Business Associate Agreement

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This Business Associate Agreement (the “Agreement”) is effective as of
(the “Agreement Effective Date”) by and between
(“CE”) and
WHEREAS, CE has engaged BA to perform services or provide goods, or both;
WHEREAS, CE possesses Individually Identifiable Health Information that is protected
under HIPAA (as hereinafter defined) and the HIPAA Regulations (as hereinafter defined), and
is permitted to use or disclose such information only in accordance with HIPAA and the HIPAA
WHEREAS, BA may receive such information from CE, or create and receive such
information on behalf of CE, in order to perform certain of the services or provide certain of the
goods, or both; and
WHEREAS, CE wishes to ensure that BA will appropriately safeguard Individually
Identifiable Health Information;
NOW THEREFORE, CE and BA agree as follows:
Definitions. The parties agree that the following terms, when used in this Agreement,
shall have the following meanings, provided that the terms set forth below shall be deemed to be
modified to reflect any changes made to such terms from time to time as defined in HIPAA and
the HIPAA Regulations.
a. “Business Associate” means, with respect to a Covered Entity, a person who:
(1) on behalf of such Covered Entity or of an organized health care arrangement
(as defined under the HIPAA Regulations) in which Covered Entity participates,
but other than in the capacity of a member of the workforce of such Covered
Entity or arrangement, performs, or assists in the performance of:
a) a function or activity involving the use or disclosure of Individually
Identifiable Health Information, including claims processing or
administration, data analysis, processing or administration, utilization
review, quality assurance, billing, benefit management, practice
management, and repricing; or
b) any other function or activity regulated by the HIPAA Regulations; or


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