Appendix_7_10_HIPAA_Business_Associate_Assessment.xlsx
XLSX spreadsheet 13 KB Posted
- Attached to
- Employee Assistance Program (EAP) and Behavioral Health Organization (BHO) Services - UPDATED
- Solicitation number
- RFP 31786-00188
- Issued by
- Davidson County, Tennessee
About this file
This is a HIPAA Business Associate Assessment document used by state and local contracting agencies to evaluate an organization's compliance with Health Insurance Portability and Accountability Act requirements. The assessment consists of a standardized questionnaire that requires organizations to mark "Yes" or "No" responses for ten compliance categories and provide supporting documentation for specific questions.
The assessment evaluates organizational readiness across critical compliance areas including knowledge of Protected Health Information location, designation of Privacy and Security Officers, completion of annual risk assessments, and updates to privacy and security policies and procedures since February 2013. Additional evaluation criteria include verification that employees with PHI access have completed HIPAA and company-specific training, accessibility of the HIPAA Compliance Plan to staff, execution of Business Associate Agreements with all subcontractors, and implementation and testing of Disaster Recovery Plans. Organizations must provide detailed information for questions 11, 24, and 26, specifically including the date of the most recent Disaster Recovery Plan test. The assessment document is formatted as an Excel spreadsheet with multiple sheets for data entry and tracking responses across the ten required compliance question categories.
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Text version
Sheet1
| HIPAA Business Associate Assessment | |||
| Mark "Yes" or "No" for each question Provide requested information. | |||
| Name of Organization: | |||
| QUESTION: | YES | NO | Please provide additional information - lines 11, 24, and 26 ONLY |
| 1. Do you know where all Protected Health Information is located |
in your company? (Electronic and Physical)
| 2. Does your company have a designated Privacy Officer? |
| Provide the Privacy Officer's Name and Contact Information: |
| 3. Does your company have a designated Security Officer? |
| Provide the Security Officer's Name and Contact Information: |
| 4. Has your company completed an Annual Risk Assessment? |
| Provide Date Last Risk Assessment was completed: |
| 5. Has your company created or updated HIPAA Privacy & Security Policies & Procedures since February 2013? |
| Provide Date of Last Update for Privacy & Security Policies & Procedures: |
| 6. Have all employees that have access to PHI completed the training on HIPAA Privacy & Security? |
| 7. Have all employees that have access to PHI completed training for your company's HIPAA Policies & Procedures within the last year? |
| Explain how employees are trained and how you track their completion: |
| 8. Is your HIPAA Compliance Plan completed and stored in a location where all staff members can find it? |
| Provide Date HIPAA Compliance Plan was enacted and where it is located: |
| 9. Do you have an Agreement with every Business Associate or |
Subcontractor that may have access to PHI?
| Provide list of Agreements: |
| 10. Do you currently have Disaster Recovery Plan? |
| When did you last update the Plan? |
| 11. If you have a Disaster Recovery Plan, have you tested it? |
| Provide Date Disaster Recovery Plan was last tested: |
Appendix 7.10
Sheet2
Sheet3
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