Certified Electronic Health Records Specialist (CEHRS) Practice Exam

Which of the following best describes the function of health plans as covered entities?

1. Used to provide medical services

2. Required to follow HIPAA regulations

3. Involved in patient treatment

4. Manage outpatient procedures

The correct answer is: Required to follow HIPAA regulations

The function of health plans as covered entities is best described by their requirement to follow HIPAA regulations. Covered entities, which include health plans, healthcare providers, and healthcare clearinghouses, must comply with the Health Insurance Portability and Accountability Act (HIPAA) to protect patient privacy and ensure the security of health information. This means that health plans are obligated to implement safeguards to protect patient data, provide patients with access to their medical records, and restrict the disclosure of health information without consent. While health plans do play roles in providing medical services, managing outpatient procedures, and being involved in patient treatment, these aspects do not encompass the regulatory aspect that defines their function as covered entities. The primary distinction is that adherence to HIPAA regulations is a fundamental requirement that shapes how health plans operate with respect to patient information and privacy rights.