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Health Insurance Portability and Accountability Act [HIPAA] - Entities that must follow HIPAA


Entities that must follow HIPAA

Entities covered under HIPAA that follow the Privacy Rule are called as covered entities. Under HIPAA, the covered entities include:

  • Healthcare Insurance Plans: This includes health insurance companies, HMOs, corporate health plans and certain government programs that reimburse health care such as Medicare and Medicaid.
  • Healthcare Service Providers: Those organizations that conduct business transactions electronically for example electronical billing of health insurance that incorporates the recognized/authorized medical practitioners, clinics, polyclinics, hospitals, alternative medical practitioners, psychologists, nursing homes, pharmacies and dentists.
  • Healthcare Clearinghouses: Entities that process health information received in a non-uniform, haphazard format from another entity into a standard (i.e., standard electronic format or data content).
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