What constitutes a "covered entity" under HIPAA?

A "covered entity" under HIPAA refers to specific organizations that are directly subject to HIPAA regulations regarding the protection and privacy of individuals' health information. This includes three main types of entities: health plans, healthcare providers, and healthcare clearinghouses.

Health plans encompass a variety of organizations that pay for or reimburse the cost of health care, including insurance companies and government programs like Medicare and Medicaid. Healthcare providers include individuals or entities that provide medical services and transmit any health information in electronic form during a transaction. Healthcare clearinghouses are entities that process or facilitate the processing of health information for health care transactions, often acting as intermediaries in the exchange of health data.

Understanding the categories of covered entities is crucial for compliance with HIPAA, especially in ensuring that these entities implement required safeguards and manage the use and disclosure of protected health information according to regulatory standards.