HIPAA covered entity

Introduction

Covered Entity (CE) is:*

• A health plan, clearinghouse, or provider regulated (covered by) by HIPAA
• who comes into contact with confidential health data
• who provides healthcare services in the normal course of business
• who conducts certain healthcare business transactions in electronic form

* Virtually all US doctors, clinics, hospitals, labs, nursing homes, & many others are HIPAA covered cntities.

Types of Covered Entities:

• Standard Covered Entity - Provider, Health Plan, Clearinghouse
• Hybrid Entity - Primary business functions not regulated by HIPAA's Privacy rule
  • a single legal entity, with different & distinct operating units
  • some operating units are covered under HIPAA, some are not
  • HIPAA-governed activities are not the primary business function
• Affiliated Entities - Legally separate entities under common ownership
  • legally separate entities are separate operating units
  • common ownership of all entities.
• Organized Health Care Arrangement (OHCA)
  • participants are integrated
  • formal designation is required.