[US] HIPAA Does not Apply to Lumiant HALO [Legal and Compliance]

HIPAA DOES NOT APPLY TO Lumiant HALO

What is HIPAA:

The Health Insurance Portability and Accountability Act of 1996, Pub. L. 104-191 (as amended from time to time, “HIPAA”) was enacted in 1996 in an effort to protect individuals’ health information. HIPAA prohibits “covered entities” and their “business associates” from disclosing a patient’s “protected health information” without the patient’s consent or authorization, except when such information is being used for treatment, payment or healthcare operations. HIPAA only applies to “covered entities,” and to “business associates” of those covered entities.

WHO has to follow HIPAA?
ONLY “covered entities” and their “business associates.” If an entity does not meet the definition of a covered entity or business associate, it does not have to comply with HIPAA.

WHAT are “covered entities”?
Covered Entities include only the following 3 types of entities:

1. Health Care Providers. Most providers, including doctors, clinics, psychologists, dentists, chiropractors, hospitals, nursing homes and pharmacies, are defined to be “health care providers,” and therefore “covered entities,” under HIPAA. Lumiant is not a health care provider.
2. Health Plans. Health insurance companies, HMOs, company health plans and government programs that pay for health care, such as Medicare, Medicaid, and the military and veterans’ health care programs, constitute health plans, and therefore “covered entities,” under HIPAA. Lumiant is not a health plan.
3. Health Care Clearinghouses. Entities that process nonstandard health information they receive from another entity into a standard format (i.e., standard electronic format or data content), or vice versa, constitute “health care clearinghouses,” and therefore “covered entities,” under HIPAA. Lumiant is not a health care clearinghouse.

Because Lumiant is not a health care provider, a health insurer, or a health care clearinghouse, it is not a “covered entity” that must comply with HIPAA.

WHAT is a “business associate”?
Under HIPAA, a “business associate” is a third party that performs certain functions or activities that involve the use or disclosure of protected health information on behalf of, or provides services to, a covered entity. A covered health care provider, health plan, or health care clearinghouse can be a business associate of another covered entity.

HALO provides services to financial advisors and other entities that do not qualify as “covered entities” under HIPAA. Since it is not obtaining, disclosing or utilizing protected health information as part of a relationship with a covered entity, Lumiant is not a business associate subject to HIPAA.

As noted above, if an entity does not meet the definition of a covered entity or a business associate, it does not need to comply with HIPAA. Lumiant is not a covered entity or a business associate. Therefore, HIPAA does not apply to Lumiant.

* The contents of this communication are for informational purposes only, and are not intended to constitute legal advice, or to establish an attorney-client relationship. You should contact your attorney to obtain advice with respect to any particular issue or problem.