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Do the services involve the use or
                                        disclosure of “protected health         No
                                                 information”?

                                                      Yes

                                      Is the person a health care provider
                                       seeking information for treatment        Yes
                                                   purposes?

                                                       No


                                     Is the person a member of the health
                                                                                Yes
                                          care providers "workforce"?

                                                       No
                                                                                       Business
                                     Is the person/entity only a conduit of            Associate
                                     information or is access to "protected     Yes   Agreement
                                         health information" incidental?                IS NOT
                                                                                       required
                                                       No


                                    Is the person/entity performing services    No
                                            on behalf of the provider?

                                                      Yes


                                    Is the information involved restricted to   Yes
                                               a "limited data set"?

                                                       No

                                        Is the disclosure preparatory to
                                      research or under an IRB approved         Yes
                                              waiver for research?

                                                       No



                                                   Business
                                                   Associate
                                                  Agreement
                                                      IS
                                                   required



{LEC972190.DOCX;188888.000001 }
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Business Associate Agreement

  • 1. Do the services involve the use or disclosure of “protected health No information”? Yes Is the person a health care provider seeking information for treatment Yes purposes? No Is the person a member of the health Yes care providers "workforce"? No Business Is the person/entity only a conduit of Associate information or is access to "protected Yes Agreement health information" incidental? IS NOT required No Is the person/entity performing services No on behalf of the provider? Yes Is the information involved restricted to Yes a "limited data set"? No Is the disclosure preparatory to research or under an IRB approved Yes waiver for research? No Business Associate Agreement IS required {LEC972190.DOCX;188888.000001 }