1. Protect the confidentiality of patient healthcare information. The “protected health information” (PHI) of patients must be identified and remain confidential from the point it
is recorded by an EMS client, transferred to DAB for billing purposes, used by DAB to file insurance claims or mail invoices and stored by DAB and/or an EMS client for record keeping purposes.

2. Not disclose PHI unless permitted to do so. DAB and our EMS clients can only use PHI and related healthcare information for the purposes of filing insurance claims, mailing invoices and conducting legitimate business operations related to financial transactions, record keeping and the administration of an EMS system. All other uses of PHI must be approved by the patient prior to the release of such information.

3. Allow patients to view and amend PHI if requested. EMS clients must establish a record keeping system that allows patients to view and (in some cases) amend their PHI. Amending the PHI of a patient is permitted under certain circumstances, but can be denied in others. In all cases, the patient has a right to view their PHI along with a record of other parties who had access to such information.

4. Report disclosures of PHI, if they occur. DAB and our EMS clients must report inadvertent or purposeful disclosures of PHI to the patient, if they occur. Such disclosures may involve civil or criminal penalties.

5. Provide accountability for PHI practices. Both DAB and our EMS clients must provide accountability for business practices, record keeping and information management related to the use or storage of PHI to the Federal Department of Health and Human Services (HHS), if requested.

To meet these requirements, DAB and our EMS clients must enter into a “Business Associate Agreement,” outlining the responsibilities of each organization with respect to HIPAA. This agreement defines the role of each organization:

• EMS clients retain responsibility for managing patient records. Because EMS clients are considered “healthcare organizations,” they retain responsibility for the management of patient records and the protection of PHI. This includes “notification of privacy practices” (NPP) to patients, obtaining an “acknowledgement of receipt” of NPP signed by patients when practical, maintaining the original patient record in a secure storage facility and meeting the procedural requirements of HIPAA with regard to patient inquires concerning PHI.

• DAB and EMS clients share responsibility for secure patient record transfer. EMS clients provide DAB with copies of patient care reports (PCRs) in paper or electronic format to be used for billing purposes. Both organizations share responsibility in developing a secure method for transferring such information. DAB shall recommend a HIPAA compliant transfer method for both paper and electronic PCRs as part of each EMS client billing contract.

• DAB becomes responsible for PHI management related to billing functions. After receiving PCR information, DAB files insurance claims and mails invoices. Our firm assumes responsibility for the management of PHI during billing operations and provides accountability to the EMS client for our business practices. DAB will release PHI only for the purpose of treatment, payment or other circumstances required by HIPAA regulations. PHI is shared only with authorized DAB employees, patient representatives and third party organizations involved in securing payment for EMS client services. DAB does not disclose PHI unless authorized by the patient, the EMS client or directed by legal authority.

Beginning in January, 2003, DAB instituted a HIPAA compliancy program for all EMS client billing operations. This program is described by the DAB HIPAA Compliancy Plan, available at each DAB office. The program is administered by the DAB HIPAA Privacy Officer who can be reached at (800) 355-1753.

As part of a billing contract with our EMS clients, DAB provides a HIPAA compliancy review of client organization policy and procedures, implementation planning (if required) and EMS client employee training. Training is provided at the beginning of the billing contract period with follow-up training conducted annually at the EMS client location.