Todd - A Covered entity is defined in the regs at 160.102 as a health plan; health care clearinghouse; or a health care provider who transmits any health information in electronic form in connection with a transaction covered by this subchapter (ie transactions).
An "entity" is not defined in the regulations. However, several places in the official comments suggest that "entity" is synonomous with legal entity so that for instance: a state agency is the legal entity responsible for an impacted program's compliance or the corporate entity is responsible to ensure a given line of business or component complies. With reference to 162.925, the means that a health plan is required to accept transactions not only from "covered entities" such as other plans or providers, but also any other entity which may not be covered - like a sponsor. See comments at page 50317 of reg. "In general, if a covered entity conducts, using electronic media, a transaction adopted under this part with another covered entity (or within the same covered entity), it must conduct the transaction as a standard. If any entity (covered or not) requests a health plan to conduct a transaction as a standard transaction, the health plan must comply." Leah Hole-Curry Fox Systems, Inc. 702-608-1045 ********************************************************************** To be removed from this list, send a message to: [EMAIL PROTECTED] Please note that it may take up to 72 hours to process your request.
