Question

Who or what are the covered entities under the HIPPA Identifier Ruke?

Answer 1

Only covered entities can have the privacy rule. It is not necessary that all the individuals or institutions which collect individually identifiable health information are covered .

HIPAA rules defines Covered entities as (1) health plans, (2) health care clearinghouses, and (3) health care providers who are authorized to transmit the health related information related to the transactions for which HHS has adopted standards.

Researchers can also be entitled as covered entities if they also performs the responsibilities of health care providers which can transmit the health related information related to the any transaction for which HHS has adopted a standard.

Health Plan – Having some exceptions, an individual or group plan that provides or pays the cost of medical care (as defined in section 2791(a)(2) of the PHS Act, 42 U.S.C. 300gg-91(a)(2)). Many types of organizations and government programs are included in this law as health plans.

Health Care Clearinghouse – A public or private entity, including a billing service, reprising company, community health management information system or community health information system, and “value added” networks and switches that either process or facilitate the processing of health information received from another entity in a nonstandard format or containing nonstandard data content into standard data elements or a standard transaction, or receive a standard transaction from another entity and process or facilitate the processing of health information into a nonstandard format or nonstandard data content for the receiving entity.

Health Care Provider – A provider of services (as defined in section 1861(u) of the Act, 42 U.S.C. 1395x(u)), a provider of medical or health services (as defined in section 1861(s) of the Act, 42 U.S.C. 1395x(s)), and any other person or organization who furnishes, bills, or is paid for health care in the normal course of business.

Health Care – Care, services, or supplies related to the health of an individual, including (1) preventive, diagnostic, therapeutic, rehabilitative, maintenance, or palliative care, and counseling, service, assessment, or procedure with respect to the physical or mental condition, or functional status, of an individual that affects the structure or function of the body; and (2) sale or dispensing of a drug, device, equipment, or other item in accordance with a prescription.