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why is establishing business associate agreement baa necessary?

Why is Business Associate Agreement (BAA) needed?


If your organization is considered a "covered entity" under the Health Insurance Portability and Accountability Act (HIPAA), you must sign Business Associate Agreements (BAAs) with subcontractors or vendors to ensure the proper protection of patients’ data.

Vendors who create, receive, maintain, or transmit protected health information (PHI) while providing a service to or on behalf of a covered entity are considered business associates. Examples include companies specializing in hosting, software development, data destruction, transcription, or billing.

HIPAA mandates Business Associate Agreements (BAAs) to outline acceptable and unacceptable uses of PHI between involved parties. They also delineate responsibilities and consequences for non-compliance with established requirements.

If you want to know what a BAA is, to understand who needs such agreements, and to learn some examples, keep reading. We also provide all HIPAA guidelines and a toolkit with everything you need to know about US regulations, such as who must comply with HIPAA, who enforces HIPAA, and how to choose a HIPAA-compliant service provider.

In this article:

What is a HIPAA Business Associate Agreement?

A Business Associate Agreement is a mandatory requirement of HIPAA that aims to safeguard protected health information (PHI) when outsourcing tasks. It establishes a legally binding relationship between:

  • A covered entity and a business associate company.

  • A business associate company of a covered entity and its subcontractor.

This creates a chain of responsibilities that ensures all parties are committed to data protection.

What is the structure of a BAA? Here are the three sections that these contracts must contain:

  1. Description of how the business associate company will relate to PHI. It clearly specifies how this data will be used and if it will be disclosed in any way.

  2. Limits. It specifies what the business associate company cannot do with PHI, including unauthorized disclosures.

  3. Definition of appropriate safeguards to prevent misuse or leakage of medical data, except for authorized disclosures outlined in the first point.

What is the purpose of a Business Associate Agreement (BAA)?

The purpose of signing a Business Associate Agreement (BAA) is to establish criteria for the use, storage, and distribution of PHI between covered entities and their vendors to prevent information leaks.

BAAs outline service characteristics, response times to incidents, and expectations for recovery in case of such contingencies. Additionally, they describe the correct and incorrect uses of PHI and specify consequences for violations for all involved parties.

Who needs HIPAA business associate agreements?

HIPAA stipulates that only the following covered entities need a BAA:

  • Health plans and health insurance companies.

  • Healthcare clearinghouses.

  • Healthcare providers who transmit any health information for transactions.

  • Healthcare institutions.

  • Hybrid entities like universities with academic medical centers or hospitals that exchange PHI for research purposes.

On the other hand, not all business associates working for a covered entity must sign a BAA, only those who:

  • Perform or assist in activities involving the use or disclosure of PHI, such as claims processing, data analysis, quality control reviews, and utilization reviews.

  • Provide actuarial, consulting, legal, data aggregation, accreditation, management, administrative, or financial services to a covered entity, involving the disclosure of PHI.

It's important to note that employees, internet service providers, and messaging service providers of a covered entity are not considered business associates. Also, a covered entity can be a business associate of another covered entity.

What information does a BAA contain?

The document signed under a BAA agreement must contain key data to comply with HIPAA guidelines. These include:

  • Date.

  • Full names of the individuals and institutions involved.

  • Acceptance of terms and conditions.

  • Legal framework declaration: HIPAA.

  • Description of the type of PHI to which access is granted.

  • Definition of permissible and impermissible uses of PHI.

  • Explanation of responsibilities and consequences.

  • Protocol for training individuals handling PHI under HIPAA.

  • Protocol for action in case of data breach.

  • Procedure for returning or destroying PHI.

  • Signatures of the involved parties.

Who typically signs a BAA? In general, the authorities of the involved entities are responsible for signing these documents and ensuring compliance within their institutions. In the case of agreements between individuals, they themselves are responsible for their commitment.

What is the difference between a BAA and an NDA?

A BAA and an NDA differ in their scope. The BAA is specifically designed to comply with HIPAA regulations, focusing on protecting health information. On the other hand, an NDA can be used in various fields such as business, technology, entertainment, human resources, and more.

An NDA, or non-disclosure agreement, is a legal contract that establishes a confidential relationship between a person with sensitive information they do not want disclosed and a subject or institution that will have access to that data. For instance, a company might require its financial employees to sign an NDA to safeguard billing and revenue data.

What happens if you don't have a BAA?

If you do not have the resources or know-how to sign a BAA, it is likely that you may miss out on some business opportunities. That is, companies working in the healthcare or health tech industry may end up choosing another provider who can establish a BAA.

The risks of working with companies that do not comply with HIPAA regulations are significant. The US Department of Health and Human Services (HHS) conducts audits, and violations can lead to hefty penalties. The Office for Civil Rights (OCR) determines fines, which can be up to $1,500,000 per year, and severe cases may involve non-monetary measures.

What is an example of a business associate of a HIPAA-covered entity?

An example of a business associate of a HIPAA-covered entity is a technology company (fictional name Sky) providing cloud data storage services to a clinic. The organization is responsible for protecting the privacy and security of all patient medical information.

To enhance data protection measures, efficiency, and accessibility, the clinic outsources its storage to Sky, which means Sky will have access to patient medical information.

In this situation, both parties must sign a business associate agreement outlining the terms of access, data protection measures, permissible uses, and penalties for non-compliance.

At XOOR, we comply with HIPAA regulations. All our teams have been trained, passed a knowledge validation exam, and are approved to work on projects involving PHI. We are accredited providers authorized to sign business associate agreements and are highly committed to data security and prevention of information breaches. Schedule a meeting and let's start working together!