According to the Health Insurance Portability and Accountability Act (HIPAA), a covered entity is a health plan, a health care clearinghouse, or a health care provider that transmits any health information in electronic form in connection with a transaction covered by HIPAA. A covered entity must report a breach of unsecured protected health information (PHI) to the following parties:
The Department of Health and Human Services (HHS), which is the federal agency responsible for enforcing HIPAA and issuing regulations and guidance on privacy and security issues. A covered entity must notify HHS of a breach affecting 500 or more individuals without unreasonable delay and in no case later than 60 days after discovery of the breach. A covered entity must also notify HHS of breaches affecting fewer than 500 individuals within 60 days of the end of the calendar year in which the breaches occurred.
The affected individuals, who are the individuals whose PHI has been, or is reasonably believed to have been, accessed, acquired, used, or disclosed as a result of the breach. A covered entity must notify the affected individuals without unreasonable delay and in no case later than 60 days after discovery of the breach. The notification must be in writing by first-class mail or, if the individual agrees, by electronic mail. The notification must include a brief description of the breach, the types of information involved, the steps the individual should take to protect themselves, the steps the covered entity is taking to investigate and mitigate the breach, and the contact information of the covered entity.
The local media, if the breach affects more than 500 residents of a state or jurisdiction. A covered entity must notify prominent media outlets serving the state or jurisdiction without unreasonable delay and in no case later than 60 days after discovery of the breach. The notification must include the same information as the notification to the affected individuals.
A covered entity does not have to report the breach to medical providers, unless they are also affected individuals or business associates of the covered entity. A business associate is a person or entity that performs certain functions or activities on behalf of, or provides certain services to, a covered entity that involve the use or disclosure of PHI. A covered entity must have a written contract or agreement with its business associates that requires them to protect the privacy and security of PHI and report any breaches to the covered entity.
References:
IAPP CIPP/US Body of Knowledge, Domain II: Limits on Private-sector Collection and Use of Data, Section C: Sector-specific Requirements for Health Information
IAPP CIPP/US Certified Information Privacy Professional Study Guide, Chapter 2: Limits on Private-sector Collection and Use of Data, Section 2.3: Sector-specific Requirements for Health Information
Practice Exam - International Association of Privacy Professionals
