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This information is provided for informational purposes only and does not represent a product or service endorsement or recommendation by the American Optometric Association

HIPAA Compliance Info

HIPPA

DATE: April 2, 2007

As you are probably aware, compliance with the HIPAA Security Rule was required as of April 20, 2005. Covered Entities must obtain a signed Business Associate Agreement with any business associates under the Privacy and Security Rules. As a Covered Entity, you may have already signed a Business Associate Agreement with Wal-Mart Stores, Inc. in the past. However, implementation of the HIPAA Security Rule required changes to the original Business Associate Agreement. Nonetheless, whether you are a new or an existing Doctor with Wal-Mart or Sam's Club, you would have been given the opportunity to sign a Business Associate Agreement that included language referencing the Security Rule.

Whether you have signed a Business Associate Agreement with Wal-Mart in the past or not, it is important to evaluate whether a business associate relationship exists and whether there is a need for you to sign a Business Associate Agreement. To assist you in doing so, the first step is to determine if you are a “Covered Entity.” Covered Entity is defined as “a health care provider who transmits health information electronically in connection with a HIPAA standard transaction such as insurance related claims, payment, eligibility, authorization or certification.”

For many of you, we provide these insurance related transactions as services on your behalf, thus making you a Covered Entity. You are also a Covered Entity if these electronic transactions are performed by your staff or contracted services in other locations inside or outside of a Wal-Mart or Sam's Club.

If you are a covered entity, we consider ourselves to be your business associate when:

  • we provide paraoptometric technicians to you
  • we provide insurance billing services on your behalf

Independent Doctors are not healthcare components or part of hybrid or affiliated entities with Wal-Mart Stores, Inc. as this requires common ownership. Wal-Mart and the Independent Doctors are separate legal entities that have no common ownership. If you are not a Covered Entity under HIPAA, a business associate relationship does not exist and Wal-Mart will not sign a Business Associate Agreement. A business associate relationship exists where Wal-Mart provides services that require use or disclosure of PHI on behalf of the Independent Doctor who is a Covered Entity.

If you wish to have Wal-Mart sign a different Business Associate Agreement, please contact me so that I may arrange for the proposed agreement to be reviewed by the Wal-Mart Legal Department.

If you have any questions or need additional information, please do not hesitate to .

Laura Asbury


Optical Links

Department of Health and Human Services, HIPAA
http://www.hhs.gov/ocr/hipaa/

HIPAAdvisory, Phoenix Health Systems
http://www.hipaadvisory.com/action/legalqa/hipaalaw.htm

Federal Trade Commission (FTC)--The Contact Lens Rule: Guide for Prescribers and Sellers
http://www.ftc.gov/bcp/conline/pubs/buspubs/contact.htm

Federal Trade Commission (FTC)--Q&A:  Complying with the Contact Lens Rule
http://www.ftc.gov/bcp/conline/pubs/buspubs/contactfaq.htm

Association of Regulatory Boards of Optometry (ARBO)
http://www.arbo.org/index.php?action=arboDirectoryOfBoards

National Academy of Opticianry – State Opticianry Boards
http://www.nao.org/AddInfo/state.htm

State Optometry Board Websites:

Alabama

Indiana

Nebraska

South Carolina

Alaska

Iowa

Nevada

South Dakota

Arizona

Kansas

New Hampshire

Tennessee

Arkansas

Kentucky

New Jersey

Texas

California

Louisiana

New Mexico

Utah

Colorado

Maine

New York

Vermont

Connecticut

Maryland

North Carolina

Virginia

Delaware

Massachusetts

North Dakota

Washington

Florida

Michigan

Ohio

West Virginia

Georgia

Minnesota

Oklahoma

Wisconsin

Hawaii

Mississippi

Oregon

Wyoming

Idaho

Missouri

Pennsylvania

 

Illinois

Montana

Rhode Island