Business Associate Agreement Sample Contracts

STATE OF VERMONT CONTRACT AMENDMENT
Business Associate Agreement • August 25th, 2021 • Vermont

It is hereby agreed by and between the State of Vermont, Department of Buildings and General Services, Office of Purchasing and Contracting (the "State") and Ardent Technologies Inc with a principal place of business in Dayton, OH (the "Contractor") that the contract between them originally dated as of November 19, 2018, Contract #37285, as amended to date, (the “Contract”) is hereby amended as follows:

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BUSINESS ASSOCIATE AGREEMENT Between ARKANSAS DEPARTMENT OF HUMAN SERVICES And
Business Associate Agreement • May 5th, 2020

This Business Associate Agreement (“Agreement”) is made effective on , (the “Effective Date”) by and between the Arkansas Department of Human Services (“Covered Entity”) and , (“Business Associate,”) (collectively, the “Parties”).

Attachment A - Specifications of Work to be Performed Attachment B - Payment Provisions Attachment C - Customary State Contract provisions Attachment E - Business Associate Agreement Attachment F - Customary Contract Provisions of the Agency of Human...
Business Associate Agreement • November 11th, 2022 • Vermont

BY THE STATE OF VERMONT: BY THE CONTRACTOR: E-SIGNED by Mark Larson March 29, 2014on 2014-03-29 10:41:20 GMT E-SIGNED by Michael Bailit March 28, 2014on 2014-03-28 21:21:28 GMT Mark Larson, Commissioner Date312 Hurricane Lane, Suite 201Williston, VT 05495-2087Phone: 802-879-5901Email: Mark.Larson@state.vt.us Michael Bailit, Title Date56 Pickering StreetNeedham, MA. 02492Phone: 781 453-1166Email:mbailit@bailit-health.com

BUSINESS ASSOCIATE AGREEMENT
Business Associate Agreement • May 4th, 2020

Covered Entity and Business Associate agree that under entered into by Covered Entity and Business Associate (the “Agreement”), Business Associate provides services for or on behalf of Covered Entity that may involve access to PHI (as defined below) and that, as such, the parties agree as follows:

RFPQ#HSS2022.E2) BUSINESS ASSOCIATE AGREEMENT
Business Associate Agreement • May 17th, 2022

This Business Associate Agreement (“BAA”) supplements and is made a part of the agreement by and between the City and County of San Francisco, the Covered Entity (“CE”), and [insert name of contractor] (“Contractor”), the Business Associate (“BA”), dated [insert date] (CMS #____) (“Agreement”)]. To the extent that the terms of the Agreement are inconsistent with the terms of this BAA, the terms of this BAA shall control.

AMENDED and RESTATED HIE Participation Agreement
Business Associate Agreement • July 13th, 2023 • District of Columbia

NOW, THEREFORE, for and in consideration of the mutual covenants herein contained, CRISP and Participant agree as follows:

BUSINESS ASSOCIATE AGREEMENT BETWEEN THE OFFICE OF MANAGEMENT AND ENTERPRISE SERVICES (COVERED ENTITY) AND __________________ (BUSINESS ASSOCIATE) Definitions Catch-all definitions:
Business Associate Agreement • October 20th, 2022 • Oklahoma

The following terms used in this Agreement shall have the same meaning as those terms in the HIPAA Rules: Breach, Data Aggregation, Designated Record Set, Disclosure, Health Care Operations, Individual, Minimum Necessary, Notice of Privacy Practices, Protected Health Information, Required By Law, Secretary, Security Incident, Subcontractor, Unsecured Protected Health Information, and Use.

BUSINESS ASSOCIATE AGREEMENT
Business Associate Agreement • December 14th, 2020

This Business Associate Agreement (the “Agreement”) is made by and between Commissioners of Caroline County (herein known as “Covered Entity”), and University of Maryland Shore Regional Health (herein known as “Business Associate”).

STATE OF VERMONT CONTRACT AMENDMENT
Business Associate Agreement • June 30th, 2021 • Vermont

It is hereby agreed by and between the State of Vermont, Department of Buildings and General Services, Office of Purchasing and Contracting (the "State") and Competitive Computing Inc., with a principal place of business in Colchester, VT (the "Contractor") that the contract between them originally dated as of June 01, 2016, Contract #31667, as amended to date, (the “Contract”) is hereby amended as follows:

BUSINESS ASSOCIATE AGREEMENT
Business Associate Agreement • June 27th, 2022

purposes of the disclosure; and person/entity agrees to notify Business Associate of any breaches of confidentiality in a timely fashion and in writing. Documentation needs to follow the same standards and time frames as item 5 below.

§ BUSINESS ASSOCIATE AGREEMENT COUNTY OF TARRANT §
§ Business Associate Agreement • June 11th, 2020 • Texas

This Business Associate Agreement (“BA Agreement”) is between Tarrant County, Texas, (“COUNTY”), and , (“Business Associate”), for the purpose of complying with the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”), the Standards for Privacy of Individually Identifiable Health Information (the “Privacy Rule”), and the Standards for Security of Electronic Protected Health Information (the “Security Rule”) promulgated thereunder, and the Health Information Technology for Economic and Clinical Health Act (Division A, Title XIII and Division B, Title IV, of the American Recovery and Reinvestment Act of 2009, Pub. L 111-5) (the “HITECH Act”), and the regulations implementing the HITECH Act and other applicable law with regard to the provision of services to Tarrant County Public Health.

BUSINESS ASSOCIATE AGREEMENT
Business Associate Agreement • July 20th, 2023 • New York

This Agreement supplements the Underlying Agreement and is intended to satisfy the requirements for business associates agreements as set forth in the HIPAA Rules, which requires that the County, as a covered entity, receives adequate assurances that Contractor, as a business associate, will comply with certain obligations with respect to the protected health information received in the course of providing Services to or on behalf of the County and that prohibit the disclosure to or use of protected health information by Contractor if such an agreement is not in place.

ATTACHMENT C: STANDARD STATE PROVISIONS FOR CONTRACTS AND GRANTS
Business Associate Agreement • April 11th, 2022 • Vermont
CFDA Title: Cooperative Agreement to Support Establishment of the Affordable Care Act's Health Insurance Exchange
Business Associate Agreement • May 5th, 2020 • Vermont

Subrecipient, wherein services authorized under this grant are provided, is not in compliance with State and Federal law, the State may terminate this grant immediately and notify the Subrecipient accordingly. Also, in the event that federal funds supporting this grant become unavailable or are reduced, the State may cancel this grant with no obligation to pay the Subrecipient from State revenues.

Business Associate Agreement
Business Associate Agreement • March 27th, 2020

T his Business Associate Agreement ("Agreement") is entered into this 27th day of March, 2020 (the “Effective Date”), by and between Synergy of Spirit Counseling &Hypnosis, a New York Professional corporation ("Covered Entity") and Doxy.me, LLC

SAMPLE
Business Associate Agreement • December 3rd, 2020

This Agreement is made effective the ____ of ____, 201_, by and between CLINIC NAME, hereinafter referred to as “Covered Entity”, and YOUR ORGANIZATION, hereinafter referred to as “Business Associate”, (individually, a “Party” and collectively, the “Parties”).

New York City Health and Hospitals Corporation’s Standard Business Associate Agreement
Business Associate Agreement • May 11th, 2021 • New York

This business associate agreement (the “BAA”) is entered into by and between New York City Health and Hospitals Corporation, located at 125 Worth Street, New York, New York 10013, (“NYC Health + Hospitals”) and , located at (“Business Associate”), each individually referred to as a party (“Party”) and collectively referred to as the parties (“Parties”).

BUSINESS ASSOCIATE AGREEMENT UNDER THE HEALTH INSURANCE PORTABILITY
Business Associate Agreement • August 18th, 2022

County is a Covered Entity as defined by, and subject to the requirements and prohibitions of, the Administrative Simplification provisions of the Health Insurance Portability and Accountability Act of 1996, Public Law 104-191 (HIPAA), and regulations promulgated thereunder, including the Privacy, Security, Breach Notification, and Enforcement Rules at 45 Code of Federal Regulations (C.F.R.) Parts 160 and 164 (collectively, the "HIPAA Rules").

STATE OF VERMONT
Business Associate Agreement • March 14th, 2022
BUSINESS ASSOCIATE AGREEMENT
Business Associate Agreement • October 25th, 2017 • New York

This Business Associate Agreement (“Agreement”), effective (“Effective Date”), is entered into by and between , with principal place of business at (“Business Associate”) and the New York City Health and Hospitals Corporation, with principal place of business at 125 Worth Street, New York, New York 10013 (“Covered Entity”) (each a “Party” and collectively the “Parties”).

Contract
Business Associate Agreement • April 21st, 2021

THIS BUSINESS ASSOCIATE AGREEMENT (“BA Agreement”) is entered into by and between Boston Scientific Corporation (“Boston Scientific”), with offices at 300 Boston Scientific Way, Marlborough, MA 01752 and the entity or individual (“Provider”) to whom Boston Scientific makes available patient reimbursement assistance by facilitating the preparation and submission of requests for coverage determinations, prior authorizations, pre- certifications and appeals of denied claims, relating to Boston Scientific’s own medical technologies, as allowed under the AdvaMed Code of Ethics on Interactions with Health Care Professionals (“Reimbursement Assistance”). These services require the exchange of information about patients that is protected by the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”) as applicable to Business Associates, as well as any amendments or additions thereto, including amendments made by the HITECH Act and GINA (defined below). The Provider is a “Covered

BUSINESS ASSOCIATE AGREEMENT
Business Associate Agreement • March 25th, 2021 • New Jersey

,(the“Business Associate”) and the New Jersey Department of Human Services, Division of Mental Health and Addiction Services (DMHAS), (the “Covered Entity”) (collectively the “Parties”).

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BUSINESS ASSOCIATE AGREEMENT
Business Associate Agreement • March 3rd, 2023

This Business Associate Agreement (“Agreement”) is made and entered into effective as of the XXrd day of Month CCYY (the “Effective Date”), by and between State of Arkansas, Department of Transformation & Shared Services- Employee Benefits Division (EBD), with a principal business address of 501 Woodlane Street, Suite 500 Little Rock, Arkansas 72201 (“Covered Entity”) and Vendor Name, with a principal business address of Vendor Address, City State Zip (“Business Associate”).

BUSINESS ASSOCIATE AGREEMENT
Business Associate Agreement • November 30th, 2021 • New Jersey

Rutgers, The State University of New Jersey (“Rutgers”), an instrumentality of the State of New Jersey, a public entity, with offices at Winants Hall, 7 College Avenue, New Brunswick, NJ 08901, for itself and on behalf of its organizational unit, Rutgers Biomedical and Health Sciences (“RBHS”), and the unincorporated constituent units therein. Individually and together, Rutgers and RBHS, and all of their other present and future Affiliates, are collectively, “Covered Entity”,

ADDENDUM 1 Business Associate Agreement
Business Associate Agreement • December 12th, 2022 • Texas

This Business Associate Agreement (“Agreement”), effective ______________ (“Effective Date”), is entered into by and between The University of Texas ____________________ on behalf of its ____________________________ (“Covered Entity”) and _________________________________, a _____________________________ company doing business as “________________________” (“Business Associate”, as more fully defined in section 1(c)) (each a “Party” and collectively the “Parties”).

BUSINESS ASSOCIATE AGREEMENT
Business Associate Agreement • March 31st, 2023 • Mississippi

THIS BUSINESS ASSOCIATE AGREEMENT (“Agreement”) is entered into by and between the DIVISION OF MEDICAID IN THE OFFICE OF THE GOVERNOR, an administrative agency of the STATE OF MISSISSIPPI (hereinafter “DOM”), and (hereinafter “Business Associate”), hereinafter collectively referred to as the Parties, and modifies any other prior existing agreement for this purpose. In consideration of the mutual promises below and the exchange of information pursuant to this Agreement and in order to comply with all legal requirements for the protection of this information, the Parties therefore agree as follows:

FORM OF STANDARD BUSINESS ASSOCIATE AGREEMENT
Business Associate Agreement • April 29th, 2019 • New York

In connection with the Underlying Contact (as defined below), which requires HEALTH ADVANCEMENT COLLABORATIVE OF CENTRAL NEW YORK, INC. d/b/a

AMENDMENT
Business Associate Agreement • May 5th, 2020 • Vermont

It is agreed between the State of Vermont, Department of Vermont Health Access (hereinafter called “State”) and Healthfirst, Inc., (hereinafter called “Subrecipient”) with principal place of business at Williston, VT that the grant #04310-1457-15 dated January 21, 2015 is to be amended January 1, 2016 as follows:

CFDA Title: State Innovation Models CFDA Number: 93.624
Business Associate Agreement • May 16th, 2022 • Vermont

For the State For the Subrecipient Name: Georgia Maheras Paul Reiss Phone #: 802-505-5137 802-343-1036 E-mail: Georgia.maheras@state.vt.us pjr@vthealth1st.org

BUSINESS ASSOCIATE AGREEMENT (HIPAA)
Business Associate Agreement • November 16th, 2023

This Privacy Agreement ("Agreement"), is effective upon signing this Agreement and is entered into by and between Park Avenue Medical LLC ("Covered Entity") and

BUSINESS ASSOCIATE AGREEMENT
Business Associate Agreement • January 27th, 2023

This Business Associate Agreement (“Agreement”) is entered into by and between Insert Other Party’s Name and its affiliated entities (“Business Associate”) and Children’s Hospital and Health System, Inc. and its affiliated covered entities (collectively referred to as the “Covered Entity”), (each a “Party” and collectively the “Parties”). This Agreement shall be effective as of the date on which the last of the Parties has executed this Agreement (“Effective Date”).

University of Arizona Information Security and Privacy Addendum
Business Associate Agreement • April 4th, 2021 • Arizona

This Information Security and Privacy Addendum (“ISPA”) is between the Arizona Board of Regents on behalf of The University of Arizona (“University”) and [VENDOR] (“Vendor”) and is hereby incorporated into the Agreement between the parties dated [DATE] (the “Agreement”). Vendor is providing [description of services] (the “Services”), and by doing so, add the following terms and conditions as an addendum.

HIPAA Business Associate Agreement: Boston University and ______________________ Under the Health Insurance Portability and Accountability Act and the Health Information Technology for Economic and Clinical Health Act Massachusetts General Laws...
Business Associate Agreement • February 9th, 2022

This Agreement is between the University and [____________], acting as the Business Associate of the University. This Agreement reflects both parties’ commitment to protect the privacy and security of Protected Health Information and to meet the data security, data breach notification, and other requirements of HIPAA, the Massachusetts Security Breach Law, and other applicable laws.

The Medicaid Managed Specialty Supports and Services Concurrent 1915(i)/(c), 1115 Waiver Program(s), the 1115 Healthy Michigan Plan and Substance Use Disorder Community Grant Programs Agreement
Business Associate Agreement • September 1st, 2020 • Michigan

THIS AGREEMENT, made and entered into this 1st day of October, 2020 between the Mid- State Health Network (MSHN), whose administrative offices are located at 530 W. Ionia Street, Suite F, Lansing, Michigan 48933 (hereinafter referred to as the “MSHN”, “PIHP”, or "Payor"), and

MASTER SOFTWARE & SERVICES AGREEMENT
Business Associate Agreement • May 26th, 2022

This Master Agreement sets forth the terms and conditions under which TRITAN will make the Solutions available to Client, and will serve as the controlling document under which Client and Client's Affiliates may license software and procure services from TRITAN by entering into one or more appropriate order, statement of work, work order, purchase order, or other mutually agreeable document entered into by the parties and expressly incorporating this Master Agreement (each an “Order”). To the extent conflicts or inconsistencies exist between this Master Agreement and an Order, the provisions of this Master Agreement shall govern and control.

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