Covered Entity Decision ToolsBackgroundThe Administrative Simplification standards adopted by HHS under the Health Insurance Portability and Accountability Act of 1996 (HIPAA) apply to any entity that is:
An entity that is one or more of these types of entities is referred to as a "covered entity" in the Administrative Simplification regulations. Decision Tools
How To Use These ToolsTo determine if a natural person, business, or government agency is a covered entity, go to the tool(s) that apply to the person, business, or agency, and answer the questions until you receive an answer. If you are uncertain about which tool(s) applies, answer the questions on all of the tools. Many terms used in the tools are defined terms or have a special meaning. The definitions or special meanings will appear as footnotes on the relevant questions' pages to assist you. Covered Entity ChartsThis guidance on how to determine whether an entity is a covered entity under the Administrative Simplification provisions of HIPAA is also available in a Covered Entity Flowchart (PDF, 61.4KB).
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