Common use of Limitations on Access to and Use of Data Clause in Contracts

Limitations on Access to and Use of Data. Notwithstanding anything to the contrary contained herein, all rights of Crescent, Payors and any other person under this Agreement to collect, review and use any records and data regarding Provider’s operations or Provider’s patients, and Provider’s obligations to comply with the Medical Management Programs and other programs and procedures of Crescent, TPAs, and Payors pursuant to this Agreement, shall be subject to the following limitations: (a) Nothing herein shall be construed to interfere with or in any way alter any provider-patient relationship, shall interfere with the independent medical judgment of the professionals practicing and working at Provider’s facilities, or shall interfere with Provider’s ability to provide information or assistance to any patient. (b) Nothing herein shall require Provider to permit review and disclosure of records in violation of the requirements of applicable federal or state law regarding the confidentiality of medical records and prescription drug records. Prior to obtaining access to such records, Provider may require the requestor to obtain from Members such general or specific consents to Provider’s release of such records, if Provider shall determine such consents are required or advisable. Crescent and Provider shall comply with all applicable state and federal laws and regulations regarding confidentiality of medical records. (c) All rights of Crescent, TPAs and Payors to examine and review the Provider’s records shall be limited to the records reasonably necessary for legitimate and proper purposes of such person and shall not entitle Crescent, any TPA or any Payor to conduct a general review of Provider’s records. All information obtained by Crescent, any TPA or any Payor as a result of any audit and/or examination of records shall be used solely for the limited purposes stated in this Agreement. (d) All encounter data, medical records, billing information and other information provided to Crescent, TPAs or Payors by Provider, or compiled by Crescent, TPAs or Payors regarding Provider Services rendered by and the operations of Provider is confidential information (“Confidential Information”) that is not generally available to the public and that has value to Crescent and Provider because it is not known to others. Provider, Crescent, TPAs and Payors shall preserve the confidentiality of all Confidential Information and shall use the Confidential Information solely in connection with their obligations and rights pursuant to this Agreement and applicable Crescent Network Access Agreements. Provider, Crescent, TPAs and Payors shall disclose Confidential Information only (A) to those of their employees and contractors who are required to know such information for purposes of enabling Provider, Crescent, TPAs and Payors to perform their obligations under this Agreement and Crescent Network Access Agreements and only so long as each person to whom such disclosure is made will be informed of Provider’s, Crescent’s, TPAs’ and Payors’ obligations under this confidentiality provision, and (B) as required by court order or other legal process binding upon Provider, Crescent, any TPA or any Payor, as appropriate. If Provider, Crescent or any TPA or Payor becomes legally compelled to disclose any Confidential Information, such person shall promptly notify the owner of the applicable Confidential Information of such fact so that such owner may seek an appropriate remedy to prevent such disclosure, and request the person demanding such disclosure to allow the owner of such Confidential Information a reasonable period of time to seek such remedy. (e) No individual and unaggregated data obtained or compiled about Provider which data specifically identifies Provider or any of Provider’s patients shall be disclosed by Crescent or any TPA or Payor, except to the extent necessary to carry out the terms of this Agreement or any applicable Crescent Network Access Agreement. Provider shall have the right to inspect, upon not less two (2) weeks prior notice, Provider’s individual data collected by Crescent, TPAs or Payors (or their designees) under Medical Management Programs and to request correction of errors and omissions therein. (f) All costs of copying, compiling and auditing the records of Crescent or Provider pursuant to this Agreement shall be paid by the entity conducting the audit of such records. All audits shall be conducted during normal business hours and in a manner that is not disruptive to the other party’s operations, and shall be subject to the reasonable requirements of the party whose records are being audited. (g) Crescent shall contractually require each Payor and TPA to be bound by the provisions of this Section 6.8, including without limitation the confidentiality provisions of subsection (d). (h) The recovery of damages may not be an adequate means to redress a breach of this Section 6.8, and accordingly, Provider and Crescent shall have a right of injunctive relief or specific performance to enforce the provisions of this Section 6.8. Nothing contained in this Section 6.8, however, shall prohibit Provider or Crescent from pursuing any remedies in addition to injunctive relief or specific performance, including damages. (i) The provisions of this Section 6.8 shall survive the termination or expiration of this Agreement.

Limitations on Access to and Use of Data. Notwithstanding anything to the contrary contained herein, all rights of Crescent, Payors and any other person under this Agreement to collect, review and use any records and data regarding ProviderFacility’s operations or ProviderFacility’s patients, and ProviderFacility’s obligations to comply with the Medical Management Programs and other programs and procedures of Crescent, TPAs, and Payors pursuant to this Agreement, shall be subject to the following limitations: (a) Nothing herein shall be construed to interfere with or in any way alter any providerphysician-patient relationship, shall interfere with the independent medical judgment of the professionals practicing and working at ProviderFacility’s facilities, or shall interfere with ProviderFacility’s ability to provide information or assistance to any patient. (b) Nothing herein shall require Provider Facility to permit review and disclosure of records in violation of the requirements of applicable federal or state law regarding the confidentiality of medical records and prescription drug records. Prior to obtaining access to such records, Provider Facility may require the requestor to obtain from Members such general or specific consents to ProviderFacility’s release of such records, if Provider Facility shall determine such consents are required or advisable. Crescent and Provider Facility shall comply with all applicable state and federal laws and regulations regarding confidentiality of medical records. (c) All rights of Crescent, TPAs and Payors to examine and review the ProviderFacility’s records shall be limited to the records reasonably necessary for legitimate and proper purposes of such person and shall not entitle Crescent, any TPA or any Payor to conduct a general review of Provider’s Facility's records. All information obtained by Crescent, any TPA or any Payor as a result of any audit and/or examination of records shall be used solely for the limited purposes stated in this Agreement. (d) All encounter data, medical records, billing information and other information provided to Crescent, TPAs or Payors by ProviderFacility, or compiled by Crescent, TPAs or Payors regarding Provider Facility Services rendered by and the operations of Provider Facility is confidential information (“Confidential Information”) that is not generally available to the public and that has value to Crescent and Provider Facility because it is not known to others. ProviderFacility, Crescent, TPAs and Payors shall preserve the confidentiality of all the Confidential Information and shall use the Confidential Information solely in connection with their obligations and rights pursuant to this Agreement and applicable Crescent Network Access Agreements. ProviderFacility, Crescent, TPAs and Payors shall disclose Confidential Information only (A) to those of their employees and contractors who are required to know such information for purposes of enabling ProviderFacility, Crescent, TPAs and Payors to perform their obligations under this Agreement and Crescent Network Access Agreements and only so long as each person to whom such disclosure is made will be informed of ProviderFacility’s, Crescent’s, TPAs’ and Payors’ obligations under this confidentiality provision, and (B) as required by court order or other legal process binding upon ProviderFacility, Crescent, any TPA or any Payor, as appropriate. If ProviderFacility, Crescent or any TPA or Payor becomes legally compelled to disclose any Confidential Information, such person shall promptly notify the owner of the applicable Confidential Information of such fact so that such owner may seek an appropriate remedy to prevent such disclosure, and request the person demanding such disclosure to allow the owner of such Confidential Information a reasonable period of time to seek such remedy. (e) No individual and unaggregated data obtained or compiled about Provider Facility which data specifically identifies Provider Facility or any of Provider’s its patients shall be disclosed by Crescent or any TPA or Payor, except to the extent necessary to carry out the terms of this Agreement or any applicable Crescent Network Access Agreement. Provider Facility shall have the right to inspect, upon not less two (2) weeks prior notice, Provider’s its individual data collected by Crescent, TPAs or Payors (or their designees) under Medical Management Programs and to request correction of errors and omissions therein. (f) All costs of copying, compiling and auditing the records of Crescent or Provider Facility pursuant to this Agreement shall be paid by the entity conducting the audit of such records. All audits shall be conducted during normal business hours and in a manner that is not disruptive to the other party’s operations, and shall be subject to the reasonable requirements of the party whose records are being audited. (g) Crescent shall contractually require each Payor and TPA to be bound by the provisions of this Section 6.8, including without limitation the confidentiality provisions of subsection (d). (h) The recovery of damages may not be an adequate means to redress a breach of this Section 6.8, and accordingly, Provider Facility and Crescent shall have a right of injunctive relief or specific performance to enforce the provisions of this Section 6.8. Nothing contained in this Section 6.8, however, shall prohibit Provider Facility or Crescent from pursuing any remedies in addition to injunctive relief or specific performance, including damages. (i) The provisions of this Section 6.8 shall survive the termination or expiration of this Agreement.

Limitations on Access to and Use of Data. Notwithstanding anything to the contrary contained herein, all rights of Crescent, Payors and any other person under this Agreement to collect, review and use any records and data regarding ProviderPhysician’s operations or ProviderPhysician’s patients, and ProviderPhysician’s obligations to comply with the Medical Management Programs and other programs and procedures of Crescent, TPAs, and Payors pursuant to this Agreement, shall be subject to the following limitations: (a) Nothing herein shall be construed to interfere with or in any way alter any providerphysician-patient relationship, shall interfere with the independent medical judgment of the professionals practicing and working at ProviderPhysician’s facilities, or shall interfere with ProviderPhysician’s ability to provide information or assistance to any patient. (b) Nothing herein shall require Provider Physician to permit review and disclosure of records in violation of the requirements of applicable federal or state law regarding the confidentiality of medical records and prescription drug records. Prior to obtaining access to such records, Provider Physician may require the requestor to obtain from Members such general or specific consents to ProviderPhysician’s release of such records, if Provider Physician shall determine such consents are required or advisable. Crescent and Provider Physician shall comply with all applicable state and federal laws and regulations regarding confidentiality of medical records. (c) All rights of Crescent, TPAs and Payors to examine and review the ProviderPhysician’s records shall be limited to the records reasonably necessary for legitimate and proper purposes of such person and shall not entitle Crescent, any TPA or any Payor to conduct a general review of Provider’s Physician records. All information obtained by Crescent, any TPA or any Payor as a result of any audit and/or examination of records shall be used solely for the limited purposes stated in this Agreement. (d) All encounter data, medical records, billing information and other information provided to Crescent, TPAs or Payors by ProviderPhysician, or compiled by Crescent, TPAs or Payors regarding Provider Physician Services rendered by and the operations of Provider Physician is confidential information (“Confidential Information”) that is not generally available to the public and that has value to Crescent and Provider Physician because it is not known to others. ProviderPhysician, Crescent, TPAs and Payors shall preserve the confidentiality of all Confidential Information and shall use the Confidential Information solely in connection with their obligations and rights pursuant to this Agreement and applicable Crescent Network Access Agreements. ProviderPhysician, Crescent, TPAs and Payors shall disclose Confidential Information only (A) to those of their employees and contractors who are required to know such information for purposes of enabling ProviderPhysician, Crescent, TPAs and Payors to perform their obligations under this Agreement and Crescent Network Access Agreements and only so long as each person to whom such disclosure is made will be informed of ProviderPhysician’s, Crescent’s, TPAs’ and Payors’ obligations under this confidentiality provision, and (B) as required by court order or other legal process binding upon ProviderPhysician, Crescent, any TPA or any Payor, as appropriate. If ProviderPhysician, Crescent or any TPA or Payor becomes legally compelled to disclose any Confidential Information, such person shall promptly notify the owner of the applicable Confidential Information of such fact so that such owner may seek an appropriate remedy to prevent such disclosure, and request the person demanding such disclosure to allow the owner of such Confidential Information a reasonable period of time to seek such remedy. (e) No individual and unaggregated data obtained or compiled about Provider Physician which data specifically identifies Provider Physician or any of ProviderPhysician’s patients shall be disclosed by Crescent or any TPA or Payor, except to the extent necessary to carry out the terms of this Agreement or any applicable Crescent Network Access Agreement. Provider Physician shall have the right to inspect, upon not less than two (2) weeks prior notice, ProviderPhysician’s individual data collected by Crescent, TPAs or Payors (or their designees) under Medical Management Programs and to request correction of errors and omissions therein. (f) All costs of copying, compiling and auditing the records of Crescent or Provider Physician pursuant to this Agreement shall be paid by the entity conducting the audit of such records. All audits shall be conducted during normal business hours and in a manner that is not disruptive to the other party’s operations, and shall be subject to the reasonable requirements of the party whose records are being audited. (g) Crescent shall contractually require each Payor and TPA to be bound by the provisions of this Section 6.8, including without limitation the confidentiality provisions of subsection (d). (h) The recovery of damages may not be an adequate means to redress a breach of this Section 6.8, and accordingly, Provider Physician and Crescent shall have a right of injunctive relief or specific performance to enforce the provisions of this Section 6.8. Nothing contained in this Section 6.8, however, shall prohibit Provider Physician or Crescent from pursuing any remedies in addition to injunctive relief or specific performance, including damages. (i) The provisions of this Section 6.8 shall survive the termination or expiration of this Agreement.