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The analysis of any legal or medical billing is dependent on numerous specific facts — including the factual situations present related to the patients, the practice, the professionals and the medical services and advice. Additionally, laws and regulations and insurance and payer policies are subject to change. The information that has been accurate previously can be particularly dependent on changes in time or circumstances. The information contained in this web site is intended as general information only. It is not intended to serve as medical, health, legal or financial advice or as a substitute for professional advice of a medical coding professional, healthcare consultant, physician or medical professional, legal counsel, accountant or financial advisor. If you have a question about a specific matter, you should contact a professional advisor directly. CPT copyright American Medical Association. All rights reserved. CPT is a registered trademark of the American Medical Association.

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Who does the Security Rule Apply to?

The Security Rule specifically focuses on protecting the confidentiality, integrity, and availability of EPHI, as defined in the Security Rule. The EPHI that a covered entity creates, receives, maintains, or transmits must be protected against reasonably anticipated threats, hazards, and impermissible uses and/or disclosures. In general, the requirements, standards, and implementation specifications of the Security Rule apply to the following covered entities:

  • Covered Healthcare Providers— Any provider of medical or other health services, or supplies, who transmits any health information in electronic form in connection with a transaction for which HHS has adopted a standard.
  • Health Plans— Any individual or group plan that provides or pays the cost of medical care (e.g., a health insurance issuer and the Medicare and Medicaid programs).
  • Healthcare Clearinghouses— A public or private entity that processes another entity’s healthcare transactions from a standard format to a nonstandard format, or vice versa.
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