Hipaa Business Associate Agreement printable pdf download

ABILITY NETWORK INC |

HIPAA BUSINESS ASSOCIATE AGREEMENT

This HIPAA Business Associate Agreement (“HIPAA Agreement”), effective as of the _________ day

of _________________ 20___, is made by and between _____________________________________________

(“Covered Entity”) and ABILITY Network Inc. (“ABILITY”) for the purpose of compliance with the Health Insurance

Portability and Accountability Act and its implementing administrative simplification regulations (45 CFR 160-164)

(“HIPAA”) and Subtitle D of the Health Information Technology for Economic and Clinical Health Act (“HITECH”).

This HIPAA Agreement hereby amends and is incorporated into any underlying agreement with respect to Covered

Entity and ABILITY; to the extent that the provisions of this HIPAA Agreement conflict with those of an underlying

agreement, the provisions of this HIPAA Agreement shall control. Terms used but not otherwise defined herein

shall have the same meaning as those terms defined in 45 CFR 160.103 and 164.501.

If, in the provision of services to Covered Entity, ABILITY representatives receive or have access to

Protected Health Information (“PHI”) that is created and/or maintained by Covered Entity, ABILITY shall be bound

to the terms outlined below. These provisions will not apply to the disclosure, use or access to de-identified

information:

1. Permitted Uses and Disclosures. ABILITY may use and disclose PHI: (i) in the course of performing services

for or on behalf of Covered Entity; (ii) or as required or permitted by law, regulation, regulatory agency or by

any accrediting body to whom Covered Entity or ABILITY may be required to disclose such PHI; (iii) as set

forth in an authorization that complies with HIPAA and HITECH, or (iv) to provide Data Aggregation services,

as permitted by 45 C.F.R. § 164.504(e)(2)(i)(B).

Except as otherwise limited in this Agreement, ABILITY may use PHI for the proper management and

administration of ABILITY or to carry out the legal responsibilities of ABILITY.

2. ABILITY’s Obligations. ABILITY shall:

ensure that its agents and subcontractors to whom it may provide PHI agree to the same

terms and conditions as are applicable to ABILITY through a written contractual agreement

that complies with 42 C.F.R. § 164.314;

implement appropriate and reasonable safeguards to prevent use or disclosure of PHI other

than as permitted herein, including those safeguards required pursuant to 45 C.F.R.

§ 164.308, 164.310, 164.312, 164.314, and 164.316, in the same manner that those

requirements apply to Covered Entity pursuant to 45 C.F.R. § 164.504, and report to Covered

Entity any use or disclosure of PHI not provided for by this Agreement;

make available to the Secretary of Health and Human Services, ABILITY’s internal practices,

books and records relating to the use or disclosure of PHI for purposes of determining

Covered Entity’s compliance with HIPAA; subject to any attorney-client or other privileges;

report to the Covered Entity, and mitigate to the extent practicable, any harmful effect that is

known to ABILITY of, uses or disclosures of PHI of which ABILITY becomes aware that do not

comply with the terms herein, including breaches of unsecured PHI as required by 45 C.F.R.

§ 164.410, and any Security Incident of which it becomes aware;

to the extent that Covered Entity and ABILITY agree in writing that ABILITY shall maintain PHI

as part of a Designated Record Set, upon Covered Entity’s request, provide paper or

electronic access and make amendments to such PHI, in order to meet the requirements

under HIPAA, and if an individual requests an electronic copy of their information from

Covered Entity, ABILITY must provide Covered Entity with the information requested in the

electronic form and format requested by the individual and/or Covered Entity if it is readily

producible in such form and format; or if not, in a readable electronic form and format as

requested by Covered Entity; and if ABILITY receives a request for amendment to PHI directly

from an individual, ABILITY shall notify Covered Entity upon receipt of such request;

document such uses and disclosures of PHI and, upon Covered Entity’s request, provide such

information as would be required for Covered Entity to account for disclosures of PHI as

required under HIPAA;

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Hipaa Business Associate Agreement

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