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HIPAA Definitions

The Health Insurance Portability and Accountability Act (HIPAA) is a federal regulation that safeguards health care recipients' personal health information. The policy provides protection for individuals, while allowing entities to share information for the sake of quality care. HIPAA is governed by the Office of Civil Rights and the U.S. Department of Health and Human Services.

  1. Significance

    • HIPAA is accompanied by the Privacy Rule: The Standards for Privacy of Individually Identifiable Health Information. Working together, these laws ensure that your personal health information is protected, yet can be disclosed appropriately in efforts to improve the quality of health care service.

    Privacy Rule

    • The Privacy Rule is a collection of documented national standards governing how personal health information is used, as well as who is allowed to see it. Specifically, personal health information is individually identifiable information--information that identifies you individually.

    Individually Identifiable Information

    • This is health information that "identifies the individual, or for which there is a reasonable basis to believe it can be used to identify an individual." This definition is important because it states that some, but not all, of your personal information may be disclosed. If your doctor or care facility shares information with outside parties, they cannot disclose your identity or information that would provide your identity.

    Covered Entities

    • Only certain entities are subject to HIPAA compliance. An entity may be a person, business or organization. These entities are: health plans, insurance companies, health care providers and health care service clearinghouses.

    Health Care Clearinghouse

    • Health Care Clearinghouses are businesses or organizations that process health information for your doctor or care facility. A clearinghouse company most likely is in the business of translating health information into standardized data.

    Business Associate

    • Business associates of the covered entities are also subject to HIPAA compliance. Such an associate is defined as any entity that performs duties for the covered entity, but is not a part of the covered entity's work force. Work force individuals may be employees or independent contractors. An example of a business associate would be an outsourced company that processes your doctor's medical billing. Business associates are subject to HIPAA only if they handle your health information.

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