Hi All,
I agree with Noel's interpretation....
But, I would like to confirm a related Privacy implication:
When you disclose PHI to either the state or an auditing group that the
state hired, must you record that as a disclosure? Do you have to record
the disclosure at the individual level or can you just put a statement into your
NPP that this kind of disclosure could happen to the person's PHI?
The main reason I ask the question really centers on what TPO
consists of. If the state audits, say an insurance company as a part of
it's oversight of all insurance companies, is that disclosure of PHI to the
state a part of TPO, since the insurance company doesn't have any choice in the
matter? Can the same be said for all regulatory types of
disclosures?
All opinions expressed are my own and should not be construed to be Medical
Mutual or Antares Management Solutions official policy.
Jim Moores - HIPAA Team Leader - Privacy
Antares Management Solutions
23700 Commerce Park Road
Beachwood, Ohio 44122-5832
Antares Management Solutions
23700 Commerce Park Road
Beachwood, Ohio 44122-5832
>>> "Noel Chang" <[EMAIL PROTECTED]> 02/04/03 10:36PM >>>
Is the audit being done at your request or are you required to submit to the
audit by the state?
If you are initiating the audit then I'd say you should have a BA agreement.
If the audit is being imposed on you by the state then I'd say no BA is
required.
If the billing information you submit to the schools/nursing homes/welfare
departments are for services you delivered to them, I don't see why a BA
agreement would be necessary. You are making a disclosure to obtain
payment. Such disclosures are specifically permitted, even if the disclosure
is to the financially responsible party who is not the same person as the
subject of the PHI.
BA agreements are only necessary when you have a third party performing a
covered function on your behalf.
Noel Chang
--
Open WebMail Project (http://openwebmail.org)
---------- Original Message -----------
From: "Teri Baskett" <[EMAIL PROTECTED]>
To: "WEDI SNIP Privacy Workgroup List" <[EMAIL PROTECTED]>
Sent: Tue, 4 Feb 2003 17:42:31 -0500
Subject: BA Agreement Questions
> I've met with my CFO and our Purchasing Mgr and we've figured out
> most of our vendor list. But we had a couple of questions I hoped
> someone could help with:
>
> 1. What do we do about auditors that come on-site to review records
> for payment/compliance. If i read this right, if the auditor is a
> govt agency (Medicaid or Medicare) then we don't need an agreement.
> But our state contracts with another company to audit our state
> contract funds. Do we have to have the BA with that company for that?
>
> 2. We have service contract agreements with several schools/nursing
> homes/welfare depts. In addition to the treatment piece, we also
> (of course) submit bills that include patient identifiers (name, SSN,
> address). Do we need BA's for those relationships?
>
> Teri Baskett
> Information Officer
> LifeSpring Mental Health Services
>
> ---
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