HomeMy WebLinkAbout2012-417 EMS - EMS Management & Consultants for Update Business Associate Agreement in ref to HIPAA $0 BUSINESS ASSOCIATE AGREEMENT
This [Amended and Restated] Business Associate Agreement (the "Agreement") is made
effective the 1St day of September, 2012, by and between Orange County EMS, hereinafter referred to as
"Covered Entity," and EMS Management & Consultants, Inc., hereinafter referred to as "Business
Associate"(individually, a"Party"and collectively,the"Parties").
WITNESSETH:
WHEREAS, the Parties wish to enter into a Business Associate Agreement to ensure compliance
with the Privacy and Security Rules of the Health Insurance Portability and Accountability Act of 1996
("HIPAA Privacy and Security Rules") (45 C.F.R. Parts 160 and 164) and the"Red Flag Rules"as found
at 16 C.F.R. § 681.1 and applicable to creditors subject to the administrative enforcement of the FCRA by
the Federal Trade Commission pursuant to 15 U.S.C. § 1681s(a)(1); and
WHEREAS, the Health Information Technology for Economic and Clinical Health("HITECH")
Act of the American Recovery and Reinvestment Act of 2009, Pub. L. 111-5, modified the HIPAA
Privacy and Security Rules (hereinafter, all references to the "HIPAA Privacy and Security Rules"
include all amendments thereto set forth in the HITECH Act and any accompanying regulations); and
WHEREAS, the Parties have entered into a written or oral arrangement or arrangements (the
"Agreements") whereby Business Associate will provide certain services to Covered Entity and,pursuant
to such Agreements, Business Associate may be considered a "business associate" of Covered Entity as
defined in the HIPAA Privacy and Security Rules; and
WHEREAS, Business Associate may have access to Protected Health Information or Electronic
Protected Health Information (as defined below) in fulfilling its responsibilities under the Agreements;
[and
WHEREAS, prior to enactment of the HITECH Act, Covered Entity and Business Associate
previously entered into a Business Associate Agreement and now intend this Agreement to supersede the
prior agreement in order to comply with the requirements of the HITECH Act;] and
WHEREAS, Covered Entity wishes to comply with the HIPAA Privacy and Security Rules, and
Business Associate wishes to honor its obligations as a Business Associate to Covered Entity; and
WHEREAS, in the event that Business Associate is engaged to perform any activity in
connection with any "covered account" of Covered Entity as defined in 16 C.F.R. § 681.1 (commonly
referred to as the "Red Flag Rules" and applicable to any"creditor" or any"service provider" providing
any service to such creditor with regard to a covered account), Business Associate agrees to fully adopt
and comply with the Red Flag Rules as are currently in effect and as may be promulgated in the future,
including but not limited to the adoption of a Red Flag program that is compliant with applicable federal
regulations, and to take all necessary and appropriate steps to ensure that its activities are conducted in
accordance with the Red Flag Rules designed to detect,prevent and mitigate the risk of identity theft.
THEREFORE, in consideration of the Parties' continuing obligations under the Agreements, and
for other good and valuable consideration, the receipt and sufficiency of which is hereby acknowledged,
the Parties agree to the provisions of this Agreement.
I. DEFINITIONS
Except as otherwise defined herein, any and all capitalized terms in this Agreement shall have the
definitions set forth in the HIPAA Privacy and Security Rules. In the event of an inconsistency between
the provisions of this Agreement and mandatory provisions of the HIPAA Privacy and Security Rules, as
amended, or the Red Flag Rules,the HIPAA Privacy and Security Rules and the Red Flag Rules in effect
at the time shall control. Where provisions of this Agreement are different than those mandated by the
HIPAA Privacy and Security Rules or the Red Flag Rules, but are nonetheless permitted by the HIPAA
Privacy and Security Rules or the Red Flag Rules,the provisions of this Agreement shall control.
The term "Breach" means the unauthorized acquisition, access, use, or disclosure of protected health
information which compromises the security or privacy of such information, except where an
unauthorized person to whom such information is disclosed would not reasonably have been able to retain
such information. The term"Breach" does not include: (1) any unintentional acquisition, access, or use
of protected health information by any employee or individual acting under the authority of a covered
entity or business associate if(a) such acquisition, access, or use was made in good faith and within the
course and scope of the employment or other professional relationship of such employee or individual,
respectively, with the covered entity or business associate, and (b) such information is not further
acquired, accessed,used, or disclosed by any person; or(2) any inadvertent disclosure from an individual
who is otherwise authorized to access protected health information at a facility operated by a covered
entity or business associate to another similarly situated individual at same facility; and (3) any such
information received as a result of such disclosure is not further acquired, accessed, used, or disclosed
without authorization by any person.
The term "Electronic Health Record" means an electronic record of health-related information on an
individual that is created, gathered,managed, and consulted by authorized health care clinicians and staff.
The term "HIPAA Privacy and Security Rules" refers to 45 C.F.R. Parts 160 and 164 as currently in
effect or hereafter amended.
The term "Protected Health Information" means individually identifiable health information including,
without limitation, all information, data, documentation, and materials, including without limitation,
demographic, medical and financial information, that 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; and that identifies the
individual or with respect to which there is reasonable basis to believe the information can be used to
identify the individual. "Protected Health Information" includes, without limitation, `Electronic
Protected Health Information,"as defined below.
The term `Electronic Protected Health Information" means Protected Health Information which is
transmitted by or maintained in Electronic Media(as now or hereafter defined in the HIPAA Privacy and
Security Rules).
The term"Red Flag Rules" refers to the provisions found at 16 C.F.R. § 681.1 as applicable to financial
institutions and creditors subject to the administrative enforcement of the FCRA by the Federal Trade
Commission pursuant to 15 U.S.C. § 1681s(a)(1).
The term "Red Flag" has the same meaning as provided within 16 C.F.R. § 681.1(b)(9) and means a
pattern,practice,or specific activity that indicates the possible existence of identity theft.
The term"Secretary"means the Secretary of the Department of Health and Human Services.
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The term "Unsecured Protected Health Information" means Protected Health Information that is not
rendered unusable, unreadable, or indecipherable to unauthorized individuals through the use of a
technology or methodology specified by the Secretary in guidance published in the Federal Register at 74
Fed.Reg. 19006 on April 27, 2009 and in annual guidance published thereafter.
11. PERMITTED USES AND DISCLOSURES BY BUSINESS ASSOCIATE
a. Business Associate may use or disclose Protected Health Information to perform
functions, activities, or services for, or on behalf of, Covered Entity as specified in the Agreements,
provided that such use or disclosure would not violate the HIPAA Privacy and Security Rules if done by
Covered Entity. Until such time as the Secretary issues regulations pursuant to the HITECH Act
specifying what constitutes"minimum necessary"for purposes of the HIPAA Privacy and Security Rules,
Business Associate shall, to the extent practicable, disclose only Protected Health Information that is
contained in a limited data set (as defined in Section 164.514(e)(2) of the HIPAA Privacy and Security
Rules), unless the person or entity to whom Business Associate is making the disclosure requires certain
direct identifiers in order to accomplish the intended purpose of the disclosure, in which event Business
Associate may disclose only the minimum necessary amount of Protected Health Information to
accomplish the intended purpose of the disclosure.
b. Business Associate may use Protected Health Information in its possession for its proper
management and administration and to fulfill any present or future legal responsibilities of Business
Associate,provided that such uses are permitted under state and federal confidentiality laws.
C. Business Associate may disclose Protected Health Information in its possession to third
parties for the purposes of its proper management and administration or to fulfill any present or future
legal responsibilities of Business Associate,provided that:
1. the disclosures are required by law; or
2. Business Associate obtains reasonable assurances from the third parties to whom
the Protected Health Information is disclosed that the information will remain confidential and be
used or further disclosed only as required by law or for the purpose for which it was disclosed to
the third party, and that such third parties will notify Business Associate of any instances of
which they are aware in which the confidentiality of the information has been breached.
d. Until such time as the Secretary issues regulations pursuant to the HITECH Act
specifying what constitutes"minimum necessary"for purposes of the HIPAA Privacy and Security Rules,
Business Associate shall, to the extent practicable, access, use, and request only Protected Health
Information that is contained in a limited data set (as defined in Section 164.514(e)(2) of the HIPAA
Privacy and Security Rules), unless Business Associate requires certain direct identifiers in order to
accomplish the intended purpose of the access, use, or request, in which event Business Associate may
access, use, or request only the minimum necessary amount of Protected Health Information to
accomplish the intended purpose of the access, use, or request. Covered Entity shall determine what
quantum of information constitutes the "minimum necessary" amount for Business Associate to
accomplish its intended purposes.
III. OBLIGATIONS AND ACTIVITIES OF BUSINESS ASSOCIATE
a. Business Associate acknowledges and agrees that all Protected Health Information that is
created or received by Covered Entity and disclosed or made available in any form, including paper
record, oral communication, audio recording, and electronic display by Covered Entity or its operating
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units to Business Associate or is created or received by Business Associate on Covered Entity's behalf
shall be subject to this Agreement.
b. Business Associate agrees to not use or further disclose Protected Health Information
other than as permitted or required by this Agreement or as required by law,
C. Business Associate agrees to use appropriate safeguards to prevent use or disclosure of
Protected Health Information other than as provided for by this Agreement. Specifically, Business
Associate will:
1. implement the administrative, physical, and technical safeguards set forth in
Sections 164.308, 164.310, and 164.312 of the HIPAA Privacy and Security Rules that
reasonably and appropriately protect the confidentiality, integrity, and availability of any
Protected Health Information that it creates, receives, maintains, or transmits on behalf of
Covered Entity, and, in accordance with Section 164.316 of the HIPAA Privacy and Security
Rules, implement and maintain reasonable and appropriate policies and procedures to enable it to
comply with the requirements outlined in Sections 164.308, 164.310,and 164.312; and
1 2. report to Covered Entity any use or disclosure of Protected Health Information
not provided for by this Agreement of which Business Associate becomes aware. Business
Associate shall report to Covered Entity any Security Incident of which it becomes aware. For
purposes of this Agreement, "Security Incident" means the successful unauthorized access, use,
disclosure, modification, or destruction of Protected Health Information or interference with
system operations in an information system, of which Business Associate has knowledge or
should, with the exercise of reasonable diligence, have knowledge, excluding (i) "pings" on an
information system firewall; (ii) port scans; (iii) attempts to log on to an information system or
enter a database with an invalid password or user name; (iv) denial-of-service attacks that do not
result in a server being taken offline; or(v)malware(e.g., a worms or a virus)that does not result
in unauthorized access, use, disclosure, modification or destruction of Protected Health
Information.
d. Business Associate agrees to ensure that any agent, including a subcontractor, to whom it
provides Protected Health Information received from, or created or received by Business Associate on
behalf of Covered Entity, agrees to the same restrictions and conditions that apply through this Agreement
to Business Associate with respect to such information.
e. Business Associate agrees to comply with any requests for restrictions on certain
disclosures of Protected Health Information to which Covered Entity has agreed in accordance with
Section 164.522 of the HIPAA Privacy and Security Rules and of which Business Associate has been
notified by Covered Entity. In addition, and notwithstanding the provisions of Section 164.522(a)(1)(ii),
Business Associate agrees to comply with an individual's request to restrict disclosure of Protected Health
Information to a health plan for purposes of carrying out payment or health care operations if the
Protected Health Information pertains solely to a health care item or service for which Covered Entity has
been paid by in full by the individual or the individual's representative.
f. At the request of Covered Entity and in a reasonable time and manner, Business
Associate agrees to make available Protected Health Information required for Covered Entity to respond
to an individual's request for access to his or her Protected Health Information in accordance with Section
164.524 of the HIPAA Privacy and Security Rules. If Business Associate maintains Protected Health
Information electronically, it agrees to make such Protected Health Information available electronically to
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the applicable individual or to a person or entity specifically designated by such individual, upon such
individual's request.
g. At the request of Covered Entity and in a reasonable time and manner, Business
Associate agrees to make available Protected Health Information required for amendment by Covered
Entity in accordance with the requirements of Section 164.526 of the HIPAA Privacy and Security Rules.
h. Business Associate agrees to document any disclosures of and make Protected Health
Information available for purposes of accounting of disclosures, as required by Section 164.528 of the
HIPAA Privacy and Security Rules.
i. Business Associate agrees that it will make its internal practices, books, and records
relating to the use and disclosure of Protected Health Information received from, or created or received by
Business Associate on behalf of, Covered Entity, available to the Secretary for the purpose of determining
Covered Entity's compliance with the HIPAA Privacy and Security Rules, in a time and manner
designated by the Secretary.
j. Business Associate agrees that, while present at any Covered Entity facility and/or when
accessing Covered Entity's computer network(s), it and all of its employees, agents, representatives and
subcontractors will at all times comply with any network access and other security practices, procedures
and/or policies established by Covered Entity including, without limitation, those established pursuant to
the HIPAA Privacy and Security Rules and the Red Flag Rules.
k. Business Associate agrees that it will not directly or indirectly receive remuneration in
exchange for any Protected Health Information of an individual without the written authorization of the
individual or the individual's representative, except where the purpose of the exchange is:
1. for public health activities as described in Section 164.512(b) of the Privacy and
Security Rules;
2. for research as described in Sections 164.501 and 164.512(1) of the Privacy and
Security Rules, and the price charged reflects the costs of preparation and transmittal of the data
for such purpose;
3. for treatment of the individual, subject to any further regulation promulgated by
the Secretary to prevent inappropriate access,use, or disclosure of Protected Health Information;
4. for the sale,transfer,merger, or consolidation of all or part of Business Associate
and due diligence related to that activity;
5. for an activity that Business Associate undertakes on behalf of and at the specific
request of Covered Entity;
6. to provide an individual with a copy of the individual's Protected Health
Information pursuant to Section 164.524 of the Privacy and Security Rules; or
7. other exchanges that the Secretary determines in regulations to be similarly
necessary and appropriate as those described in this Section IIl.k.
1. Business Associate agrees that it will not directly or indirectly receive remuneration for
any written communication that encourages an individual to purchase or use a product or service without
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first obtaining the written authorization of the individual or the individual's representative,unless:
1. such payment is for a communication regarding a drug or biologic currently
prescribed for the individual and is reasonable in amount(as defined by the Secretary); or
2. the communication is made on behalf of Covered Entity and is consistent with
the terms of this Agreement.
in. Business Associate agrees that if it uses or discloses patients' Protected Health
Information for marketing purposes, it will obtain such patients' authorization before making any such
use or disclosure.
IV. BUSINESS ASSOCIATE'S MITIGATION AND BREACH NOTIFICATION OBLIGATIONS
a. Business Associate agrees to mitigate,to the extent practicable, any harmful effect that is
known to Business Associate of a use or disclosure of Protected Health Information by Business
Associate in violation of the requirements of this Agreement.
b. Following the discovery of a Breach of Unsecured Protected Health Information,
Business Associate shall notify Covered Entity of such Breach without unreasonable delay and in no case
later than forty-five (45) calendar days after discovery of the Breach. A Breach shall be treated as
discovered by Business Associate as of the first day on which such Breach is known to Business
Associate or, through the exercise of reasonable diligence, would have been known to Business
Associate.
C. Notwithstanding the provisions of Section IV.b., above, if a law enforcement official
states to Business Associate that notification of a Breach would impede a criminal investigation or cause
damage to national security,then:
1. if the statement is in writing and specifies the time for which a delay is required,
Business Associate shall delay such notification for the time period specified by the official;or
2. if the statement is made orally, Business Associate shall document the statement,
including the identity of the official making it, and delay such notification for no longer than
thirty(30) days from the date of the oral statement unless the official submits a written statement
during that time.
Following the period of time specified by the official,Business Associate shall promptly deliver a copy of
the official's statement to Covered Entity.
d. The Breach notification provided shall include,to the extent possible:
1. the identification of each individual whose Unsecured Protected Health
Information has been, or is reasonably believed by Business Associate to have been, accessed,
acquired,used,or disclosed during the Breach;
2. a brief description of what happened, including the date of the Breach and the
date of discovery of the Breach, if known;
3. a description of the types of Unsecured Protected Health Information that were
involved in the Breach (such as whether full name, social security number, date of birth, home
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address,account number, diagnosis,disability code, or other types of information were involved;
4. any steps individuals should take to protect themselves from potential harm
resulting from the Breach;
5. a brief description of what Business Associate is doing to investigate the Breach,
to mitigate harm to individuals,and to protect against any further Breaches; and
6. contact procedures for individuals to ask questions or learn additional
information, which shall include a toll-free telephone number, an e-mail address, Web site, or
postal address.
e. Business Associate shall provide the information specified in Section IVA, above, to
Covered Entity at the time of the Breach notification if possible or promptly thereafter as information
becomes available. Business Associate shall not delay notification to Covered Entity that a Breach has
occurred in order to collect the information described in Section IVA. and shall provide such information
to Covered Entity even if the information becomes available after the forty-five (45)-day period provided
for initial Breach notification.
V. WARRANTIES OF BUSINESS ASSOCIATE
Business Associate war-rants:
a. That its internal practices, policies, and records relating to the use and disclosure of
Protected Health Information will comply with the HIPAA Privacy and Security Rules; and
b. That it will train all of its employees, agents, representatives, and subcontractors on the
network access and other security practices, procedures and/or policies established by Covered Entity
including, without limitation, those established pursuant to the HIPAA Privacy and Security Rules and
the Red Flag Rules prior to permitting such employees, agents, representatives, and subcontractors to be
present at any Covered Entity facility and/or to access Covered Entity's computer network(s).
VI. OBLIGATIONS OF COVERED ENTITY
a. Upon request of Business Associate, Covered Entity shall provide Business Associate
with the notice of privacy practices that Covered Entity produces in accordance with Section 164.520 of
the HIPAA Privacy and Security Rules.
b. Covered Entity shall provide Business Associate with any changes in, or revocation of,
permission by an individual to use or disclose Protected Health Information, if such changes affect
Business Associate's permitted or required uses and disclosures.
C. Covered Entity shall notify Business Associate of any restriction to the use or disclosure
of Protected Health Information to which Covered Entity has agreed in accordance with Section 164.522
of the HIPAA Privacy and Security Rules, and Covered Entity shall inform Business Associate of the
termination of any such restriction, and the effect that such termination shall have, if any, upon Business
Associate's use and disclosure of such Protected Health Information.
VII. REQUIRED COMPLIANCE WITH RED FLAG RULES
In the event that Business Associate is engaged to perform an activity in connection with any
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"covered account" as defined in 16 C.F.R. § 681.1 (as applicable to Covered Entity as a "creditor" and
therefore to Business Associate as a "service provider" providing any service to Covered Entity),
Business Associate agrees to: (i) fully adopt and comply with the Red Flag Rules currently in effect and
as may be promulgated in the future; (ii) adopt a Red Flag program that is compliant with federal
regulations as promulgated in 16 C.F.R. § 681.1; and (iii) take all necessary and appropriate steps to
ensure that its activities undertaken as a part of this Agreement are conducted in accordance with the Red
Flag Rules and its Red Flag program, including, without limitation, ensuring the adoption of and
continued compliance with reasonable policies and procedures designed to detect, prevent, and mitigate
the risk of identity theft, detecting any Red Flag that may arise during the term of this Agreement,
reporting any such Red Flag to Covered Entity, and taking any such further steps as may be necessary to
prevent or mitigate identity theft.
VIII. TERM AND TERMINATION
a. Term. The Tenn of this Agreement shall be effective as of the date first written above,
and shall terminate upon the later of the following events: (i)in accordance with Section VIII.c.,when all
of the Protected Health Information provided by Covered Entity to Business Associate or created or
received by Business Associate on behalf of Covered Entity is destroyed or returned to Covered Entity or,
if such return or destruction is infeasible,when protections are extended to such information; or(ii) upon
the expiration or termination of the last of the Agreements.
b. Termination for Cause. Upon Covered Entity's knowledge of a material breach of this
Agreement by Business Associate, Covered Entity shall have the right to immediately terminate this
Agreement and the Agreements. If termination is not feasible, Covered Entity shall report such violation
to the Secretary.
C. Effect of Termination.
1. Except as provided in paragraph 2. of this subsection, upon termination of this
Agreement, the Agreements or upon request of Covered Entity, whichever occurs first, Business
Associate shall within ten (10) days return or destroy all Protected Health Information received
from Covered Entity, or created or received by Business Associate on behalf of Covered Entity.
This provision shall apply to Protected Health Information that is in the possession of
subcontractors or agents of Business Associate. Neither Business Associate nor its
subcontractors or agents shall retain copies of the Protected Health Information.
2. In the event that Business Associate determines that returning or destroying the
Protected Health Information is infeasible, Business Associate shall provide within ten(10) days
to Covered Entity notification of the conditions that make return or destruction infeasible. Upon
mutual agreement of the Parties that return or destruction of Protected Health Information is
infeasible, Business Associate shall extend the protections of this Agreement to such Protected
Health Information and limit further uses and disclosures of such Protected Health Information to
those purposes that make the return or destruction infeasible, for so long as Business Associate
maintains such Protected Health Information.
IX MISCELLANEOUS
a. Indemnification. Business Associate shall indemnify and hold Covered Entity harmless
from and against all claims, liabilities, judgments, fines, assessments, penalties, awards, or other
expenses, of any kind or nature whatsoever, including,without limitations, attorneys' fees, expert witness
fees, and costs of investigation, litigation or dispute resolution, relating to or arising out of any breach or
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alleged breach of this Agreement, or any Breach, by Business Associate or subcontractors or agents of
Business Associate.
b. No Rights in Third Parties. Except as expressly stated herein, in the HIPAA Privacy and
Security Rules, or in the Red Flag Rules, the Parties to this Agreement do not intend to create any rights
in any third parties.
C. Survival. The obligations of Business Associate under Section VIII(c) of this Agreement
shall survive the expiration, termination, or cancellation of this Agreement, the Agreements, and/or the
business relationship of the parties, and shall continue to bind Business Associate, its agents, employees,
contractors, successors,and assigns as set forth herein.
d. Amendment. This Agreement may be amended or modified only in a writing signed by
the Parties. The Parties agree that they will negotiate amendments to this Agreement to conform to any
changes in the HIPAA Privacy and Security Rules or Red Flag Rules as are necessary for Covered Entity
to comply with the current requirements of the HIPAA Privacy and Security Rules, the Health Insurance
Portability and Accountability Act, and the Red Flag Rules. In addition, in the event that either Party
believes in good faith that any provision of this Agreement fails to comply with the then-current
requirements of the HIPAA Privacy and Security Rules or any other applicable legislation including, but
not limited to,the Red Flag Rules,then such Party shall notify the other Party of its belief in writing. For
a period of up to thirty(30)days,the Parties shall address in good faith such concern and amend the terms
of this Agreement, if necessary to bring it into compliance. If, after such thirty (30)-day period, the
Agreement fails to comply with the HIPAA Privacy and Security Rules, the Red Flag Rules or any other
applicable legislation, then either Party has the right to terminate this Agreement and the underlying
arrangement upon written notice to the other party.
e. Assignment. Neither Party may assign its respective rights and obligations under this
Agreement without the prior written consent of the other Party.
f. Independent Contractor. None of the provisions of this Agreement are intended to create,
nor will they be deemed to create, any relationship between the Parties other than that of independent
parties contracting with each other solely for the purposes of effecting the provisions of this Agreement
and any other agreements between the Parties evidencing their business relationship.
g. Governing Law. To the extent this Agreement is not governed exclusively by the HIPAA
Privacy and Security Rules,the Red Flag Rules, or other provisions of federal statutory or regulatory law,
it will be governed by and construed in accordance with the laws of the state in which Covered Entity has
its principal place of business.
h. No Waiver. No change, waiver, or discharge of any liability or obligation hereunder on
any one or more occasions shall be deemed a waiver of performance of any continuing or other
obligation,or shall prohibit enforcement of any obligation, on any other occasion.
i. Interpretation. Any ambiguity of this Agreement shall be resolved in favor of a meaning
that permits Covered Entity to comply with the HIPAA Privacy and Security Rules and the Red Flag
Rules.
j. Severability. In the event that any provision of this Agreement is held by a court of
competent jurisdiction to be invalid or unenforceable, the remainder of the provisions of this Agreement
will remain in full force and effect.
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k. Notice. Any notification required in this Agreement shall be made in writing to the
representative of the other Party who signed this Agreement or the person currently serving in that
representative's position with the other Party.
1. Certain Provisions Not Effective in Certain Circumstances. The provisions of this
Agreement relating to the HIPAA Security Rule shall not apply to Business Associate if Business
Associate does not receive any Electronic Protected Health Information from or on behalf of Covered
Entity.
IN WITNESS WHEREOF, the Parties have executed this Agreement as of the day and year
written above.
Covered Entity: Business Associate:
Orange County EMS EMS Management& Consultants,Inc.
By:
Title:
AA ' Title: VP Provider Business Services
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IN WITNESS WHEREOF, Orange County and the Provider have signed this
Agreement, effective as of the day first written above.
ORANGE COUNTY PROVIDER
By: By:
Cou Manager Title:
200 S. Cameron S
P.O. Box 8181
Hillsborough,NC 27278
This instrument has been approved as to technical content.
De artment Director
This instrument has been pre-audited in the manner required by the Local Government Budget
and Fiscal Control Act.
YA Li 'w �/1, Au-
Office of the Finance Director
VM7been approved as to legal form and sufficiency.
Of Ace of ttk County Attorney