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Covered Entity

What is Covered Entity?

Under HIPAA, a health plan, healthcare clearinghouse, or healthcare provider that transmits any health information electronically. Covered entities must comply with all HIPAA Administrative Simplification rules.

Compliance

Each of these is named in at least one of the same controls as covered entity. The number is how many controls name both.

What the standards actually require on covered entity

Requirements naming covered entity across 6 standards, quoted from the control text.

HITECH Act16 controls

A business associate that holds, uses or discloses unsecured protected health information must, following discovery of a breach, notify the covered entity and identify each individual whose information has been or is reasonably believed to have been accessed,...

hitech-act::13402b · Section 13402(b): a business associate notifies the covered entity of a breach and identifies each affected individual →

Defines the operative scope: a covered entity is an entity in a critical infrastructure sector (PPD-21) meeting the criteria set by the CISA final rule;

CIRCIA-2240 · Definitions: Covered Entity, Covered Cyber Incident, Ransom Payment →

A business associate must notify the covered entity of a breach without unreasonable delay and no later than 60 days after discovery, identifying to the extent possible each individual whose unsecured PHI was breached and providing the information the covered...

hipaa-breach-notification-rule::164.410 · Business associate notification to the covered entity →

A covered entity may not use or disclose protected health information except as the Privacy Rule permits or requires, or as the individual (or personal representative) authorizes in writing.

hipaa-privacy-rule::164.502a · General rule: PHI may be used or disclosed only as the Privacy Rule permits or requires, or with written authorization →

When a covered entity and its business associate are both governmental entities, the requirements may be met through an MOU or other law that accomplishes the objectives of paragraph (a)(2)(i).

164.314(a)(2)(ii) · Other Arrangements (Government) →

Questions people ask about covered entity

What is Covered Entity?
Under HIPAA, a health plan, healthcare clearinghouse, or healthcare provider that transmits any health information electronically. Covered entities must comply with all HIPAA Administrative Simplification rules.
Why is Covered Entity important for compliance?
Covered Entity is a key concept in Compliance. Understanding covered entity helps organizations meet regulatory requirements, reduce risk, and demonstrate due diligence during audits. Our compliance platform maps 1,016 frameworks with 316K cross-framework control mappings.
Which compliance frameworks address Covered Entity?
Covered Entity appears in the requirement text of HITECH Act, CIRCIA (Cyber Incident Reporting for Critical Infrastructure Act), HIPAA Breach Notification Rule, HIPAA Privacy Rule, Nevada Gaming Control Board Cybersecurity Requirements. Across these standards we have identified 72 controls that name it directly, each linked to the control text on the compliance platform.
Where can I learn more about Covered Entity?
Explore our compliance framework pages to see how covered entity applies across different standards and regulations. Our implementation guides provide step-by-step guidance, and the compliance platform offers AI-powered analysis of how this concept maps across 1,016 frameworks.

See how Covered Entity applies across compliance frameworks

Our platform maps 1,016 frameworks with 316K cross-framework control mappings. Explore how this concept is addressed across standards.

Written and maintained by Gerard Blokdyk, The Art of Service.