Compliance Overview

HIPAA - Scope

¡Applies to

lHealth plans

lHealth care providers

lHealth care clearinghouses

¡Covered Entity = an organization that transmits health information in electronic form in connection with a “HIPAA transaction” (financial and administrative activities related to health care)


	A health care provider becomes a covered entity only if it transmits health information in electronic form in connection with a “HIPAA transaction”

	HIPAA transaction = the electronic transmission of information “to carry out financial or administrative activities related to health care”. Sample transactions – claims information, enrollment in a health plan, payment, billing, etc.

	Electronic transmission is required to be considered a covered entity, but once a provider is a covered entity all of its health information is subject to the rule