COVERED ENTITY SURVEY

This page serves as a starting point for Executive Branch agencies to complete the Covered Entity survey. Agencies are required to print the survey, obtain all required signatures and turn it into the PMO with an org chart by 9/3.

Before beginning the survey, it may help to know:

• This survey consists of eight sections which, when completed, will be used to determine your agency's role in future HIPAA activities.

• A button is provided at the end of each page to progress through each section of the survey.

• The following information is required when completing the survey: contact information, such as the name, address and phone number of your government entity, components and HIPAA coordinator.

• After completing the survey, you will be provided with the option of reviewing your responses for errors or printing a copy of the survey for your records.

CLICK HERE TO COMPLETE THE COVERED ENTITY SURVEY ONLINE

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File Type	The following documents may be helpful to those completing the survey:
	COVERED ENTITY SURVEY QUESTIONNAIRE INSTRUCTION SET
	COVERED ENTITY SURVEY ANSWER SHEET
	Tactical Implementation for HIPAA Compliance – State Governments - A White Paper Describing the Unique State Government Implementation Issues and Options for Addressing Those Issues
	Application of the Privacy Standards to Integrated Delivery Systems and Other Complex Health Care Arrangements - This analysis discusses the concepts of the organized health care arrangement, the single affiliated covered entity, and the hybrid entity under the final HIPAA privacy regulations issued by the federal Department of Health and Human Services
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