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Are You a Covered Entity?

The Administrative Simplification standards adopted by Health and Human Services (HHS) under the Health Insurance Portability and Accountability Act of 1996 (HIPAA) apply to any entity that is

  • a health care provider that conducts certain transactions in electronic form (called here a "covered health care provider").
  • a health care clearinghouse.
  • a health plan.

An entity that is one or more of these types of entities is referred to as a "covered entity" in the Administrative Simplification regulations.

Covered Entity Charts

Guidance on how to determine whether an entity is a covered entity under the Administrative Simplification provisions of HIPAA is available under the Downloads link listed below.