NY Hybrid Entity Status Pursuant to HIPAA 2025

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Covered entities are defined in the HIPAA rules as (1) health plans, (2) health care clearinghouses, and (3) health care providers who electronically transmit any health information in connection with transactions for which HHS has adopted standards.
Generally, public schools, colleges, and other educational institutions that provide medical services for students and staff (as a work benefit) are not considered to be covered entities under HIPAA.
1. HIPAA regulates employers. An employer in and of itself is not a covered entity under HIPAA.
What is a non-covered entity under HIPAA? Non-covered entities dont fall under the Privacy Rule but may still have to comply with other aspects of HIPAA. They are not healthcare providers, healthcare clearinghouses, or health plans, but often store health-related information.
HIPAA does not apply to all healthcare providers or all insurance companies that cover the cost of medical care. For example, HIPAA does not apply to healthcare providers that only bill clients directly or to auto insurance companies that cover the cost of medical care if a plan member is injured in an auto accident.
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In order to prove HIPAA compliance, you have to evaluate your operation against the HIPAA regulations. One way to do that is to audit your organization using the HHS Office of Civil Rights (OCR) HIPAA Audit Protocol. The protocol outlines the expected policies and procedures for HIPAA compliance.
Evaluating your organization. To determine if your organization qualifies as a hybrid entity, you must first conduct a comprehensive evaluation of your operations. Identifying covered functions. Documenting designation. Ensuring HIPAA compliance.

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