Who is a “Covered Entity” under HIPAA?
Health plans, health care clearinghouses, and health care providers who engage in an “electronic transaction” (i.e., generally meaning the transmission of any health information in electronic form but see below for complete definition) are “Covered Entities” under HIPAA. Please note that health care providers who do not submit electronic transactions of health care information may still become Covered Entities under this rule when another entity, such as a billing service or a hospital, transmits a standard electronic transactions on their behalf. Please also note that health plans and health care clearinghouses do not need to enter into an “electronic transaction” involving PHI before they can be defined as a “covered entity”. Only a health care provider must engage in an “electronic transaction” involving PHI before it becomes a “covered entity”. Therefore, if a medical practice engages in any electronic transaction described above (even only one transaction), then the Privacy Rule o
