No. As with other business associates, the Privacy Rule would require that a covered entity enter into a relationship with a HIO in a way which anticipates and reasonably safeguards against the potential for inappropriate uses and disclosures, specifically through the use of a business associate agreement. The Privacy Rule also would require the covered entity to respond appropriately to complaints and evidence of violations, but it would not otherwise require the covered entity to actively monitor or oversee the extent to which a HIO, acting as its business associate, abides by the privacy provisions of the agreement, or the means by which the HIO carries out its privacy safeguard obligations. See 45 C.F.R. §§ 164.502(e), 164.504(e).
