Who is considered a covered entity under HIPAA?

Under HIPAA, a covered entity is defined as any health care provider who transmits any health information in electronic form in connection with a HIPAA transaction, health plans that provide or pay for medical care, and health care clearinghouses that process health information. The inclusion of health care providers, health plans, and health care clearinghouses ensures that various stakeholders involved in the health care system are subject to HIPAA regulations, which aim to protect the privacy and security of individuals’ medical information.

Health care providers are included because they directly handle patient data. Health plans encompass insurance companies that cover health care services, and health care clearinghouses serve as intermediaries to process medical information. This framework is necessary to ensure comprehensive safeguarding of personal health information across multiple entities within the health care continuum, which is crucial in maintaining patient confidentiality and providing a regulated structure for the handling of sensitive information.