Health Care Operations definition

Health Care Operations shall have the meaning given to such term under the HIPAA 2 Privacy Rule in 45 CFR § 164.501.

Health Care Operations shall have the meaning given to such term under the Privacy Rule, including but not limited to, 45 C.F.R. Section 164.501.

Health Care Operations has the same meaning as the term "health care operations" at 45 C.F.R. § 164.501.

Examples of Health Care Operations in a sentence

• However, BA may disclose Protected Information as necessary (i) for the proper management and administration of BA; (ii) to carry out the legal responsibilities of BA; (iii) as required by law; or (iv), for Data Aggregation purposes relating to the Health Care Operations of CE.

• However, BA may use Protected Information as necessary (i) for the proper management and administration of BA; (ii) to carry out the legal responsibilities of BA; (iii) as required by law; or (iv) for Data Aggregation purposes relating to the Health Care Operations of CE [45 C.F.R. Sections 164.504(e)(2) and 164.504(e)(4)(i)].

• VITL will provide Data Access on the VHIE to Authorized Users designated by STATE for the purposes of Payment and Health Care Operations related to covered Health Plans administered by STATE for individuals who have not opted-out of the sharing of their data on the VHIE.

• Contractor may provide access to Data in the VHIE for the services related to Permitted Use, and may provide access to such Data for Treatment, Payment, and Health Care Operations consistent with its Policy on Secondary Use of PHI on the VHIE which provides for use by Accountable Care Organizations or HealthPlans for Quality Review under a Data Use Agreement.

• STATE is not permitted under this agreement to engage in or facilitate Data Access by or on behalf of any individuals or entities except those performing Payment and Health Care Operations of or on behalf of STATE.

More Definitions of Health Care Operations

Health Care Operations means activities of the Plan related to its health care functions, including quality assessment, case management, care coordination, reviewing competence of health care professionals, evaluating provider performance, health plan performance, cost management, resolution of grievances, or any other related activities.

Health Care Operations shall have the meaning set out in its definition at 45 C.F.R. § 164.501.

Health Care Operations means any of the following activities

Health Care Operations has the meaning given such term in 45 C.F.R. § 164.501.

Health Care Operations means certain administrative, financial, legal, and quality improvement activities that are necessary to run programs including, but not limited to, conducting quality assessment and improvement activities, population-based activities relating to improving health or reducing health care costs, case management and care coordination, evaluating practitioner, provider, or health plan performance, and underwriting, enrollment, premium rating and other activities related to creation, renewal, or replacement of a health insurance contract.

Health Care Operations shall have the meaning set forth at 45 CFR § 164.501 of the HIPAA Regulations.

Health Care Operations means any of the following activities of the Plan, to the extent such activities relate to the covered functions of the Plan, including, but not limited to: Conducting quality assessment and improvement activities including outcomes evaluation and development of clinical guidelines, provided that the obtaining of generalizable knowledge is not the primary purpose of any studies resulting from such activities; Patient safety activities; Population-based activities relating to improving health or reducing Health Care costs, protocol development, case management and care coordination, disease management, contacting Health Care Providers and patients with information about Treatment alternatives and related functions that do not include Treatment;Reviewing the competence or qualifications of Health Care professionals, evaluating practitioner and Provider performance, rating Health Care Provider and Plan performance, including accreditation, certification, licensing, or credentialing activities; Underwriting (subject to the prohibition in this Article 11), premium rating and other activities relating to the creation, renewal, or replacement of a contract of health insurance or health benefits, securing or placing a contract for reinsurance of risk relating to Health Care claims, including stop-loss insurance and excess of loss insurance; Conducting or arranging for medical review, legal services and auditing functions, including fraud and abuse detection and compliance programs; Business planning and development, such as conducting cost-management and planning- related analysis associated with managing and operating the Plan, including formulary development and administration, development or improvement of payment methods or coverage policies; Business management and general administrative activities of the Plan, including, but not limited to: Management activities relating to the implementation of and compliance with HIPAA’s administrative simplification requirements; Customer service, including the provision of data analysis for policyholders, Plan Sponsors, or other customers; Resolution of internal grievances; The sale, transfer, merger or consolidation of all or part of the Plan with another Covered Entity, or an entity that following such activity will become a Covered Entity, and due diligence related to such activity; Consistent with the applicable requirements of 45 CFR Section 164.514, creating de-identified Health Information or a limited data set, a...