Protected Health Information by NiceTime

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									                                        .     Except        as     otherw             ise    specified herein, Busines
           A   s s o c i aBUSINESS ASSOCIATE AGREEMENTs e s
                          te m  ay m   ake any and all u                                        of Protected H  ealth
ation        (_PH         I_) necessary to
           perform              its obligations under existing contracts and any contrac
a y e n t e r i S tU wB i tU t h e
                      n o               h       R     B   A      N      H      O        SPIT      A    L       H      E    A
                 v      d      n             r                                        (
       C C o A e r eR E E t i t y S fY o m S T t i m eM t o ,t i m N e Ct h e . _ U n d e r l y i n g C o n t r a c
                                                          E                I
A      ll other uses not
           authorized by this A                         greem      ent are prohibited.               N   othing in th
reem                                r he it
             e n t s h a l .l p To h i b f e d e r a l p r i v a c y r e g u l a t i o n s a t 4 5 C . F . R . p a r t s 1 6
       a r B u s i n e s s F I N s s o I Ta t e I O d iN c l oS u r e o f P H
       1.   e D        E      A            ci       _s     s     s                      I received from            or cr e
                              ha         rf
r e c e i v e d f eo n e db e t o l fh e o e i n a s _ H
             re     rr                                         IPA    A     _.       A     ll capitalized term           s
       t h tah e a Ceo v n o e d o t hnetri wy , i s o t h e C o v e r e d E n t i t y .
              t     r     er t       E        t      te                                      W     ith regard to its
             isf osu                    tH
d / o r dd e c il n e d r eh a o fe P h e I
                                 v               m     eanings ascribed in H                  IPA    A   .
                t R
           o b P a i n e d f r o m E C oC e r e d E n t i t D , B u s i n eE s As s o L i a t e a g r e e s ItN : F O
                         O       T                v    T     E     y     H        s      a     c   T    H         o
                                                              .
      2. R   T E O SPO
                   I         N         N        SIB         IL       IT        IE         S O      F T       H      E       PA
      S . a .W U s p oIeT iabniHi/ toire s R ios fc Eo suesSi Ph e s PC
      2 1 Re
                     s
                       ns
                               d
                               l
                                           d        l
                                                      B
                                                              t E
                                                              nes
                                                                      H
                                                                      A        Ts oocni laT e a s p e r m i t t e d o r
                                                                               I
                                                                               s
                                                                                          y
                                                                                           t    O                          requir e
is    A    greem          ent or as
            perm          itted or required                 by     law          .

        b. U         se    appropriate            safeguards              to        prevent      unauthorized        use    of   di
of    PH   I.

        c. Report to the                    Covered         Entity,            any     use    or    disclosure       of    PH    I
ich    Business
           A  ssociate m                    anagem         ent      becom             es    aw     are   that   is   not     perm
or    required by this
           A  greem   ent.

      d. Require all of its subcontractors and agent that receive or use
ve  access to, PH     I
         under the U    nderlying Contracts, to agree, in w  riting, to ess
the sam    e
        restrictions and conditions on the use and/or disclosure of PH
apply to Business
         A   ssociate pursuant to Section 2.1 of this A   greem   ent.

        e. M    ake available its internal practices, books and records r ela
the    use and
           disclosure of PH   I to the Secretary of H    H  S for purposes o
m     ining the Covered
           Entity_s com   pliance w  ith H   IPA   A  .

      f. W    ithin 30 days of receiving a w   ritten request from   the
Entity, provide to the
         Covered Entity such inform   ation as is requested by the Cover
y and necessary
         to enable the Covered Entity to respond to a request by an in
for an
         accounting of the disclosures of the individual_s PH   I in acco
w   ith H   IPA   A  .

      g. Return to the Covered Entity or destroy, w     ithin 90 days of
nation of this
         A  greem  ent, the PH   I in its possession and retain no copie
is feasible to do so.    If
        return or destruction is infeasible, Business A   ssociate agrees
nd all protections
        contained in this A   greem   ent to Business A    ssociate_s use a
isclosure of any
             retained PHI, and to limit any further uses and/or disclosures to the purpose that
             m     ake the return or destruction of PH                                 I infeasible.

                                                        oovere          nn t
  2 . 2 R e s p o n s i b i l i t i e s . o f T h e e C C v e r e d d E E t ittiy y a g r e e s t o t i m
                                                th                                                                ely notify
        Business A                 ssociate, in w             riting, of any arrangem                          ents betw               e
  ered Entity and the
        individual that is the subject of PH                                      I that m            ay im          pact in a
  r the use and/or
        disclosure of that PH                        I b y B u s i n e .s s T h e s s o c i a t e u n d e r t h i s A
                                                                                  A                                                    g
        term        s of this A                greem       ent have been included based solely o
  s 3 dffg                        e
  2 t. a n E i n e c t b yo f t hC h a n g e s o f H       IPA       A         Privacy Regulation on Respon
  f t            es iea
        Phaer t iP a r t t h s t t h e y a r e r e q u i r e d b y H             IPA       A     .     To the extent th
  evant provision of
        H      IPA         A        is later elim            inated or held to be invalid by a cou
  petent jurisdiction, the
        corresponding term                       or term           s in this A               greem        ent shall be d
  no force and effect for
        any purpose.                  To the extent that any relevant provision of H                                                 IP
  m       aterially am                ended in
        a m         anner that changes that the obligations of business associat
  ed entities that are
        e m N b oF Oe d . R n Ut e r n l eA(s s ) o to fe I wh i s i Nteo l t h i s i Ae d g h e e e i n , e nB u s it n e s sP aA t i e
          I           di         i     M m s         T h r tO        s       im        t       r erm           t,      he        r
     eg
  ny: ot iate i n good fait h
  a
        appropriate am                   endm       ent(s) to this A                  greem          ent to give effect
  evised obligations.                        In
        a. U         se the PH               I in its possession for its proper m                                      anagem
        addition, the term                     s of this A              greem         ent should be construed
  m       inistration and to
  any interpretation
              fulfill any legal responsibilities of Business A                                              ssociate.
        and/or guidance on H                         IPA       A       issued by H                 H    S from               tim       e
     b. D        isclose the PH             I in its possession to a third party for th
  3.
  of    E
      P u s i n Rs s M
      B         e              IT     T     E   D       U    SE      S A       N    D          D     ISC
  R                O           P p     O
       E A S s s o c i a tFe _ s R r o p e r Tm  a n a gC m Te n t E a n d a d m
                                                 E      e                D      H i nE s t r At i o n o r t o
                                                                                      i      a      L   T
  y legal
         responsibilities of Business A                     ssociate, provided that (i) the
  are perm         itted
         or required by law                  , or (ii) Business A             ssociate has receive
  e third party
         reasonable assurances regarding the confidential handling of su
  s required
         under H           IPPA      .

       c. W             ith w           r i t t e n a u t h .o r i z a t i o n o f e a c h C o v e r e d E n t i t y , a g g r e g
  I of such
               eo e          T i n et               obt
4 . 1 E f f C c tvi .v ree d Dh E s attiA i e sg r e e ma i neen t b y a lB u sbi e ceo m Ae e s f e c t it v e a ism a m u sei d iea
                                                                 d sh l                n ss            sfocia e                         b     n
  , o n r r a ci td e d
  c ptov
               t at t t a p               hall of
       s i g n h a u r e h e n d u rs p o s e c o n tsi u c h a g g reefg a t it o nu nitsi l t o e rp r o v ii n a t e t h e a s C o v e r ei
                                                            nue in                fec                 t    m       de d                    prov
              h       a
  w e c ti it o n d 4 .t a C e r t a i n
  S
               vi a yse           r d t i q u r o t oe H                    f a t h C Ar        Oe p e a i n e
       p r o a n s il o n s s a n e l a r e n gTi hte m C h evnet rse do e E lnt thiitsy a me gar y e me rr m tn toi n saht aol fl t hsiue vA voe
                                           .                                                            t     e                       t hs r iC
  t .          U otd
  e iso n a noyr unndheer r l n o n g a g r e e m
                                  yi                         ents if it determ                     ines that Business A
               c c uda i m o f t r m               s a                         s              o atd dis o
       t er rem icrh ien m t a osnt a n caetse h i a l A y gB u s i n e s e n t A i n s s a ccci o r e a n c e c lw s e i t P H S e Ic t ioof n
               a                                                reem                                                          h
  d . 2E tTeterirmy t i o faa n o n s e ry t g r e eC o v e rnet d E A t i t lyt e r n a t i v e l y , t h e C o v e r e d E n t i
  4       n tm                     ot
                          on t it h i h b A        he m          e      .       n
                    ve
          d eC oB u sr iende s E n t i t y s saobcsiean t t h e w
                                  s A                   te                      ritten authorization of the Cover
           l
  i n v ow v e d t. h p r o m
                  i                      pt w         ritten notice of an alleged m                                   aterial breach
          usiness A                 ssociate an
          o       oFu           y                re      e          e
  4 . E p p F r t E n i t C t oT c u I V t hE a l lD g e dA b r T a c hE            e       .               e
                                                                                                 F a i l u rN t o c u r e t hE mR
                                                                                                    A              D            T          e
  A       wT        tO         3
                  i I h i n N0 d a y s
     of receipt of notice is grounds for the immediate termination of this Agreement and its
     underlying agreem                   ents w       ithout penalty or further                                        obligation.

4.3 Term                                                  n B         i
                        i n a t i o n . b y I fB utshi e e s su s An e ssss o Ai a t s s o c i a t e d e t e r m
                                                                                 c     e                                    ines that a
     condition of perform                               ance has changed under the existing agreem
h the Covered
     Entity or this agreem                                 ent, or that the Covered Entity has brea c
terial term                     of this
     A        greem            ent, Business A                      ssociate m             ay provide thirty (30) da
f its intention to
     term           inate this A                     greem         ent.        Business A               ssociate agrees, how
cooperate w                     ith Covered
                                                m       t usine s i                              or t               td E
     E n t i t y t o f i .n d Eai t h e r uB u a l l y s s a tA s f a c toocri y t er e s o l uC ioovne r e o t hnet i tm m t t e
                                                                                ss       a                                           y     a     a
term
ate            inating, and
     furt A                         s       ha
     t h i s h e r aggr reeeem t e n tt , a n o t w h e i t h s s a n d a n e d t u n sd e p lr y ivni g i oang, r e iet m s h e n l s n w t
                                                       d t           a t oci it g         hi      r o       s                      alt        o
                        e i
t h i s b yA p rgorv iedm n g e ns ti x s o
se
                          at y          xis ie          A         e
     l o n g m a s o n n h s en o t it c n g t o o tghr e re mP a retn t; b e tow i d e e n h tohw tew e r o t h a tr t ieeist h e
     (6)                                                                       y     pr v          d          e        v         pa              r
n y e f e e mt . i n a t.e
a        tfrc                         This A            greem           ent w        ill autom             atically term                   inat
                        r
a n y m f u r t h ee d i a t e l y o n n o t i c e i f t h e r e i s n o U
     i          m                                                                                      nderlying Contract t
        c e it r n o f n t h n a a ii e . u t C
c t 4a bTt e o m e ien atth e e P p r tr it e tshsou p o n a tuhsee t e r m
4.             w                 io         w                                         ination or expiration of t he
ent betw                 een the
4 . 5P a r t i e s .o m . a t Uo n p o n r mh e i n a tei n tn o f t e r m
         A       ut                 i          Te t          ev o                          ination pursuant to the ab
ess
                                  ag e             to r n
4 . 6A E f s s o c i aot fe T e rr m e s i n a t i o e t u r n o r d e s t r o y a l l P r o t e c t e d H
              fect                                                                                                               ealth In
if it is feasible to do
     so.          Prior to doing so, the Business A                                           ssociate Further agrees
any Protected
     H        ealth Inform                     ation in possession of its subcontractors or age
is not feasible, the
     Business A                     ssociate w                ill notify the Covered Entity in w                                          ritin
tification shall
     include: (i) a statem                                ent that the Business A                             ssociate has dete
at it is infeasible to
     return or destroy the Protected H                                             ealth Inform                 ation in its po s
(ii) the specific
     reasons for such determ                                   ination.            Business A              ssociate further a
tend any and all
     protections, lim                          itations and restrictions contained in this A                                                 gr
the Business
     A                          .                                    c os to i f an                                         s and h
              s s o c i a t e _ s uT h e a P a r t ire s d iasg rl e e u r e o n d e m y n iufryt ,h e d e fuesned a n d / o ro l d i
                                           se       nd/o                                           f            r
e a ct h e p u r p o s e s t h a t
o       h
     o                                                      strpec in                     p Prots
     mt h eark ea ntdh e e ar c h u ront h e r _ sd e r e s u c t it o v e o e m t h e l o y e e e c taen d H g eenat lst,h a Ignafio rsm
                                     et           o                              f                            d      a                       n
cl s b                          a i
e a a ii m l e . d aIm i t g e s o r
                         f
     li fea          y                           n re A            fr m            t y t b ai
     i na b i lsi it b l e t hfaot r m u sai y e s s s u l t s s o c i a t e a n o o h it r d n ,p a fr rt o m c l a it m e s i fb c a n d r
                                         B                                                                    y             h       u      ont
ent p any                              y c
a g e n t r o x i m P ra tteelc t e d a u s e d
                              o
     b y e a lyt h b r e a c h m o f a tt ihoi n iA p o s s e s s i e n t ob y t h h e s o t h e rn, t r a s t odre t o r m a g i n
     H         an           Infor                     s     n greem            o        f     te       ubco               c        e           en
u r ts s o f c o mo c ipaet tee n t
ne           A       ss
     j u r i u d t c tp r o v i daen d a pw o v r d tet d n t heaxt p l tahnea t ipoan t yt o s e eo v e r e di n E e mi t y n iaf n c a t ri e q
     m        s si ion,                          r    ii e                            r          C king              d nt             id       on
                                   .
t c t te tors
b o o n h r a co t h e r a n d
     prom            pt w                                          nd      . q
                                     r i t t e n n1o, t i c e a n d r e n u i sai lt le aruot theo rt iet y , e i n f o r m            i of a
          Surv to ag
          e                                                                                          c
6 e 1a g o n t se.if v a lS e c tr ieoen s t o 2 . e x t e5n, d a a n y 6 a 5 d s h a l l p s u r v i v i o nt s ,r ml i mi n aittiaot n o n s
c.              d aine
i o n st ecnot n t aenndd .d i n
           s A           gr
     t h i c o n t i n u e e ei m d e f innt i, t e a y d s o o e l lyi mw i ti t h n y e sfpuerc th e t o u P e s a n d / u s i nd isssc l A
                                  n         e        ln       tl                   a r           t     r       sH        I B or e               o
           s          a                 k
r p o s e n s t h n t a mc o rad aen cteh e
                   i         c
        e u          to r
6 . r Mt w r n Ii ShC Sdeecsttirounc t i2oL1 ( g A. t hN PE o t e O t e d U H S e a l t h I n f o r m a t i o n i n f e
                                 E         L      . n o)f        e       r     c

5.    IN        D      EM          N       IFIC          A      TIO         N
6.2 A                       f o
                 r.b i t rI a t i a n y c o n t r o v e r s y , d i s p u t e o r c l a i m     s betw      een the Pa
h respect to this
        A      greem              ent, the Parties shall m                         ake good faith efforts to re
m       atters inform                     ally.
        If the dispute or claim                                is not resolved to the satisfaction of
es, then such m                           atter
        shall be settled exclusively by arbitration under the rules of th
ican A             rbitration N     .            othing in this A                   greem    ent shall confer upo
on A           ssociation.                 The Parties agree to be bound by the decision
                          fn
r a t o o t haesr at h a i n atlh e P a r t i e s a n d t h e i r r e s p e c t i v e s u c c e s s o r s o r a s s i g n s
        r
                   e        s
s , rreem o l u tdi ioen , o f t h e m
            s                                         atter.
                                                  il     es              t      ay .
        o b l i g a t i o n s , o r h li isa ba g ir tei e m we n th ams o e v e r b e e x e c u t e d i n a n y n u m
                                 .      T                                                                                 b
6.3       o      t     parts
        c N u n o e r T h i r d , Peaarct h o fe n w f i chi iacr h e ss h a l l b e d e e m
                                             y B        e         i                             ed an original.          F
c. p C                             sh l ce
6 o 4 i e s o uhnet reer o fa r t s :a l F a b s i m
                          p                              iles
        deem                           .    oX       n E s.
                      e d t o b e E r i g i C a lP T P U                 RSU        A    N   T TO         SECTIO      N
H      ER
          A             Y             H
6 . 5 PL I M R T I T A S T I O A N L L OB E F L L AA B B IE I T O II         L L      Y     TH      E O    TH    ER PA
R A           N      Y           IN       CID       EN      TA      L,
        CO         N      SEQ            U    ETIA         L, SPECIA              L, O     R PU       N   ITIV    E D
G      ES O            F A            N     Y        K     IN    D         O      R
        N      A       TU          RE, W            H     ETH       ER SU           CH      LIA      BILITY      IS A
IN          TH        E BA               SIC
        CO         N      TRA            CT, O         R (IN        CLU          D    IN   G      N    EG    IG   EN     C
RICT LIA                  BILITY             ), O        R
        O      TH         ERW             ISE, EV           EN        IF TH          E O     TH      ER PA      RTY      H
EN           A       D       V       ISED          O      F TH        E
        PO        SSIBILITY                   O      F SU        CH          LO      SS O     R D       A   M    A     G

IN   W   ITN   ESS W    H EREO   F, each of                                            the   undersigned        has     c
A  greem   ent to be duly
executed in its nam  e and on its behalf.


C     O     V      ER       ED         EN       TITY         :            B     U        SIN     ESS       A     SSO
E:

Suburban          H      ospital        H      ealthcare          System           ,     Inc.    ____________
________


B   y:      ______________________________                                     B        y:   _______________
___


Print N  am               e:     _______________________                                Print   N      am      e:     __
_________


Print      Title:       ________________________                              Print          Title:    _________
___

_________________________________                                        ________________________


D  ate:         ____________________________                                   D         ate:   _____________
____

								
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