Which entities are considered covered under HIPAA?

• A. Health plans
• B. Healthcare providers that transmit PHI electronically in certain transactions
• C. Healthcare clearinghouses
• D. All of the above

Answer: (D)

HIPAA covers entities that handle protected health information in ways the law regulates. Specifically, it includes health plans (like insurers, HMOs, employer-sponsored plans, and government programs that pay for care), healthcare providers that electronically transmit PHI in the standard formats for certain transactions (such as electronic claims, eligibility checks, or claim status), and healthcare clearinghouses (organizations that translate nonstandard PHI into standard formats or vice versa). Because each of these categories is explicitly included, all of the listed types are covered by HIPAA. Note that business associates—those who work with covered entities and handle PHI under contract—are also subject to HIPAA through their agreements, even though they’re not themselves categorized as covered entities.