RE: Business Associates (BA)

[Jensen, Christine]

Steve, You are correct in your assessment.  But it has nothing to do with an organized health care arrangement; in this case the payer is not providing a service as defined in the rule to the provider entity.  The preamble, pg. 82476,  uses as a specific example the payer/provider relationship, "For example, when a health care provider discloses PHI to health plans for payment purposes, not business associate relationship is established. ...neither entity is acting on behalf of or providing a service to the other"   Christine Jensen HIPAA Project Manager Denver Health 303.436.7942 -----Original Message----- From: Giesecke, Steve [mailto:[EMAIL PROTECTED]] Sent: Friday, July 12, 2002 2:27 PM To: '[EMAIL PROTECTED]' Subject: Business Associates (BA) Would appreciate your comments on the following BA issue:   For payer-provider relationships (the "payer" I'm referring to is a State Government agency which pays for health care delivered by private sector providers to its "clients),  is there a requirement to accomplish a Business Associate agreement to formalize this relationship?   My interpretation is that, in this situation, neither entity is technically performing activities "on behalf of the other."  The Privacy Rule specifically addresses non-treatment based services:  legal, actuarial, accounting, consulting, management, administrative accreditation, data aggregation, and financial services... as being the primary candidates for BA agreements.  Further, to again reference the regulation:       We also add language to the final rule that clarifies that the mere fact that two covered entities participate in an organized health care arrangement does not make either of the covered entities a business associate of the other covered entity. The fact that the entities participate in joint health care operations or other joint activities, or pursue common goals through a joint activity, does not mean that one party is performing a function or activity on behalf of the other party (or is providing a specified services to or for the other party).     So, my practical view is that a BA agreement is not required in the above payer-provider situation. Appreciate your thoughts....   Thanks very much,   Steve Giesecke, MBA, FACHE Independent HIPAA Consultant Washington State 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/. Posting of advertisements or other commercial use of this listserv is specifically prohibited. 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/. Posting of advertisements or other commercial use of this listserv is specifically prohibited.