Who is receiving payment from whom is not always the deciding factor. At my organization, we contract for Medical Directors, they are doing that on our behalf, and they are being paid... but in their role of providing treatment to our residents, they are NOT BAs. In our situation, they are considered part of an OHCA. (BTW, when these same Medical Directors participate in our QA efforts, *then* they are doing something for us as a facility, vs. for our residents, and they are BAs.)
Typically, if the relationship is solely for the purposes of treatment or solely for the purposes of payment, a BA relationship does not exist. It's when you get into HCO that there is more likely to be a BA relationship. In the given situation, it seems that there are cross-referrals going on (your CE to the diagnostic CE; and they back to you if necessary) - but referrals qualify as treatment, so no BA. It also seems that when they provide the treatment, they are 1) providing treatment, and 2) doing so on their own behalf (regardless of whom is paying them to do so). It also seems that when you are paying them, you are acting on your own behalf, just as any payor is acting on its own behalf when it pays. Just my 2c. Sherriann Hamilton, Privacy Officer/Training Director The Christian Church Homes of KY 12700 Shelbyville Road, Ste. 1000 Louisville, KY 40243 (502) 254-4254 - phone (502) 396-4217 - cell (502) 254-5117 - fax Please check out our web site at www.cchk.org -----Original Message----- From: Rachel Foerster [mailto:[EMAIL PROTECTED] Sent: Monday, November 10, 2003 2:27 PM To: WEDI SNIP Privacy Workgroup List Subject: RE: business associate - yes or no? Roger, the key difference in this scenario and which brought me to my conclusions is this statement by Wendy: " . . . the contractor is providing this service on our behalf, for us, and are receiving money from us to provide these services. " Therefore, the contractor is providing treatment services on behalf of Wendy's company and Wendy's company is paying the contractor for those services performed, not the patient. Neither is the contractor submitting a claim to a payer for reimbursement. While it's not totally clear, it does appear that Wendy's company is a healthcare provider and is contracting with another healthcare provider to perform treatment services to its patients on its behalf. Rachel Rachel Foerster Rachel Foerster & Associates, Ltd. Voice: 847-872-8070 email: [EMAIL PROTECTED] -----Original Message----- From: taway3 [mailto:[EMAIL PROTECTED] Sent: Monday, November 10, 2003 1:18 PM To: Rachel Foerster; WEDI SNIP Privacy Workgroup List Subject: RE: business associate - yes or no? Rachel and Wendy, I'm going to respectfully disagree. If my physician sends me to an imaging facility for x-ray, would that not be a treatment relationship? My understanding is that two CE's collaborating on treatment do not require a BAA. What is different here? Regards, Roger Wernow RMW Associates (A Consulting Company) 321-956-0485 -----Original Message----- From: Rachel Foerster [mailto:[EMAIL PROTECTED] Sent: Monday, November 10, 2003 1:38 PM To: WEDI SNIP Privacy Workgroup List Subject: RE: business associate - yes or no? Wendy, based on your description of this activity I would conclude that your contractor is indeed your business associate. You have engaged this contractor to perform a function on your behalf using PHI. Rachel Foerster Rachel Foerster & Associates, Ltd. Voice: 847-872-8070 email: [EMAIL PROTECTED] -----Original Message----- From: Reynolds, Wendy J [mailto:[EMAIL PROTECTED] Sent: Monday, November 10, 2003 12:06 PM To: WEDI SNIP Privacy Workgroup List Subject: business associate - yes or no? I am in the process of reviewing a contact which will entail an agreement between us (a covered entity) and the contractor (another covered entity) in which the contractor will provide cancer screening/diagnostic tests to a specific category of women (income guidelines, age, etc.) per grant parameters. I am having trouble with this one, because usually "treatment" reasons do not necessitate a business associate agreement between two covered entities. However, we are paying the contractor a per capita rate to provide the services (diagnostic tests) to these patients. If patients need further treatment, they are referred back to us to take care of. In this situation, I am not sure the contractor is really providing "treatment" to the patients. Furthermore, in this situation, the contractor is providing this service on our behalf, for us, and are receiving money from us to provide these services. This arrangement does not fit the business associate exceptions or examples as listed on the OCR website. I have read the definition of treatment in the regs, but really think this arrangement should have a BAA. But of course the contractor disagrees. Am I being too picky? Any opinions out there? Wendy J. Reynolds, MPA, CHP EVMS Director of Privacy Program EVMS HS Clinical Auditor Eastern Virginia Medical School Fairfax Hall, 1st floor 721 Fairfax Avenue Norfolk, VA 23507 (757) 446-0337 [EMAIL PROTECTED] --- Outgoing mail is certified Virus Free. Checked by AVG anti-virus system (http://www.grisoft.com). Version: 6.0.537 / Virus Database: 332 - Release Date: 11/6/2003 --- 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 blank email to [EMAIL PROTECTED] If you need to unsubscribe but your current email address is not the same as the address subscribed to the list, please use the Subscribe/Unsubscribe form at http://subscribe.wedi.org --- The WEDI SNIP listserv to which you are subscribed is not moderated. 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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 blank email to [EMAIL PROTECTED] If you need to unsubscribe but your current email address is not the same as the address subscribed to the list, please use the Subscribe/Unsubscribe form at http://subscribe.wedi.org --- 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 blank email to [EMAIL PROTECTED] If you need to unsubscribe but your current email address is not the same as the address subscribed to the list, please use the Subscribe/Unsubscribe form at http://subscribe.wedi.org
