Question 178 - CIPP-US discussion

Under the Health Insurance Portability and Accountability Act (HIPAA), entities involved in the handling of protected health information (PHI) are classified as either covered entities or business associates based on their roles and activities.

Definitions Under HIPAA:

Covered Entity (CE):

A healthcare provider, health plan, or healthcare clearinghouse that creates, receives, maintains, or transmits PHI.

Miraculous Healthcare qualifies as a covered entity because it is a medical practice directly providing healthcare services to patients.

Business Associate (BA):

An organization or individual that performs functions, activities, or services involving the use or disclosure of PHI on behalf of a covered entity.

MedApps qualifies as a business associate because it is providing a telehealth app service to Miraculous, which involves hosting and maintaining PHI (e.g., appointment details, patient information).

Analysis of the Relationship:

Miraculous Healthcare: As the healthcare provider, it is responsible for patient care and compliance with HIPAA. Since it directly provides healthcare services to patients, it is the covered entity in this scenario.

MedApps: Although MedApps designed, hosts, and supports the telehealth app, it is providing these services on behalf of Miraculous Healthcare. As such, MedApps is a business associate under HIPAA. This designation requires MedApps to comply with HIPAA regulations through a Business Associate Agreement (BAA), ensuring that it appropriately safeguards the PHI it handles on behalf of Miraculous Healthcare.

Consideration of the Benchmarking Service:

The optional benchmarking service also reinforces MedApps' role as a business associate. Miraculous Healthcare would need to assess whether the PHI uploaded for benchmarking meets HIPAA's minimum necessary standard and that MedApps implements appropriate safeguards for PHI used for benchmarking. The BAA would need to address these specific uses.

Explanation of Options:

A . Miraculous Healthcare would be the covered entity because its name and branding are on the app. MedApps would be a business associate because it is hosting the data that supports the app: While this is close, it oversimplifies the reasoning by focusing solely on branding. The covered entity designation is determined by the healthcare services provided, not just branding.

B . MedApps would be the covered entity because it built and hosts the app and all the data. Miraculous Healthcare would be a business associate because it only provides its brand on the app: This is incorrect because MedApps is not directly providing healthcare services. Hosting and maintaining PHI does not make it a covered entity but rather a business associate.

C . Miraculous Healthcare would be a covered entity because it is the healthcare provider; MedApps would also be a covered entity because the data in the app is being shared with it: This is incorrect because MedApps does not independently provide healthcare services to patients. Its role is solely as a service provider to Miraculous.

D . Miraculous Healthcare would be the covered entity because it is the healthcare provider; MedApps would be a business associate because it is providing a service to support Miraculous: This is the correct answer. Miraculous is the covered entity, and MedApps, by hosting the telehealth app and handling PHI on Miraculous' behalf, is a business associate.

Reference from CIPP/US Materials:

HIPAA Privacy Rule (45 CFR 160.103): Defines covered entities and business associates.

Business Associate Agreements (BAAs): HIPAA requires a BAA between covered entities and business associates to ensure PHI is appropriately protected.

IAPP CIPP/US Certification Textbook: Provides detailed examples of covered entities and business associates, along with their roles and responsibilities under HIPAA.