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Healthcare Provider Obligations and Covered Entities Flashcards

7 cards from real HIPAA practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.

Read the first 7 Healthcare Provider Obligations and Covered Entities flashcards as text

  1. A small solo-practice physician transmits claims electronically to Medicare. Under HIPAA, this physician is classified as:

    Answer: A covered entity

    Any healthcare provider that transmits health information electronically in connection with HIPAA-covered transactions is a covered entity.

  2. Which of the following healthcare providers is NOT required to comply with HIPAA because they do not conduct covered electronic transactions?

    Answer: A cash-only psychiatrist who never files insurance claims

    A provider that conducts no HIPAA-covered electronic transactions is not a covered entity and has no HIPAA compliance obligation.

  3. Under the HIPAA Privacy Rule, a covered entity must provide patients with a Notice of Privacy Practices (NPP) at what point?

    Answer: No later than the date of first service delivery

    Covered entities must provide the NPP no later than the date of first service delivery to a patient.

  4. A hospital outsources its medical transcription to a company that will create and store PHI. What agreement must the hospital obtain before sharing PHI with this company?

    Answer: A business associate agreement (BAA)

    Covered entities must execute a Business Associate Agreement with any vendor that creates, receives, maintains, or transmits PHI on their behalf.

  5. Which entity type may voluntarily choose to be treated as a covered entity under HIPAA even if not strictly required?

    Answer: A non-covered provider

    A non-covered provider may voluntarily comply with HIPAA, often to facilitate electronic transactions with covered entities.

  6. A health plan that is self-administered and has fewer than how many participants is exempt from the HIPAA Privacy Rule?

    Answer: 50

    Self-administered health plans with fewer than 50 participants are exempt from the HIPAA Privacy Rule.

  7. When a covered entity undergoes a merger with another covered entity, what happens to their HIPAA obligations regarding existing BAAs?

    Answer: The surviving entity assumes responsibility for existing BAAs

    The surviving entity in a merger assumes the HIPAA obligations, including existing Business Associate Agreements, of both predecessor entities.