Darrell,
I respectfully disagree.
Under HIPAA, a BAC is NOT required between two or more health care providers disclose PHI to each other for the purpose of treating a patient. And while the Privacy rules do say that a CE may act in the capacity of a BA (as in the scenario that I described below related to a physician providing “peer review” services), when two entities are engaged in sharing PHI (as CEs) no BAC would be required.
I hope that this helps.
Your questions are always welcome.
Matt
Matthew Rosenblum Chief Operations Officer Privacy, Quality Management & Regulatory Affairs
CPI Directions, Inc. 10 West 15th Street, Suite 1922 New York, NY 10011
(212) 675-6367
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-----Original Message-----
In both cases a BA would be required. In your example, the clearinghouse is providing "a function or activity regulated by HIPAA" (formatting the data to be compliant with HIPAA) for both the provider and the health plan. The regulations clearly state that the relationship between two covered entities may require a BA. The key concept to keep in mind is not what kinds of entities are involved, but the relationship between the entities in terms of who is doing what for whom.
Darrell Rishel, J.D.
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