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What may a HIPAA covered entity’s business associate agreement authorize a health information organization (HIO) to do with electronic protected health information (PHI) it maintains or has access to in the network?

A business associate agreement may authorize a business associate to make uses and disclosures of PHI the covered entity itself is permitted by the HIPAA Privacy Rule to make. See 45 C.F.R. § 164.504(e). In addition, the Privacy Rule permits a business associate agreement to authorize a business associate (e.g., a HIO) to: (1) use and disclose PHI for the proper management and administration of the business associate, in accordance with 45 C.F.R. § 164.504(e)(4); and (2) to provide data aggregation services related to the health care operations of the covered entities for which it has agreements. In most cases, the permitted uses and disclosures established by a business associate agreement will vary based on the particular functions or services the business associate is to provide the covered entity. Similarly, a covered entity’s business associate agreement with a HIO will vary depending on a number of factors, such as the electronic health information exchange purpose which the HIO is to manage, the particular functions or services the HIO is to perform for the covered entity, and any other legal obligations a HIO may have with respect to the PHI. For example, the business associate agreements between covered entities and a HIO may authorize the HIO to:

•Manage authorized requests for, and disclosures of, PHI among participants in the network;
•Create and maintain a master patient index;
•Provide a record locater or patient matching service;
•Standardize data formats;
•Implement business rules to assist in the automation of data exchange;
•Facilitate the identification and correction of errors in health information records; and
•Aggregate data on behalf of multiple covered entities.


Created 12/15/08

Content created by Office for Civil Rights (OCR)
Content last reviewed on July 26, 2013