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Business Associates Agreement Involving the Access to Protected Health Information
This Business Associate Agreement Agreement
Is Related To and a Part of the Following
Underlying Agreement:
__________________________________________
Effective Date of Underlying Agreement:_________
School/Unit: _______________________________
Vendor: ___________________________________
Business Associate Agreement
Involving the Access to Protected Health Information
This Business Associate Agreement ("BAA") is entered into between RowanSOM - [Name of School/Department/Unit]("Rowan University"), a body corporate and politic of the State of New Jersey having its principal administrative offices at 40 East Laurel Road, UEC Bldg. Suite # 1031, Stratford, NJ 08084 (hereinafter referred to as "Covered Entity") and [Name and Address of Contracting Party] (hereinafter referred to as "Business Associate") (the "Covered Entity" and "Business Associate" hereinafter collectively referred to as the "Parties"). Any conflict between the terms of this BAA and the Underlying Agreement between the Parties shall be governed by the terms of this BAA.
WHEREAS, in connection with the Underlying Agreement the Business Associate provides services to Covered Entity and Covered Entity discloses to Business Associate certain Protected Health Information that is subject to protection under the Health Insurance Portability and Accountability Act of 1996 ("HIPAA"), the Health Information Technology for Economic and Clinical Health Act (Title XIII of the American Recovery and Reinvestment Act of 2009) (the "HITECH Act"), and regulations promulgated by the U.S. Department of Health and Human Services (the "HHS") (hereinafter the "HIPAA Regulations" and the "HITECH Regulations," respectively) and/or applicable state and/or local laws and regulations; and
WHEREAS, for good and lawful consideration and with acknowledgment of the mutual promises, set forth in the Underlying Agreement and herein, the Parties, intending to be legally bound, hereby agree as follows:
I. Definitions [1]
[1] An expanded definition of the following terms, as well as the definition of other relevant terms are availableon RowanSOM website at https://www.rowan.edu/compliance. Terms used in this Business Associate Agreement but not otherwise defined shall have the meaning ascribed to those terms in HIPAA, the HITECH Act, and any current and future regulations promulgated under HIPAA and/or the HITECH Act. See 45 C.F.R. 160.103, 164.402 and 164.501.
An expanded definition of the following terms, as well as the definition of other relevant terms are availableon RowanSOM website at https://www.rowan.edu/compliance. Terms used in this Business Associate Agreement but not otherwise defined shall have the meaning ascribed to those terms in HIPAA, the HITECH Act, and any current and future regulations promulgated under HIPAA and/or the HITECH Act. See 45 C.F.R. 160.103, 164.402 and 164.501.
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To The Covered Entity: To The Business Associate:
School/Unit/Department: Name/Title:____________________
Address: Address:
Telephone: Telephone:
E-Mail: E-Mail:
IN WITNESS WHEREOF, the parties have executed this Business Associate Agreement the day and year first written below.
By: ROWANSOM By: [BUSINESS ASSOCIATE]
[COVERED ENTITY]
Approved: Approved:
Title: Title:
Date: Date:
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