Health care providers often send out patients or specimens for tests. They also often bill the patients for those services and then pay the entity performing the tests. As a patient, I like this as I get a consolidated bill. The example below is exactly this relationship. If this relationship requires a BAA, then, among others, so does every relationship between a health care provider and a clinical laboratory or test provider -- for a mammography, MRI, x-ray, etc. It is clear that laboratories and others who do testing are health care providers. It also is clear that BAAs are not needed between health care providers when they are providing treatment.
=============================================== The opinions expressed in this message are mine only, and do not reflect the opinion or position of my employer. ------------------------------------------------------------------------------------- Andrew H. Melczer, Ph.D. Vice President, Health Policy Research Illinois State Medical Society 20 N. Michigan, Suite 700 Chicago, IL 60602 312-580-2468 FAX: 312-782-1654 E-mail: mailto:[EMAIL PROTECTED] -----Original Message----- From: Huber, Cheri [mailto:[EMAIL PROTECTED] Sent: Monday, November 10, 2003 1:46 PM To: WEDI SNIP Privacy Workgroup List Subject: RE: business associate - yes or no? I tend to agree, Rachel, that on its face the relationship described by Wendy meets the definition of a BA relationship. However, I must point out that (my recollection of) the Rule as well as language from both the Preamble and subsequent guidances refer to business associate activities as being 'business-type services' and I can't recall any reference to treatment in any of the examples of such a service. Because the sort of situation described by Wendy is not unusual, and because reasonable minds obviously disagree, it would be helpful to have the OCR's "official" opinion on this issue. I will submit the question to the OCR unless someone chimes in to this exchange to advise that this has already been formally addressed. Thank you. Cheri Huber Napa County Privacy Officer 1195 Third Street, Suite 301 Napa, CA 94559 707-253-4523 [EMAIL PROTECTED] -----Original Message----- From: Rachel Foerster [mailto:[EMAIL PROTECTED] Sent: Monday, November 10, 2003 11:27 AM 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] --- The WEDI SNIP listserv to which you are subscribed is not moderated. 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