HIPPA FORM (2).pdf

This document is a HIPAA Business Associate Addendum between the State of West Virginia and an unnamed Business Associate, designed to establish responsibilities for handling Protected Health Information (PHI) in compliance with the Health Insurance Portability and Accountability Act (HIPAA) and the HITECH Act. The addendum outlines the terms under which the Associate will perform services for the Agency, focusing on the proper use, disclosure, protection, and management of confidential health information, with specific attention to maintaining the privacy and security of PHI in accordance with federal regulations.

The addendum comprehensively details the Associate's obligations, including limiting PHI access to necessary personnel, implementing appropriate safeguards, providing notifications in case of security breaches, supporting individual rights related to health information, and ensuring compliance with privacy and security rules. Key requirements include maintaining confidentiality, reporting security incidents, protecting electronic transmission of PHI, and agreeing to terminate use of PHI upon Agency request. The document also specifies the Associate's responsibilities in the event of a breach, including investigation, notification, and mitigation efforts, with all associated costs to be borne by the Associate.