
By Stephanie J. Rodin, Esq.
Many healthcare providers are subject to the Health Insurance Portability and Accountability Act (HIPAA); however, these laws do not apply to everyone. HIPAA relates to covered entities or business associates acting on behalf of a covered entity, and the law is very particular on what falls into these categories.
A covered entity is any healthcare provider that transmits any Protected Health Information (PHI) in an electronic form in connection with a transaction for which the U.S. Department of Health and Human Services has adopted a standard. A healthcare provider includes any doctors, psychologists, clinics, dentists, chiropractors, nursing homes or pharmacies. In today’s age of technology, there is an increased chance that a healthcare provider will be transmitting this type information electronically, especially to third party insurance carriers, and thus is covered under the act.
However, a self-pay practice that operates without any insurance – i.e., the patient is providing payment by credit card, check or cash – may not be considered a covered entity pursuant to HIPAA.
It is imperative that every healthcare practitioner understand whether HIPAA applies to their practice and to then ensure that they are compliant with the rules and regulations.
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