20 20 BUSINESS ASSOCIATE AGREEMENT

• Jurisdiction: Arkansas
• Library: Arkansas Form Book - Complete (2023 Ed.)

20-20 BUSINESS ASSOCIATE AGREEMENT

BUSINESS ASSOCIATE AGREEMENT

This Business Associate Agreement (this "Agreement") is made effective this [day] day of [month, year], by and between [law firm name] ("Law Firm" or "Business Associate") and [client name] ("Client" or "Covered Entity").

WHEREAS, Law Firm acknowledges that the Client is subject to the Administrative Simplification requirements of the Health Insurance Portability and Accountability Act of 1996, and regulations promulgated thereunder, including the Standards for Privacy of Individually Identifiable Health Information at 45 Code of Federal Regulations Parts 160 and 164 ("Privacy Regulations").

WHEREAS, the Privacy Regulations require the Client to enter into a contract with Law Firm in order to mandate certain protections for the privacy and security of any Protected Health Information that may be transmitted by the Client to Law Firm in the course of Law Firm's performance of legal services for the Client.

NOW THEREFORE, in consideration of the foregoing and the mutual covenants and conditions herein contained, Covered Entity and Business Associate agree as follows:

Section 1. Definitions.

1.1 "Disclose" and "Disclosure" mean, with respect to Protected Health Information, the release, transfer, provision of access to, or divulging in any other manner of Protected Health Information outside Law Firm's internal operations.

1.2 "Protected Health Information" or "PHI" means information, including demographic information, that (i) relates to the past, present or future physical or mental health or condition of an individual; the provision of health care to an individual, or the past, present or future payment for the provision of health care to an individual; (ii) identifies the individual (or for which there is a reasonable basis for believing that the information can be used to identify the individual); and (iii) is received by Law Firm from or on behalf of the Client, or is created by Law Firm on behalf of the Client, or is made accessible to Law Firm by the Client.

1.3 "Services" means the legal services for which Client has engaged Law Firm.

1.4 "Use" or "Uses" mean, with respect to Protected Health Information, the sharing, employment, application, utilization, examination or analysis of such information within Law Firm's internal operations.

Section 2. Responsibilities Of Business Associate.

2.1 Permitted Uses and Disclosures of PHI. Law Firm:

(a) shall Use and Disclose PHI as necessary or

...