Covered Entity (CE)


The following are covered entities under the HIPAA regulations: 

  1. A health plan.

  2. A health care clearinghouse.

  3. A health care provider who transmits any health information in electronic form in connection with a transaction covered by this subchapter. [45 CFR 160.103]

The Privacy Rule, as well as all the Administrative Simplification rules, apply to health plans, health care clearinghouses, and to any health care provider who transmits health information in electronic form in connection with transactions for which the Secretary of HHS has adopted standards under HIPAA (the “covered entities”). For help in determining whether you are covered, use the decision tool at:

http://cms.hhs.gov/hipaa/hipaa2/support/tools/decisionsupport/CoveredEntityFlowcharts.pdf



Covered Entities With Multiple Covered Functions 

A covered entity that performs multiple covered functions must operate its different covered functions in compliance with the Privacy Rule provisions applicable to those covered functions. The covered entity may not use or disclose the protected health information of an individual who receives services from one covered function (e.g., health care provider) for another covered function (e.g., health plan) if the individual is not involved with the other function. 

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