Who qualifies as a "covered entity" under HIPAA?

The definition of a "covered entity" under HIPAA includes health care providers who transmit any health information in electronic form in connection with a HIPAA transaction. This is significant as the Privacy Rule applies specifically to those who handle protected health information (PHI) in electronic formats, which enhances patient privacy and security.

Health care providers encompass a variety of practitioners, from individual doctors and dentists to hospitals and clinics, as long as they engage in electronic transactions related to health care. This means that health care providers who send patient data electronically—such as billing or insurance claims—must comply with HIPAA regulations to protect patient privacy.

In contrast, other given options do not match the definition of "covered entity": health insurance companies fall under a broader category of covered entities but are not the only ones; patients are the recipients of healthcare services and do not handle PHI in a way that necessitates HIPAA compliance; and not all medical professionals—especially those who do not engage in electronic transactions involving PHI—are considered covered entities.