Hipaa Confidentiality And Non-Disclosure Agreement printable pdf download

HIPAA CONFIDENTIALITY AND NON-DISCLOSURE AGREEMENT

EMPLOYEE DOCUMENTATION OF HIPAA OMNIBUS RULE TRAINING

THIS AGREEMENT entered into this ____ day of ____________, 20___, by and between

Spectrum Social and Recreation Services, LLC (DBA Spectrum Services), hereafter this

“Healthcare Facility” and _______________________ (name of Employee), hereafter

“Employee”, sets forth the terms and conditions under which information created or

received by or on behalf of this Healthcare Facility (hereafter collectively referred to as

protected health information or “PHI”) may be used or disclosed under state law and the

Health Insurance Portability and Accountability Act of 1996 and updated through HIPAA

Omnibus Rule of 2013 and will also uphold regulations enacted there under (hereafter

“HIPAA”).

THEREFORE, in consideration of the premises and the covenants and agreements

contained herein, the parties hereto, intending to be legally bound hereby, covenant

and agree as follows:

1. All parties acknowledge that meaningful employment may or will necessitate

disclosure of confidential information by this Healthcare Facility to the Employee and

use of confidential information by the Employee. Confidential information includes,

but is not limited to, PHI, any information about patients or other employees, any

computer log-on codes or passwords, any patient records or billing information, any

patient lists, any financial information about this Healthcare Facility or its patients that

is not public, any intellectual property rights of Practice, any proprietary information

of Practice and any information that concerns this Healthcare Facility’s contractual

relationships, relates to this Healthcare Facility’s competitive advantages, or is

otherwise designated as confidential by this Healthcare Facility.

Disclosure and use of confidential information includes oral communications as well

as display or distribution of tangible physical documentation, in whole or in part, from

any source or in any format (e.g., paper, digital, electronic, internet, social networks

like Facebook™ or MySpace™ posting, magnetic or optical media, film, etc.). The

parties have entered into this Agreement to induce use and disclosure of confidential

information and are relying on the covenants contained herein in making any such

use or disclosure.

This Healthcare Facility, not the Employee, is the records owner

under state law and the Employee has no right or ownership interest in any

confidential information.

3. Confidential information will not be used or disclosed by the Employee in violation of

applicable law, including but not limited to HIPAA Federal and State records owner

statute; this Agreement; the Practice’s Notice of Privacy Practices, as amended; or

other limitations as put in place by Practice from time to time. The intent of this

Agreement is to ensure that the Employee will use and access only the minimum

amount of confidential information necessary to perform the Employee’s duties and

will not disclose Confidential information outside this Healthcare Facility unless

expressly authorized in writing to do so by this Healthcare Facility. All Confidential

information received (or which may be received in the future) by Employee will be

held and treated by him or her as confidential and will not be disclosed in any

manner whatsoever, in whole or in part, except as authorized by this Healthcare

Facility and will not be used other than in connection with the employment

relationship.

4. The Employee understands that he or she will be assigned a log-on code or password

by Practice, which may be changed as this Healthcare Facility, in its sole discretion,

sees fit. The Employee will not change the log-on code or password without this

Hipaa Confidentiality And Non-Disclosure Agreement

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