Office for Civil Rights

HIPAA Privacy Rule: Disclosures for Emergency Preparedness - A Decision Tool

Who is the source of the information to be disclosed?

Is the source of the information a Covered Entity?

Definitions:

A Covered Entity is:

A health plan. An individual or group plan that provides, or pays the cost of, medical care. Health plans include private entities (e.g., health insurers and managed care organizations) and government organizations (e.g., Medicaid, Medicare, and the Veterans Health Administration)

A health care provider. A provider of health care services and any other person or organization that furnishes, bills, or is paid for health care in the normal course of business. Health care providers (e.g., physicians, hospitals, and clinics) are covered entities if they transmit health information in electronic form in connection with a transaction for which a HIPAA standard has been adopted by HHS. (e.g., billing)

A health care clearinghouse. A public or private entity, including a billing service, repricing company, or community health information system, that processes non-standard data or transactions received from another entity into standard transactions or data elements, or vice versa.

For more specific decision tool options to determine if you are a covered entity, go to http://www.cms.hhs.gov/apps/hipaa2decisionsupport/default.asp.

Last revised: June 27, 2006

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