What is a 'covered entity' under HIPAA?

A 'covered entity' under HIPAA is defined as a healthcare provider, health plan, or healthcare clearinghouse that transmits any health information in electronic form in connection with a HIPAA transaction. This definition is crucial because it establishes which organizations and individuals are subject to HIPAA regulations regarding the protection and privacy of health information.

Healthcare providers include doctors, clinics, and hospitals that provide treatment and transmit health information. Health plans refer to organizations that pay for health care services, such as insurance companies and health maintenance organizations. Healthcare clearinghouses are entities that process health information or data from one format to another, such as billing services that convert patient records into standard formats for insurance claims.

The other options mention various entities that are not classified as covered entities under HIPAA. A private company that stores health information might handle data but does not fit into the specific categories defined in HIPAA unless it also qualifies as a healthcare provider, health plan, or clearinghouse. An individual who has received medical care is a patient and is not categorized as a covered entity, while a regulatory agency overseeing healthcare compliance may enforce HIPAA regulations but does not perform the functions that HIPAA designates for covered entities.