HIPAA Covered Entity
HIPAA's regulations directly cover three basic groups
of individual or corporate entities: health plans, health care providers, and
health care clearinghouses.
Health Plan
Fairfax County Government's Health Plan is a separate legal
entity and a covered entity under HIPAA. Many of the implementation
provisions of HIPAA do not apply to Fairfax County's fully-insured
components of the Health Plan; however, all provisions of HIPAA
apply to the self-insured component of the Health Plan.
Fairfax County Government employees may participate in the
many benefit plans offered by the County, such as health insurance,
long term care insurance, the employee assistance program, and
flexible spending programs. Fairfax County Government retirees
are eligible to continue their health, dental, life, and long-term
care insurance. HIPAA applies to these benefit plans, therefore
the County benefit plans will be HIPAA compliant. Employees
who request assistance from the Department of Human Resources
with respect to benefit claims or issues may be asked to sign
a waiver, authorizing County benefit staff to discuss their
benefit issues with a plan provider. Waivers are available from
each individual health plan.
Health Care Provider
Fairfax County Government provides care and services related
to the physical or mental health of our residents. Fairfax County
also provides numerous non-health care related services to our
residents. Fairfax County has chosen to restrict the application
of the HIPAA Privacy Rule to those parts of the County enterprise
that are performing covered health care transactions. A covered
health care transaction is an electronic billing function related
to payment or authorization for health care services. The application
of the HIPAA Privacy Rule to certain components of the County
is permissible within the definition of a hybrid entity.
Fairfax County's hybrid entity currently consists of the Fire and Rescue Department
(FRD), the Health Department (HD) and the Fairfax-Falls Church Community Services
Board (CSB). Agencies providing human services support to clients of the HD
and the CSB will be designated within the hybrid entity as appropriate policies
and procedures are adopted. In addition, as agencies seek to automate business
processes related to health care billing and electronic transactions, then they
will be designated within the Fairfax County Government's HIPAA hybrid entity.
Agencies providing other health care services to employees,
students, inmates or residents will continue to apply the appropriate
confidentiality provisions mandated by licensure standards,
ethical codes, county personnel policies, and other federal
and state laws.
Health Care Clearinghouse
Fairfax County Government does not consist of any health care
clearinghouse functions.