Covered Entity Definition
A Covered Entity is:
A health plan. An individual or group plan that
provides, or pays the cost of, medical care. Health plans include
private entities (e.g., health insurers and managed care organizations)
and government organizations (e.g., Medicaid, Medicare, and the Veterans
Health Administration)
A health care provider. A provider of health care
services and any other person or organization that furnishes, bills, or
is paid for health care in the normal course of business. Health care
providers (e.g., physicians, hospitals, and clinics) are covered
entities if they transmit health information in electronic form in
connection with a transaction for which a HIPAA standard has been
adopted by HHS. (e.g., billing)
A health care clearinghouse. A public or private
entity, including a billing service, repricing company, or community
health information system, that processes non-standard data or
transactions received from another entity into standard transactions or
data elements, or vice versa.
| Physician Revises Faxing Procedures to Safeguard PHI Covered Entity: Health Care Provider Issue: Safeguards A doctor's office disclosed a patient's HIV status when the office mistakenly faxed medical records to the patient's place of employment instead of to the patient's new health care provider. The employee responsible for the disclosure received a written disciplinary warning, and both the employee and the physician apologized to the patient. To resolve this matter, OCR also required the practice to revise the office's fax cover page to underscore a confidential communication for the intended recipient. The office informed all its employees of the ...read more |
| If a CSP stores only encrypted ePHI and does not have a decryption key, is it a HIPAA business associate? Answer: Yes, because the CSP receives and maintains (e.g., to process and/or store) electronic protected health information (ePHI) for a covered entity or another business associate. Lacking an encryption key for the encrypted data it receives and maintains does not exempt a CSP from business associate status and associated obligations under the HIPAA Rules. An entity that maintains ePHI on behalf of a covered entity (or another business associate) is a business associate, even if the entity cannot actually ...read more |
| Thursday, November 10, 2022 Five Former Methodist Hospital Employees Charged with HIPAA Violations Memphis, TN – A federal grand jury has indicted five former Methodist Hospital Employees for conspiring with Roderick Harvey, 40, to unlawfully disclose patient information in violation of the Health Insurance Portability and Accountability Act of 1996, commonly known as “HIPAA.” United States Attorney Kevin G. Ritz announced the indictment today. HIPAA was enacted by Congress in 1996 to create national standards to protect sensitive patient information from being disclosed without a patient’s knowledge or consent. HIPAA’s provisions make it a crime to disclose patient information, ...read more |
| Pharmacy Chain Institutes New Safeguards for PHI in Pseudoephedrine Log Books Covered Entity: Pharmacies Issue: Safeguards A grocery store based pharmacy chain maintained pseudoephedrine log books containing protected health information in a manner so that individual protected health information was visible to the public at the pharmacy counter. Initially, the pharmacy chain refused to acknowledge that the log books contained protected health information. OCR issued a written analysis and a demand for compliance. Among other corrective actions to resolve the specific issues in the case, OCR required that the pharmacy chain implement national policies and procedures to safeguard the ...read more |
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Blog Home
Newest Blog Entries
1/21/25 Understanding Business Associate Agreements
11/12/22 Modernizing Medicine Agrees to Pay $45 Million to Resolve Allegations of Accepting and Paying Illegal Kickbacks and Causing False Claims
11/12/22 Indian National Charged in $8 Million COVID-19 Relief Fraud Scheme
11/12/22 Former Hospital Employee Pleads Guilty To Criminal HIPPA Charges
11/12/22 Covered entities and those persons rendered accountable by general principles of corporate criminal liability may be prosecuted directly under 42 U.S.C. § 1320d-6
11/12/22 The Delaware Division of Developmental Disabilities Services Data Breach
11/12/22 OCR Settles Three Cases with Dental Practices for Patient Right of Access under HIPAA
11/12/22 HHS Issues Guidance on HIPAA and Audio-Only Telehealth
11/12/22 Five Former Methodist Hospital Employees Charged with HIPAA Violations
11/12/22 May a covered entity use or disclose protected health information for litigation?
11/12/22 When does the Privacy Rule allow covered entities to disclose protected health information to law enforcement officials?
Blog Archives
November 2022 (54)
January 2025 (1)
Blog Labels
Data Breach (1)
EHR Fraud (1)
HIPAA (2)
HIPAA Enforcement (3)
ePHI (2)
BAA (4)
Telehealth (1)
Covered Entity (40)
PPP Fraud (1)
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