agreement

Information for Agents and Brokers Regarding the HIPAA Business Associate Agreement Information for Agents and Brokers Regarding the HIPAA Business Associate Agreement You may be aware that the Health Insurance Portability and Accountability Act of 1996 ( HIPAA ) requires health plans

More information

SAMPLE BUSINESS ASSOCIATE AGREEMENT

SAMPLE BUSINESS ASSOCIATE AGREEMENT SAMPLE BUSINESS ASSOCIATE AGREEMENT THIS AGREEMENT IS TO BE USED ONLY AS A SAMPLE IN DEVELOPING YOUR OWN BUSINESS ASSOCIATE AGREEMENT. ANYONE USING THIS DOCUMENT AS GUIDANCE SHOULD DO SO ONLY IN CONSULT

More information

UNIVERSITY PHYSICIANS OF BROOKLYN HIPAA BUSINESS ASSOCIATE AGREEMENT CONTRACT NO(S):

UNIVERSITY PHYSICIANS OF BROOKLYN HIPAA BUSINESS ASSOCIATE AGREEMENT CONTRACT NO(S): UNIVERSITY PHYSICIANS OF BROOKLYN HIPAA BUSINESS ASSOCIATE AGREEMENT CONTRACT NO(S): THIS AGREEMENT is made by and between UNIVERSITY PHYSICIANS OF BROOKLYN, INC., located at 450 Clarkson Ave., Brooklyn,

More information

Policies and Procedures POLICY: Breach Notification and Mitigation Policy Policy #21 Effective Date: November 7, 2013

Policies and Procedures POLICY: Breach Notification and Mitigation Policy Policy #21 Effective Date: November 7, 2013 Policies and Procedures POLICY: Breach Notification and Mitigation Policy Policy #21 Effective Date: November 7, 2013 Purpose: HIPAA, HITECH, the Illinois Personal Information Protection Act ( PIPA ),

More information

BUSINESS ASSOCIATE AGREEMENT

BUSINESS ASSOCIATE AGREEMENT BUSINESS ASSOCIATE AGREEMENT This Business Associate Agreement is effective September 1, 2013 and made between Community Health Solutions of America, Inc., a Florida corporation ( CHS ) and ( Company ).

More information

BUSINESS ASSOCIATE AGREEMENT

BUSINESS ASSOCIATE AGREEMENT BUSINESS ASSOCIATE AGREEMENT This Business Associate Agreement ( Agreement ) is entered between ("Covered Entity" or "CE") and, ("Business Associate" or "BA"), collectively the Parties, who agree as follows:

More information

BUSINESS ASSOCIATE ADDENDUM

BUSINESS ASSOCIATE ADDENDUM BUSINESS ASSOCIATE ADDENDUM This BA Agreement, effective as of the effective date of the Terms of Use, adds to and is made part of the Terms of Use by and between Business Associate and Covered Entity.

More information

Check In Systems. Software Usage Agreement

Check In Systems. Software Usage Agreement Check In Systems Software Usage Agreement Usage of Check In Systems Inc. software shall constitute agreement with the following; You understand that you have the right to terminate or not use the software

More information

May 9, 2005 HIPAA SECURITY COMPLIANCE GUIDE FOR PIONEER EDUCATORS HEALTH TRUST. Revised 9-2008

May 9, 2005 HIPAA SECURITY COMPLIANCE GUIDE FOR PIONEER EDUCATORS HEALTH TRUST. Revised 9-2008 HIPAA SECURITY COMPLIANCE GUIDE May 9, 2005 FOR PIONEER EDUCATORS HEALTH TRUST. PIONEER EDUCATORS HEALTH TRUST HIPAA Security Introduction Various sponsoring employers (referred to collectively as the

More information

UNH Policy on Compliance with the Health Insurance Portability and Accountability Act (HIPAA)

UNH Policy on Compliance with the Health Insurance Portability and Accountability Act (HIPAA) UNH Policy on Compliance with the Health Insurance Portability and Accountability Act (HIPAA) 1 Preamble Approved August 5, 2014 1.1 The Health Insurance Portability and Accountability Act of 1996 (Public

More information

ADMINISTRATIVE REQUIREMENTS OF HIPAA

ADMINISTRATIVE REQUIREMENTS OF HIPAA ADMINISTRATIVE REQUIREMENTS OF HIPAA Policy: The University of Connecticut will comply with all administrative requirements of the Health Insurance Portability and Accountability Act. Rationale: To maintain

More information

HIPAA BUSINESS ASSOCIATE AGREEMENT

HIPAA BUSINESS ASSOCIATE AGREEMENT HIPAA BUSINESS ASSOCIATE AGREEMENT This HIPAA Business Associate Agreement and is made between BEST Life and Health Insurance Company ( BEST Life ) and ( Business Associate ). RECITALS WHEREAS, the U.S.

More information

Heather L. Hughes, J.D. HIPAA Privacy Officer U.S. Legal Support, Inc. hhughes@uslegalsupport.com www.uslegalsupport.com

Heather L. Hughes, J.D. HIPAA Privacy Officer U.S. Legal Support, Inc. hhughes@uslegalsupport.com www.uslegalsupport.com Heather L. Hughes, J.D. HIPAA Privacy Officer U.S. Legal Support, Inc. hhughes@uslegalsupport.com www.uslegalsupport.com HIPAA Privacy Rule Sets standards for confidentiality and privacy of individually

More information

White Paper THE HIPAA FINAL OMNIBUS RULE: NEW CHANGES IMPACTING BUSINESS ASSOCIATES

White Paper THE HIPAA FINAL OMNIBUS RULE: NEW CHANGES IMPACTING BUSINESS ASSOCIATES White Paper THE HIPAA FINAL OMNIBUS RULE: NEW CHANGES IMPACTING BUSINESS ASSOCIATES CONTENTS Introduction 3 Brief Overview of HIPPA Final Omnibus Rule 3 Changes to the Definition of Business Associate

More information

Business Associates, HITECH & the Omnibus HIPAA Final Rule

Business Associates, HITECH & the Omnibus HIPAA Final Rule Business Associates, HITECH & the Omnibus HIPAA Final Rule HIPAA Omnibus Final Rule Changes Business Associates Marissa Gordon-Nguyen, JD, MPH Health Information Privacy Specialist Office for Civil Rights/HHS

More information

HIPAA Security. 5 Security Standards: Organizational, Policies. Security Topics. and Procedures and Documentation Requirements

HIPAA Security. 5 Security Standards: Organizational, Policies. Security Topics. and Procedures and Documentation Requirements HIPAA Security S E R I E S Security Topics 1. Security 101 for Covered Entities 2. Security Standards - Administrative Safeguards 3. Security Standards - Physical Safeguards 4. Security Standards - Technical

More information

Executive Memorandum No. 27

Executive Memorandum No. 27 OFFICE OF THE PRESIDENT HIPAA Compliance Policy (effective April 14, 2003) Purpose It is the purpose of this Executive Memorandum to set forth the Board of Regents and the University Administration s Policy

More information

A How-To Guide for Updating HIPAA Policies & Procedures to Align with ARRA Health Care Provider Edition Version 1

A How-To Guide for Updating HIPAA Policies & Procedures to Align with ARRA Health Care Provider Edition Version 1 A How-To Guide for Updating HIPAA Policies & Procedures to Align with ARRA Health Care Provider Edition Version 1 Policy and Procedure Templates Reflects modifications published in the Federal Register

More information

What do you need to know?

What do you need to know? What do you need to know? DISCLAIMER Please note that the information provided is to inform our clients and friends of recent HIPAA and HITECH act developments. It is not intended, nor should it be used,

More information

AVE MARIA UNIVERSITY HIPAA PRIVACY NOTICE

AVE MARIA UNIVERSITY HIPAA PRIVACY NOTICE AVE MARIA UNIVERSITY HIPAA PRIVACY NOTICE This Notice of Privacy Practices describes the legal obligations of Ave Maria University, Inc. (the plan ) and your legal rights regarding your protected health

More information

Montclair State University. HIPAA Security Policy

Montclair State University. HIPAA Security Policy Montclair State University HIPAA Security Policy Effective: June 25, 2015 HIPAA Security Policy and Procedures Montclair State University is a hybrid entity and has designated Healthcare Components that

More information

DHHS POLICIES AND PROCEDURES

DHHS POLICIES AND PROCEDURES DHHS POLICIES AND PROCEDURES Section VIII: Privacy and Security Revision History: 8/21/13; 5/1/05 Original Effective Date: 4/14/03 Purpose To ensure that all individuals or organizations that perform specific

More information

USES AND DISCLOSURES OF HEALTH INFORMATION

USES AND DISCLOSURES OF HEALTH INFORMATION HIPAA Privacy Policy NOTICE OF PRIVACY PRACTICES This notice describes how health information about you may be used and disclosed. Please review carefully. The privacy of your health information is important

More information

Business Associate Agreement

Business Associate Agreement Business Associate Agreement This Business Associate Agreement (this Agreement ) is entered into as of _September 23_, 2013, (the Effective Date ) by and between Denise T. Nguyen, DDS, PC ( Dental Practice

More information