Participation means providing evidence and testimony necessary to explain the claim decisions made by the CONTRACTOR. The CONTRACTOR shall be responsible for any cost required for participation in the administrative hearings by the staff CONTRACTOR’S and any approved subcontractors, including but not limited to time spent at the hearing and travel time to and from the hearing. 150F Privacy Breach Notification The CONTRACTOR shall comply with all state and federal laws regarding patient privacy, as well as the confidentiality provision of terms and conditions of the CONTRACT. In addition to (and in accordance with) the provisions of section 22 of the Department Terms and Conditions, the CONTRACTOR shall notify the DEPARTMENT Program Manager and Privacy Officer within twenty-four (24) hours of discovering that the protected health information (PHI) and/or personally identifiable information (PII) of one (1) or more PARTICIPANTS may have been breached, or has been breached, as defined by state and federal law, including , HIPAA, and GINA. The CONTRACTOR is required to report using the form provided by the DEPARTMENT. Even if the full details are not known, the CONTRACTOR must report all identified information to the DEPARTMENT, then follow up to provide additional information as details are known, and as requested by the DEPARTMENT. At a minimum, the CONTRACTOR shall report to the DEPARTMENT the following: A description of the incident(s). The identified root cause(s). The actual or estimated number of PARTICIPANTS impacted. The actual impact list (as soon as known). A copy of any correspondence sent to affected PARTICIPANTS (this must be pre-approved by the DEPARTMENT). A description of the steps taken to ensure a similar incident will not be repeated. This notification requirement shall apply only to PHI or PII received or maintained by the CONTRACTOR pursuant to this AGREEMENT. The CONTRACTOR shall make good faith efforts to communicate with the DEPARTMENT about breaches by major provider groups if the CONTRACTOR knows those breaches affect PARTICIPANTS. The CONTRACTOR shall notify the DEPARTMENT Program Manager and Privacy Officer no less than one (1) BUSINESS DAY before any external communications are made regarding a data breach. 150G Department May Designate Vendor At its discretion, the DEPARTMENT may designate a common vendor who shall provide the annual description of BENEFITS and such other information or services it deems appropriate, including audit services.
Participation means providing evidence and testimony necessary to explain the claim decisions made by the CONTRACTOR. The CONTRACTOR shall be responsible for any cost required for participation in the administrative hearings by the CONTRACTOR’S staff and any approved subcontractors, including but not limited to time spent at the hearing and travel time to and from the hearing. 150F Privacy Breach Notification The CONTRACTOR shall comply with all state and federal laws regarding patient privacy, as well as the confidentiality provision of terms and conditions of the CONTRACT. In addition to (and in accordance with) the provisions of section 22 of the Department Terms and Conditions, the CONTRACTOR shall notify the DEPARTMENT Program Manager and Privacy Officer within twenty-four (24) hours of discovering that the protected health information (PHI) and/or personally identifiable information (PII) of one (1) or more PARTICIPANTS may have been breached, or has been breached, as defined by state and federal law, including , HIPAA, and GINA. The CONTRACTOR is required to report using the form provided by the DEPARTMENT. Even if the full details are not known, the CONTRACTOR must report all identified information to the DEPARTMENT, then follow up to provide additional information as details are known, and as requested by the DEPARTMENT. At a minimum, the CONTRACTOR shall report to the DEPARTMENT the following: A description of the incident(s). The identified root cause(s). The actual or estimated number of PARTICIPANTS impacted. The actual impact list (as soon as known). A copy of any correspondence sent to affected PARTICIPANTS (this must be pre-approved by the DEPARTMENT). A description of the steps taken to ensure a similar incident will not be repeated. This notification requirement shall apply only to PHI or PII received or maintained by the CONTRACTOR pursuant to this AGREEMENT. The CONTRACTOR shall make good faith efforts to communicate with the DEPARTMENT about breaches by major provider groups if the CONTRACTOR knows those breaches affect PARTICIPANTS. The CONTRACTOR shall notify the DEPARTMENT Program Manager and Privacy Officer no less than one (1) BUSINESS DAY before any external communications are made regarding a data breach. 150G Department May Designate Vendor At its discretion, the DEPARTMENT may designate a common vendor who shall provide the annual description of BENEFITS and such other information or services it deems appropriate, including audit services.
Exhibit1-PBP_Agreement_Rev01-04-2017_clean.docx