RE: to sign or not to sign

2003-01-24 Thread EHRIEM

Ian, Jim,

I currently am working with 9 software authors/dealers and have advised on
the subject of business associate agreements.  There are a couple of very
different flavors I have put together.  If you're interested, e-mail me off
list and I'll send you a couple samples I have put together for them to
send to their clients.  On the subject of appropriateness of a vendor
initiating, I think provider opinion will vary -- some medical providers on
this list have clearly expressed their desire not to receive these.  I
think the ones who are happy to receive these agreements are the ones who
do not participate on lists like this.

One advantage the vendor has is in a clear understanding of their business
and operations which allows crafting an appropriately worded allowed uses
and disclosures clause.  Here is one for a practice management vendor who
offers EDI software and clearinghouse services:

Business Associate is authorized to use protected health information for
the purposes of computer system training, software support, support for the
proper use and operation of EDI software, EDI clearinghouse support, data
format conversion, and troubleshooting the operation of computerized
practice management system.  Business Associate may access all information
in the computerized practice management and transmitted to the EDI
clearinghouse for the purposes of verifying proper use, operation and
function of the software.





Gary Pritts
Eagle Consulting Group
HIPAA Strategies, Compliance and Education
?xml:namespace prefix = st1 ns
= urn:schemas-microsoft-com:office:smarttags /1568 Northland Ave. /
Lakewood, OH 44107
(216) 228-7959 voice  (216) 233-4960 cell  (216) 228-6272 fax
E-mail:  [EMAIL PROTECTED]



  -Original Message-
  From: Ian Leedom [mailto:[EMAIL PROTECTED]]
  Sent: Thursday, January 23, 2003 12:23 PM
  To: WEDI SNIP Privacy Workgroup List
  Subject: RE: to sign or not to sign

  I also represent a software vendor in a similar situation.  Our take
  has been that we must have Business Agreements (BA) with the CE's
  simply because we have access to PHI.  It also means that at some
  level, we need to know who has in fact accessed things and when.  I
  think that the fact that you have access to a DB which has PHI in it
  is enough to trigger all of the privacy rule in HIPAA .

  My problem, and I'd love to hear from others about this, is what sort
  of BA we should in fact have.  We have enough clients that if we send
  every agreement from every client to our corporate attorneys then
  we'll be bankrupt before April.  And you're right that some clients
  want indemnification for things which are THEIR business and for us
  to keep data even after a business contract has ended.  If anyone has
  any to add to this, I for one would love to hear it.

  Ian Leedom
  Psyche Systems
  321 Fortune Blvd.
  Milford, MA 01757
  Tel: (508) 473-1500 x341
  Compliments humbly accepted.  Flames cheerfully ignored.
-Original Message-
From: Jim Randolph [mailto:[EMAIL PROTECTED]]
Sent: Thursday, January 23, 2003 11:39 AM
To: WEDI SNIP Privacy Workgroup List
Subject: RE: to sign or not to sign

Let me carry this a step further.  We are a software vendor
that has received BACs, TPAs and Chain of Trust agreements from
different customers.
As a vendor to this particular customer base we are exposed to
PHI but never manipulate it in any way.  Our support personnel
do review setup configurations, billing problems or DB issues;
but don't do anything to PHI.  Attorneys and consultants are
advising our customers so differently that no matter what, we
end up being the evil vendor.  Some of the BACs we receive
are rather ridiculous, like requiring us to assume financial
liability if our customer has any HIPAA problems in the future.

The question for the group is: What is required in this
scenario a BAC, TPA or COT?

Jim Randolph
The Echo Group


  -Original Message-
  From: Traci Winter [mailto:[EMAIL PROTECTED]]
  Sent: Wednesday, January 22, 2003 3:49 PM
  To: WEDI SNIP Privacy Workgroup List
  Subject: to sign or not to sign

  OK so the next question is do we sign these BACs or just
  put them in the round file. Your answers reflected what
  my impression was, but I wanted reinforcement.

  Thanks,
  Traci Winter
  ---



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RE: to sign or not to sign

2003-01-23 Thread Dee Warrington



Jim,

According to 
CMS, a software vendor is a business associate of a covered entity as long as 
the vendorneeds access to the PHI of the covered entity in order 
to provide its service. Therefore, you are only required to enter into a 
BAA.


Dee Warrington Director, HIPAA and Regulatory Compliance OAO HealthCare Solutions, Inc. 20955 
Warner Center Lane Woodland Hills, CA 
91367 (818) 598-6606 Fax: (818) 598-3270 [EMAIL PROTECTED] 

  -Original Message-From: Jim Randolph 
  [mailto:[EMAIL PROTECTED]]Sent: Thursday, January 23, 2003 8:39 
  AMTo: WEDI SNIP Privacy Workgroup ListSubject: RE: to 
  sign or not to sign
  
  Let me 
  carry this a step further. We are 
  a software vendor that has received BACs, TPAs and Chain of Trust agreements 
  from different customers.
  As a 
  vendor to this particular customer base we are exposed to PHI but never 
  manipulate it in any way. Our 
  support personnel do review setup configurations, billing problems or DB 
  issues; but dont do anything to PHI. 
  Attorneys and consultants are advising our customers so differently 
  that no matter what, we end up being the evil vendor. Some of the BACs we receive are rather 
  ridiculous, like requiring us to assume financial liability if our customer 
  has any HIPAA problems in the future.
  
  The 
  question for the group is: What is required in this scenario a BAC, TPA or 
  COT?
  
  Jim 
  Randolph 
  The 
  Echo Group
  
  
  -Original 
  Message-From: Traci 
  Winter [mailto:[EMAIL PROTECTED]]Sent: Wednesday, January 22, 2003 3:49 
  PMTo: WEDI SNIP Privacy 
  Workgroup ListSubject: to 
  sign or not to sign
  
  OK so 
  the next question is do we sign these BACs or just put them in the round file. 
  Your answers reflected what my impression was, but I wanted 
  reinforcement.
  
  Thanks,
  Traci 
  Winter
  --The 
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RE: to sign or not to sign

2003-01-23 Thread Harpe, Leslie
Carolyn,

My agreement does not tell my BA how to carry out their business obligation,
only what I expect of them in the treatment of my information.  What would
be a valid reason why I should sign my software vendors agreement? Or,
please give me an example of when I should sign a vendor's agreement. 

I am getting alot of agreements from vendors that I am not signing.  I would
appreciate any insight that you can give me!

Thanks
Leslie 

-Original Message-
From: Price, Carolyn [mailto:[EMAIL PROTECTED]]
Sent: Thursday, January 23, 2003 2:34 PM
To: Harpe, Leslie; WEDI SNIP Privacy Workgroup List
Subject: RE: to sign or not to sign


Leslie:
There are many different types of vendors who may be Business Associates.
Those who perform a function for many different clients are often accessing
PHI in order to fulfill their business obligation.  It is not workable to
have a different set of rules, imposed by each client, to perform the
business function.  This will lead to almost certain errors.  Better to have
one set of rules, spelled out clearly, to allow them to do what they have
been hired to do. The BAK should spell out what safeguards will be imposed,
and what the BA will do in order to assure compliance with HIPAA.  I
understand that you are the covered entity,but you also expect your BA to be
compliant, and to perform in an error-free manner. There will be some BAs
who have a valid reason for asking you to sign their agreement. 
Carolyn Price




-Original Message-
From: Harpe, Leslie [mailto:[EMAIL PROTECTED]]
Sent: Thursday, January 23, 2003 11:13 AM
To: WEDI SNIP Privacy Workgroup List
Subject: RE: to sign or not to sign


I don't think vendors should write agreements.
 
I represent a hospital that is getting a lot of agreements from vendors.  I
say this with strong conviction, I do not want to sign vendor agreements.  I
think that if I've given you access to my patient information, you should
sign my agreement.  After all, its my information and I'm responsible for
it.  Furthermore, you are not a covered entity and you are not required by
law to have an agreement. Do you have a Notice of Privacy Practice?  Of
course not, but why would you follow part of the law and not all of it?
 
I wonder if I'll have this same strong conviction when JCAHO sends me their
agreement.
 
Thanks,
Leslie Harpe
South Georgia Medical Center
 Valdosta, GA  31605
[EMAIL PROTECTED] mailto:[EMAIL PROTECTED] 
 

-Original Message-
From: Ian Leedom [mailto:[EMAIL PROTECTED]]
Sent: Thursday, January 23, 2003 12:23 PM
To: WEDI SNIP Privacy Workgroup List
Subject: RE: to sign or not to sign


I also represent a software vendor in a similar situation.  Our take has
been that we must have Business Agreements (BA) with the CE's simply because
we have access to PHI.  It also means that at some level, we need to know
who has in fact accessed things and when.  I think that the fact that you
have access to a DB which has PHI in it is enough to trigger all of the
privacy rule in HIPAA .  
 
My problem, and I'd love to hear from others about this, is what sort of BA
we should in fact have.  We have enough clients that if we send every
agreement from every client to our corporate attorneys then we'll be
bankrupt before April.  And you're right that some clients want
indemnification for things which are THEIR business and for us to keep data
even after a business contract has ended.  If anyone has any to add to this,
I for one would love to hear it.
 

Ian Leedom
Psyche Systems
321 Fortune Blvd.
Milford, MA 01757
Tel: (508) 473-1500 x341
Compliments humbly accepted.  Flames cheerfully ignored.

-Original Message-
From: Jim Randolph [mailto:[EMAIL PROTECTED]]
Sent: Thursday, January 23, 2003 11:39 AM
To: WEDI SNIP Privacy Workgroup List
Subject: RE: to sign or not to sign



Let me carry this a step further.  We are a software vendor that has
received BACs, TPAs and Chain of Trust agreements from different customers.

As a vendor to this particular customer base we are exposed to PHI but never
manipulate it in any way.  Our support personnel do review setup
configurations, billing problems or DB issues; but don't do anything to PHI.
Attorneys and consultants are advising our customers so differently that no
matter what, we end up being the evil vendor.  Some of the BACs we receive
are rather ridiculous, like requiring us to assume financial liability if
our customer has any HIPAA problems in the future.

 

The question for the group is: What is required in this scenario a BAC, TPA
or COT?

 

Jim Randolph 

The Echo Group

 

 

-Original Message-
From: Traci Winter [mailto:[EMAIL PROTECTED]]
Sent: Wednesday, January 22, 2003 3:49 PM
To: WEDI SNIP Privacy Workgroup List
Subject: to sign or not to sign

 

OK so the next question is do we sign these BACs or just put them in the
round file. Your answers reflected what my impression was, but I wanted
reinforcement.

 

Thanks,

Traci Winter

Re: to sign or not to sign

2003-01-23 Thread Doug Webb
Leslie,
In general, I agree.

The vendor is attempting to reduce the load on ITS legal staff by getting its 
customers to sign their version of the BAA before their cusomers write their own. 

You will have to have a BAA in place with most of these entities.

It doesn't matter who originates the agreement. The CE (in your case, the hospital) is 
the one who must see that the agreement is in place.
Note that the last part of BAA is significant - Agreement.  The final wording must be 
mutually agreed to.

On the other hand, whose wording is used may depend on the amount of competition in 
the field and/or the volume of business you do with the vendor.  If they're the only 
game in town (an example: GE/Marquette EKG systems), or you would be considered small 
potatoes, you may have to live with their wording.  If you can easily change to 
another vendor, you may be able to insist on your wording.

IMHO, the best way to ensure that the wording is closer to your wording is to beat the 
vendors to the punch (send them your version before they try to send you theirs).

In any case, don't sign just because they sent you one.  There may not even be a 
business relationship that makes one necessary.  Make sure that the final agreement 
protects your interests.

The opinions expressed here are my own and not necessarily the opinion of LCMH.

Douglas M. Webb
Computer System Engineer
Little Company of Mary Hospital  Health Care Centers
[EMAIL PROTECTED]

This electronic message may contain information that is confidential and/or legally 
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- Original Message - 
From: Harpe, Leslie [EMAIL PROTECTED]
To: WEDI SNIP Privacy Workgroup List [EMAIL PROTECTED]
Sent: Thursday, January 23, 2003 01:13 PM
Subject: RE: to sign or not to sign


 I don't think vendors should write agreements.
  
 I represent a hospital that is getting a lot of agreements from vendors.  I
 say this with strong conviction, I do not want to sign vendor agreements.  I
 think that if I've given you access to my patient information, you should
 sign my agreement.  After all, its my information and I'm responsible for
 it.  Furthermore, you are not a covered entity and you are not required by
 law to have an agreement. Do you have a Notice of Privacy Practice?  Of
 course not, but why would you follow part of the law and not all of it?
  
 I wonder if I'll have this same strong conviction when JCAHO sends me their
 agreement.
  
 Thanks,
 Leslie Harpe
 South Georgia Medical Center
  Valdosta, GA  31605
 [EMAIL PROTECTED] mailto:[EMAIL PROTECTED] 
  
 
 -Original Message-
 From: Ian Leedom [mailto:[EMAIL PROTECTED]]
 Sent: Thursday, January 23, 2003 12:23 PM
 To: WEDI SNIP Privacy Workgroup List
 Subject: RE: to sign or not to sign
 
 
 I also represent a software vendor in a similar situation.  Our take has
 been that we must have Business Agreements (BA) with the CE's simply because
 we have access to PHI.  It also means that at some level, we need to know
 who has in fact accessed things and when.  I think that the fact that you
 have access to a DB which has PHI in it is enough to trigger all of the
 privacy rule in HIPAA .  
  
 My problem, and I'd love to hear from others about this, is what sort of BA
 we should in fact have.  We have enough clients that if we send every
 agreement from every client to our corporate attorneys then we'll be
 bankrupt before April.  And you're right that some clients want
 indemnification for things which are THEIR business and for us to keep data
 even after a business contract has ended.  If anyone has any to add to this,
 I for one would love to hear it.
  
 
 Ian Leedom
 Psyche Systems
 321 Fortune Blvd.
 Milford, MA 01757
 Tel: (508) 473-1500 x341
 Compliments humbly accepted.  Flames cheerfully ignored.
 
 -Original Message-
 From: Jim Randolph [mailto:[EMAIL PROTECTED]]
 Sent: Thursday, January 23, 2003 11:39 AM
 To: WEDI SNIP Privacy Workgroup List
 Subject: RE: to sign or not to sign
 
 
 
 Let me carry this a step further.  We are a software vendor that has
 received BACs, TPAs and Chain of Trust agreements from different customers.
 
 As a vendor to this particular customer base we are exposed to PHI but never
 manipulate it in any way.  Our support personnel do review setup
 configurations, billing problems or DB issues; but don't do anything to PHI.
 Attorneys and consultants are advising our customers so differently that no
 matter what, we end up being the evil vendor.  Some of the BACs we receive
 are rather ridiculous, like requiring us to assume financial liability if
 our

RE: to sign or not to sign

2003-01-23 Thread Noel Chang
In the OCR guidance that was issued in December, the very last question in 
the section on BA's says this:

Q:  Is a software vendor a business associate of a covered entity?

A:  The mere selling or providing of software to a covered entity does 
not give rise to a business associate relationship if the vendor does not 
have access to the protected health information of the covered entity.  If 
the vendor does need access to the protected health information of the 
covered entity in order to provide its service, the vendor would be a 
business associate of the covered entity.  For example, a software company 
that hosts the software containing patient information on its own server or 
accesses patient information when troubleshooting the software function, is a 
business associate of a covered entity.  In these examples, a covered entity 
would be required to enter into a business associate agreement before 
allowing the software company access to protected health information. 
However, when an employee of a contractor, like a software or information 
technology vendor, has his or her primary duty station on-site at a covered 
entity, the covered entity may choose to treat the employee of the vendor as 
a member of the covered entity’s workforce, rather than as a business 
associate.  See the definition of “workforce” at 45 CFR 160.103.

I would say the need for a BAA then depends on the details of what you do for 
your customers.  If you are a software retailer, like CompUSA or something 
like that, I'd argue no BAA is necessary.  If you provide on site service and 
troubleshooting, or can remotely access the CE database, then I'd say you do 
need a BAA.

I don't think a TPA is appropriate.  My understanding is that this is a 
device from the Transaction and Code Set Standards and would only be used 
between parties that are conducting a covered transaction.

COT agreements I believe are a creature of the long awaited Security Rule and 
since that is not finalized I don't think we can say if a COT is appropriate 
or not.

Noel Chang


--
Open WebMail Project (http://openwebmail.org)


-- Original Message ---
From: [EMAIL PROTECTED] (Jim Randolph)
To: WEDI SNIP Privacy Workgroup List [EMAIL PROTECTED]
Sent: Thu, 23 Jan 2003 11:39:07 -0500
Subject: RE: to sign or not to sign

 Let me carry this a step further.  We are a software vendor that has
 received BACs, TPAs and Chain of Trust agreements from different customers.
 As a vendor to this particular customer base we are exposed to PHI 
 but never manipulate it in any way.  Our support personnel do review 
 setup configurations, billing problems or DB issues; but don’t do 
 anything to PHI. Attorneys and consultants are advising our 
 customers so differently that no matter what, we end up being “the 
 evil vendor.”  Some of the BACs we receive are rather ridiculous,
  like requiring us to assume financial liability if our customer has 
 any HIPAA problems in the future.
 
 The question for the group is: What is required in this scenario a 
 BAC, TPA or COT?
 
 Jim Randolph
 The Echo Group
 
 -Original Message-
 From: Traci Winter [mailto:[EMAIL PROTECTED]]
 Sent: Wednesday, January 22, 2003 3:49 PM
 To: WEDI SNIP Privacy Workgroup List
 Subject: to sign or not to sign
 
 OK so the next question is do we sign these BACs or just put them in 
 the round file. Your answers reflected what my impression was, but I 
 wanted reinforcement.
 
 Thanks,
 Traci Winter
 ---
 
 ---
 The WEDI SNIP listserv to which you are subscribed is not moderated. 
 The discussions on this listserv therefore represent the views of 
 the individual participants, and do not necessarily represent the 
 views of the WEDI Board of Directors nor WEDI SNIP. If you wish to 
 receive an official opinion, post your question to the WEDI SNIP 
 Issues Database at http://snip.wedi.org/tracking/.   These listservs 
 should not be used for commercial marketing purposes or discussion 
 of specific vendor products and services.  They also are not 
 intended to be used as a forum for personal disagreements or 
 unprofessional communication at any time.
 
 You are currently subscribed to wedi-privacy as: 
 [EMAIL PROTECTED] To unsubscribe from this list, go to the 
 Subscribe/Unsubscribe form at http://subscribe.wedi.org or send a 
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--- End of Original Message ---


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RE: to sign or not to sign

2003-01-23 Thread Hromatka, Valerie









As far as I am concerned, I am not signing
an agreement that a Business Associate sends to us, including our Practice
Management Software Vendor. 



The PHI is in OUR possession, and if a BA
wants access to it, they can sign the agreement OUR attorney drafted. Period. I recycle the ones that are being sent to me
by my Business Associates.



Respectfully,

Valerie Hromatka

Western Washington Medical Group

Privacy Officer



-Original Message-
From: Ian Leedom
[mailto:[EMAIL PROTECTED]] 
Sent: Thursday, January 23, 2003
9:23 AM
To: WEDI SNIP Privacy Workgroup
List
Subject: RE: to sign or not to
sign





I also represent a
software vendor in a similar situation. Our take has been that we must
have Business Agreements (BA) with the CE's simply because we have access to
PHI. It also means that at some level, we need to know who has in fact
accessed things and when. I think that the fact that you have access to a
DB which has PHI in it is enough to trigger all of the privacy rule in HIPAA
. 











My problem, and I'd love
to hear from others about this, is what sort of BA we should in fact
have. We have enough clients that if we send every agreement from every
client to our corporate attorneys then we'll be bankrupt before April.
And you're right that some clients want indemnification for things which are
THEIR business and for us to keep data even after a business contract has
ended. If anyone has any to add to this, I for one would love to hear it.













Ian Leedom





Psyche Systems





321 Fortune Blvd.





Milford, MA 01757





Tel: (508) 473-1500 x341





Compliments
humbly accepted. Flames cheerfully ignored.







-Original Message-
From: Jim Randolph
[mailto:[EMAIL PROTECTED]]
Sent: Thursday, January 23, 2003
11:39 AM
To: WEDI SNIP Privacy Workgroup
List
Subject: RE: to sign or not to
sign

Let me carry this a step further.
We are a software vendor that has received BACs, TPAs and Chain of Trust
agreements from different customers.

As a vendor to this particular customer base we are exposed to PHI but
never manipulate it in any way. Our
support personnel do review setup configurations, billing problems or DB
issues; but dont do anything to PHI.
Attorneys and consultants are advising our customers so differently that
no matter what, we end up being the evil vendor. Some of the BACs we receive are rather
ridiculous, like requiring us to assume financial liability if our customer has
any HIPAA problems in the future.



The question for the group is: What is required in this scenario a BAC,
TPA or COT?



Jim Randolph 

The Echo Group





-Original
Message-
From: Traci Winter
[mailto:[EMAIL PROTECTED]]
Sent: Wednesday, January 22, 2003
3:49 PM
To: WEDI SNIP Privacy Workgroup
List
Subject: to sign or not to sign



OK
so the next question is do we sign these BACs or just put them in the round
file. Your answers reflected what my impression was, but I wanted
reinforcement.



Thanks,

Traci
Winter

---



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These listservs should not be used for commercial marketing purposes or
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to be used as a forum for personal disagreements or unprofessional
communication at any time.

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to sign or not to sign

2003-01-22 Thread Traci Winter



OK so the next question is do we sign these BACs or just put them in the 
round file. Your answers reflected what my impression was, but I wanted 
reinforcement.

Thanks,
Traci Winter
---
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Re: to sign or not to sign

2003-01-22 Thread Doug Webb



Traci,
My vote's for the round file.
Any lawyers out there feel free to chime 
in.

The opinions expressed here are my own and not necessarily the opinion of 
LCMH.

Douglas M. WebbComputer System EngineerLittle Company of Mary 
Hospital  Health Care Centers[EMAIL PROTECTED]

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  - Original Message - 
  From: 
  Traci Winter 
  
  To: WEDI SNIP Privacy Workgroup List 
  
  Sent: Wednesday, January 22, 2003 02:49 
  PM
  Subject: to sign or not to sign
  
  OK so the next question is do we sign these BACs or just put them in the 
  round file. Your answers reflected what my impression was, but I wanted 
  reinforcement.
  
  Thanks,
  Traci Winter---The WEDI SNIP listserv to which you are 
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---
The WEDI SNIP listserv to which you are subscribed is not moderated. The discussions on this listserv therefore represent the views of the individual participants, and do not necessarily represent the views of the WEDI Board of Directors nor WEDI SNIP. If you wish to receive an official opinion, post your question to the WEDI SNIP Issues Database at http://snip.wedi.org/tracking/.   These listservs should not be used for commercial marketing purposes or discussion of specific vendor products and services.  They also are not intended to be used as a forum for personal disagreements or unprofessional communication at any time.

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