Covered Entities Affected by HIPAA

The Health Insurance Portability and Accountability Act (HIPAA) was instituted in 1996 by the U.S. Congress to protect the confidentiality of patient health-care information. HIPAA impacts covered entities, which are legally obligated to comply with HIPAA standards.

Health-Care Providers

• HIPAA identifies health-care providers as one of the covered entities who must adhere to privacy rules. A health-care provider is defined as a doctor, doctor's office staff, physician's assistant, nurse, dentist, chiropractor, pharmacy, pharmacist and pharmacy technician. These individuals provide direct care to patients.

Health Plans

• Health plans are covered entities under HIPAA that deal with patient health-care information. According to the Department of Health and Human Services, health plans include health insurance companies, HMOs, corporate health plans and government programs that offer medical benefits, such as Medicare and Medicaid.

Health-Care Clearinghouses

• Health-care clearinghouses are organizations that interpret or standardize health-care information. For instance, a medical office may submit billing information to a medical billing company to standardize the claims and submit them to the patient's health insurance.

Considerations

• When patient information is subpoenaed for use in a legal hearing, the lawyers, judge and other officials involved in the case are subjected to adherence to HIPAA standards. Disclosing patient information for use outside the courtroom is considered a violation and can result in HIPAA enforcement activities.