What is a covered entity under HIPAA?

A HIPAA covered entity is a healthcare provider, health plan, or healthcare clearinghouse that handles protected health information (PHI) and is subject to the privacy and security regulations under the Health Insurance Portability and Accountability Act (HIPAA).

A healthcare provider is any person or organization that provides medical treatment, services, or supplies, including doctors, nurses, hospitals, clinics, dentists, chiropractors, and pharmacies.

A health plan is any individual or group plan that provides or pays for medical care, including health insurance companies, HMOs, Medicare, Medicaid, and employer-sponsored health plans.

A healthcare clearinghouse is any entity that converts healthcare transactions from one format to another, such as claims processing, billing services, or data analysis.

As a covered entity, these organizations are required to comply with HIPAA regulations to ensure the confidentiality, integrity, and availability of individuals’ protected health information. Covered entities must establish and implement policies and procedures to safeguard PHI and ensure its appropriate use and disclosure. Additionally, they must train their workforce on HIPAA regulations and provide individuals with certain rights, such as the right to access and request a copy of their medical records.

In summary, a HIPAA covered entity is any healthcare provider, health plan, or healthcare clearinghouse that handles PHI and is subject to the privacy and security regulations under HIPAA.