1.1st Amendment 11/15/2006
DANNY L. KOLHAGE
CLERK OF THE CIRCUIT COURT
DATE:
May 11, 2007
TO:
Maria Fernandez, Sr. Administrator
Employee Benefits Division
FROM:
Pamela G. Hanc~
Deputy Clerk V
At the January 17, 2007, Board of County Commissioner's meeting the Board granted
approval to renew and authorized execution of a Second Amendment to Employer-Provide
Network and Utilization Review and Case Management Service Agreement between Monroe
County and KPHA which provides Pre-admission Certification and Medical Case Management
services of the County's Health Insurance Program. Enclosed is a duplicate original for your
handling.
J At the November 15, 2006, BOCC meeting the Board granted approval of and authorized
execution of an Amendment to Business Associate Contract between the County and Acordia
National concerning the HIPP A security regulation. Enclosed is a copy for your handling.
Should you have any questions please do not hesitate to contact this office.
cc: County Attorney
Finance
FileJ
C2%ordia.
A('ordia National
FILED FWi RECORD
AMENDMENT TO BUSINESS
ASSOCIATE CONTRACT
2007HAY II AI1/0: 0 I
r
DANNY l. ~~0L;U\GE
CUt Olf; CT.
MONROE cou,'n~', FLi\.
I
Acordia National
602 Virginia Street, East
P.O. BOl< 2381
Charleston, WV 25301.2381
Voice: Boo.624,8605
Fa)(: 304.353.8773
I
j
Maria Fernandez, Group Insuran
MONROE CNTY BRO OF COHMISS10N
HIstoric GATO Cigar Factory 11
Room 2-272
L Key West, FL 3304,0 -.J
This Amendment to the Business ASSOCiate Contract previously entered into by and between:
(hereinan~ called Entity' an NAL (herelna e ca . uslnes ASSOCiate").
WHEREAS, the Covered Entity and Busin..s Associato previously antered into a BUSin..s ASsociata Contraclthe intent of which was to a..istthe
Covered Entny and Business Associate to comply WIth the Heafth Insurance Portabilny and Accounlabiiny Act of 1996 ane r"al regulations promuigated
YJith respect thereto (collectively, ~HIPAA.); and
WHEREAS, the Covered Entny ane Business Assoctate intand to compiy WIth the securny standards for the protection of Eiectronic Protected Heafth
Information promulgated pursuant to HIPAA (the "Security Rule") as follows'
1 Business Associate shail implement administrative, physlcai, and technical safeguards that reasonably ane appropriateiy protect the
confldentialny, integrny, and avaiiabiiny of Electronic Protected Heafth Intormation that iI creat.., receiv.., maintains, transmns, or destroys on
behalf of Covered Entity.
2. Business Associate agrees to ansure that any agent, inciuding a subcontractor, to whom iI provides Protected Heafth Information or Electronic
Protected Health Information receiVed ~om, or created or received by Business Associate on behalf of Covered Entny agr... to the same
restrictions and concftions that apply through thl. Agreement to Business ASSOCiate WIth respect to such information
3. Business Associate agrees to report to Covered Entity any security incident of which II becomes aware of
4. The followin!;J terms shall have the follOwing meaning:
a. Electronic Protected Heafth Information. "Electronic Protected Hea~h Information (E-PHi)" shail have the meaning d..cribed in 45 CFR
160.103.
b. Securilv Incidanl. 'Securny IncidenF as denned in 45 CFR 164.304 shail mean the attompted or successfui unauthorized aceass, use,
disclosure, modlrlCation, or destrucUon of information or intarterence v.rth system oparallons in an information system.
This amendmenl shall become effective as or April 21, 2005
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6. This amenement shail survive the termination of any Busine.s ASSOCiate Contract previously executed belwaen Covered Entny ane Businllll!l::;: --' Z
7. ~::;:: modinM herein, ail terms ane conditions of the previously e'acuted Business ASSOCiate Contractshail remain in fuU force and e"el ~) ~ ~
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IN WITNESS WHEREOF, this Amendment has been executed by the respectiva parties on the date and year nrst written above. f- r/)~,iII i': !<
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ACO~ATllONA7' ~c.
By (jJ -Id- lM 1}
Richard H. Legg
Its: Senior Vice President and Chief
Operating Officer
(Plan Sponsorl
~~ B~;t}~F~1~Y7 R__m DI.ft W....h.
leh ' NOV 1 5 2006 Prl'nt Name: Mario
Its: Mayor auman
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! OHIN. orE<<... If y. OUSh. ould have any que. . stiQn reg_rding this form. pl&as~
cont;K;t Acardia Natio~I's HlPAA T"mle~ lit (800) 624-8605.