Certified Rehabilitation Counselor Practice

What is a covered entity under HIPAA?

1. A health information exchange

2. A healthcare provider

3. A health insurer

4. A public health organization

The correct answer is: A healthcare provider

A covered entity under the Health Insurance Portability and Accountability Act (HIPAA) is defined primarily as a healthcare provider who transmits any health information in electronic form in connection with a HIPAA transaction. This category includes individual practitioners, hospitals, clinics, and any other organization that provides healthcare services and maintains health information. Healthcare providers need to comply with HIPAA regulations to ensure the privacy and security of patient information while they are engaged in electronic health transactions, such as billing and insurance claims. While healthcare insurers and health information exchanges can also be considered covered entities, they are not classified as healthcare providers. A public health organization typically does not fall under the covered entity definitions unless it is performing health care provider activities. Therefore, the healthcare provider designation is the most straightforward and appropriate answer regarding who qualifies as a covered entity under HIPAA.