NOVA RHIO Advisory Committee

Legal Documents Committee Meeting Minutes – October 6, 2006

Thank you from Mark and from me for making our first conference a success.  Consistent with our discussion, we are  going to correspond via email and all present concurred.

 As suggested by JP, let's see if the following procedural approach  works: we talked about meeting again every other Friday with some  exceptions, either at GMU or proximate where there might be free parking available.

 The following Fridays at 7.30 AM are possible based upon your suggestions this morning:

 Oct. 13,  Oct. 27,  Nov. 3,  Nov. 10,  Nov. 20, 21 or 22 alternates should we need a last week before Dec. 1 get-together

 Please advise regarding whether we need three or four or more  conferences and regardless, whether and which of the foregoing  dates work for you.

 Here is a summary of what we are considering thus far as my first  effort and consistent with our discussion, we will allow a different member  of our committee to have the privilege of taking our "minutes" for each

 meeting hereafter:

 1.  Here, without endeavoring to be all-inclusive, are areas of  concern and likely to need attention (and without determining which in which  directions the NoVA RHIO should or likely will move for any of the  areas of concern) relative to filings, documentation, rules, policies and more:

 A.  Corporation filing (or LLC or some other entity or trust) in  Virginia

B.  Doing business filing in other jurisdictions, including DC,  MD, NC, WV

 C.  Federal Section 501c3 tax exempt determination letter application if not for profit

 D.  Virginia sales tax exemption

 E.  HIPAA Administrative Simplification subtitle rules

 F.  Virginia privacy, security and related requirements and those of other relevant state/District jurisdictions

 G.  Medicare program

 H.  Medicaid programs

 I.  Americans With Disabilities Act

 J.  Intellectual property including patent, copyright, trade secret, and web

 K.  Federal anti-kickback/anti-referral/Stark rules

 L.  Virginia anti-fraud requirements and related requirements and  those of other relevant state/District jurisdictions

 M.  Language translation requirements

 N.  Accreditation/certification requirements

 O.  Local jurisdictional doing business requirements (such as Fairfax County licensure)

 P.  Federal and other grant requirements

 Q.  Virginia professional licensure requirements and professional responsibility/ethics constraints and related requirements and  those of other relevant state/District jurisdictions

 We contemplate as a priority consideration the need to assure patients, NoVA RHIO participating providers, payors and others of the strict  controls and protections relating to privacy and security, and information  integrity, to be in force with respect to the NoVA RHIO.  One thought is to adopt the HIPAA A/S covered entity approach and to have NoVA RHIO publish a  Notice of Privacy Practices; and an alternative is to publish a HIPAA A/S  business associate agreement for use by providers, payors and  others involved with the NoVA RHIO who are covered entities and need such agreements in order to disclosure protected health information.  Another concern is how Virginia(and other relevant jurisdictional law) may be contrary to  and more stringent than federal privacy and security law, and in particular  regarding a first party to which information is disclosed eing  foreclosed from further disclosing that information.

We also contemplate the need to coordinate closely with the other  committees in areas in which our committee's mission and the  missions of the others intersect or otherwise require an early sharing of ideas.

Various Virginia governmental and non-governmental bodies are to be considered insofar as reach-out and liaison is concerned.

 The silo/federated vs. centralized approaches are "on the table"  and we are not part of our process of analysis at this time.

 Please favor me with your enhancements to the foregoing; whereupon I will produce a final version for publication amongst our entire committee.

 A final reminder regarding privacy: recall that everything we are talking about and everything in our emails will NOT be private -- no attorney client or any other privilege or confidentiality protections at all-- and so bear that in mind, please, in our communications and deliberations.