Health Care Provider Is A Covered Entity

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Like all of the administrative rules, the security rule applies to health plans, health care clearing houses, and to any health care provider who transmits health information in electronic form in connection with a transaction for which the Secretary of HHS has adopted standards under HIPAA. Health plans include health, dental, vision, and prescription drug insurers, health maintenance organizations, Medicare, Medicaid and Medicare supplement insurers, and long-term care insurers. Health plans also include employer-sponsored group health plans, government and church-sponsored health plans, and multi-employer health plans. Every health care provider, regardless of size, who electronically transmits health information in connection with certain transactions, is a covered entity. Using electronic technology, such as email, does not mean a health care provider is a covered entity; the transmission must be in connection with a standard transaction. The Privacy Rule covers a health care provider whether it electronically transmits these transactions directly or uses a billing service or other third party to do so on its behalf. Health care providers include all providers of services and providers of medical or health services as defined by Medicare, and any other person or organization that furnishes, bills, or is paid for health care. Health care clearinghouses are entities that process nonstandard information they receive from another entity into a standard (i.e., standard
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