<?xml version="1.0"?>
<?xml-stylesheet type="text/xsl" href="cfr.xsl"?>
<CFRGRANULE xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xsi:noNamespaceSchemaLocation="CFRMergedXML.xsd">
  <FDSYS>
    <CFRTITLE>45</CFRTITLE>
    <CFRTITLETEXT>Public Welfare</CFRTITLETEXT>
    <VOL>1</VOL>
    <DATE>2010-10-01</DATE>
    <ORIGINALDATE>2010-10-01</ORIGINALDATE>
    <COVERONLY>false</COVERONLY>
    <TITLE>Definitions.</TITLE>
    <GRANULENUM>164.103</GRANULENUM>
    <HEADING>Section 164.103</HEADING>
    <ANCESTORS>
      <PARENT HEADING="Title 45" SEQ="4">Public Welfare</PARENT>
      <PARENT HEADING="SUBTITLE A" SEQ="3">DEPARTMENT OF HEALTH AND HUMAN SERVICES</PARENT>
      <PARENT HEADING="SUBCHAPTER C" SEQ="2">ADMINISTRATIVE DATA STANDARDS AND RELATED REQUIREMENTS</PARENT>
      <PARENT HEADING="PART 164" SEQ="1">SECURITY AND PRIVACY</PARENT>
      <PARENT HEADING="Subpart A" SEQ="0">General Provisions</PARENT>
    </ANCESTORS>
  </FDSYS>
  <SECTION>
    <SECTNO>§ 164.103</SECTNO>
    <SUBJECT>Definitions.</SUBJECT>
    <P>As used in this part, the following terms have the following meanings:</P>
    <P>
      <E T="03">Common control</E> exists if an entity has the power, directly or indirectly, significantly to influence or direct the actions or policies of another entity.</P>
    <P>
      <E T="03">Common ownership</E> exists if an entity or entities possess an ownership or equity interest of 5 percent or more in another entity.</P>
    <P>
      <E T="03">Covered functions</E> means those functions of a covered entity the performance of which makes the entity a health plan, health care provider, or health care clearinghouse.</P>
    <P>
      <E T="03">Health care component</E> means a component or combination of components of a hybrid entity designated by the hybrid entity in accordance with § 164.105(a)(2)(iii)(C).</P>
    <P>
      <E T="03">Hybrid entity</E> means a single legal entity:</P>
    <P>(1) That is a covered entity;</P>
    <P>(2) Whose business activities include both covered and non-covered functions; and</P>
    <P>(3) That designates health care components in accordance with paragraph § 164.105(a)(2)(iii)(C).</P>
    <P>
      <E T="03">Law enforcement official</E> means an officer or employee of any agency or authority of the United States, a State, a territory, a political subdivision of a State or territory, or an Indian tribe, who is empowered by law to:</P>
    <P>(1) Investigate or conduct an official inquiry into a potential violation of law; or</P>
    <P>(2) Prosecute or otherwise conduct a criminal, civil, or administrative proceeding arising from an alleged violation of law.</P>
    <P>
      <E T="03">Plan sponsor</E> is defined as defined at section 3(16)(B) of ERISA, 29 U.S.C. 1002(16)(B).<PRTPAGE P="817"/>
    </P>
    <P>
      <E T="03">Required by law</E> means a mandate contained in law that compels an entity to make a use or disclosure of protected health information and that is enforceable in a court of law. <E T="03">Required by law</E> includes, but is not limited to, court orders and court-ordered warrants; subpoenas or summons issued by a court, grand jury, a governmental or tribal inspector general, or an administrative body authorized to require the production of information; a civil or an authorized investigative demand; Medicare conditions of participation with respect to health care providers participating in the program; and statutes or regulations that require the production of information, including statutes or regulations that require such information if payment is sought under a government program providing public benefits.</P>
    <CITA>[68 FR 8374, Feb. 20, 2003, as amended at 74 FR 42767, Aug. 24, 2009]</CITA>
  </SECTION>
</CFRGRANULE>
