What entities are subject to the Health Insurance Portability and Accountability Act (HIPAA) privacy rule?

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Last updated: May 30, 2025View editorial policy

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From the Guidelines

The correct answer is F. B and C. The Health Insurance Portability and Accountability Act (HIPAA) privacy rule specifically applies to health plans and health care clearinghouses, which are considered "covered entities" under the law [ 1 ]. Health plans include insurance companies, HMOs, Medicare, and Medicaid programs that pay for healthcare services. Health care clearinghouses are entities that process nonstandard health information they receive from another entity into a standard format.

Key Points

  • HIPAA was designed to protect sensitive patient health information from being disclosed without the patient's consent or knowledge, and these two types of organizations routinely handle such protected health information [ 1 ].
  • Institutional Review Boards and Scientific Advisory Committees (options A and D) are not directly covered by HIPAA privacy regulations unless they are part of a covered entity or are handling protected health information on behalf of a covered entity as a business associate.
  • The HIPAA privacy rule governs the use and disclosures of protected health information, which is individually identifiable health information [ 1 ].
  • Covered entities, such as healthcare providers and their business associates, must implement appropriate security safeguards to protect electronic protected health information [ 1 ].

From the Research

HIPAA Privacy Rule Applicability

The HIPAA privacy rule applies to certain entities that handle protected health information. The correct answer is:

  • F. B and C
    • A health plan
    • A health care clearinghouse

These entities are directly involved in the handling of protected health information and are therefore subject to the HIPAA privacy rule.

There are no research papers provided that directly assist in answering this question 2, 3, 4, 5, 6.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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