What defines a covered entity under HIPAA?

A covered entity under HIPAA is defined as health care providers, health plans, and health care clearinghouses. This classification is crucial for understanding which organizations and individuals are subject to HIPAA regulations regarding the protection and confidential handling of protected health information (PHI).

Health care providers include any individual or organization that provides health care services and transmits health information in electronic form in connection with a HIPAA transaction, such as doctors and hospitals. Health plans encompass any individual or group plan that provides or pays for the cost of health care, including health insurance companies and government programs like Medicare and Medicaid. Health care clearinghouses are entities that process nonstandard health information they receive from another entity into a standard format or vice versa.

The options that specify only a subset of these entities, such as health care clearinghouses alone or only health insurance companies, do not encompass the full breadth of what constitutes a covered entity. Additionally, the option that includes any person handling medical records is overly broad and does not accurately reflect the specific requirements established by HIPAA, as not all individuals or entities that handle medical records meet the definition of a covered entity unless they are specifically involved with the defined roles of health care providers, health plans, or clearinghouses.