Which of the following entities qualifies as a "covered entity" under HIPAA?

Which of the following entities qualifies as a "covered entity" under HIPAA?

• A. Health plans and healthcare providers who invoice patients
• B. Healthcare clearinghouses and insurance brokers
• C. Health plans, healthcare clearinghouses, and healthcare providers who transmit health information electronically
• D. Employers who provide health insurance to employees

Answer: (C)

The correct answer is centered on the definition of "covered entities" under the Health Insurance Portability and Accountability Act (HIPAA). According to HIPAA, a covered entity includes health plans, healthcare clearinghouses, and healthcare providers that transmit any health information in electronic form during a transaction. Health plans are organizations that provide or pay for the cost of healthcare, including insurance companies and government programs. Healthcare providers refer to hospitals, physicians, and any other individuals or entities that provide healthcare services and submit claims electronically. Healthcare clearinghouses are entities that process health information to ensure it meets the standards for electronic transactions. By specifying the inclusion of healthcare providers that transmit health information electronically, this answer emphasizes the stipulation within HIPAA that captures the electronic nature of the data transmission, which plays a crucial role in establishing the scope of covered entities. Other options, while they may mention entities involved in healthcare, do not fully satisfy the definition provided in HIPAA regulations, hence they do not qualify as covered entities in the same comprehensive manner as this correct answer.

The correct answer is centered on the definition of "covered entities" under the Health Insurance Portability and Accountability Act (HIPAA). According to HIPAA, a covered entity includes health plans, healthcare clearinghouses, and healthcare providers that transmit any health information in electronic form during a transaction.

Health plans are organizations that provide or pay for the cost of healthcare, including insurance companies and government programs. Healthcare providers refer to hospitals, physicians, and any other individuals or entities that provide healthcare services and submit claims electronically. Healthcare clearinghouses are entities that process health information to ensure it meets the standards for electronic transactions.

By specifying the inclusion of healthcare providers that transmit health information electronically, this answer emphasizes the stipulation within HIPAA that captures the electronic nature of the data transmission, which plays a crucial role in establishing the scope of covered entities. Other options, while they may mention entities involved in healthcare, do not fully satisfy the definition provided in HIPAA regulations, hence they do not qualify as covered entities in the same comprehensive manner as this correct answer.