Everything You Need to Know About HIPAA Compliance

The Health Insurance Portability and Accountability Act (HIPAA) was brought in 1996 to ensure the necessary privacy of a patient’s sensitive information. The HIPAA law lays down various mandates for healthcare organizations to safeguard protected health information (PHI) of patients, breach of which attracts both criminal and civil liabilities.

Today, where technology and data storage are highly entwined, HIPAA proves to be a major tool in the hands of patients to enforce their right of non-disclosure.

What is Protected Health Information (PHI)?

PHI is any information, including demographic data that can be used to identify a patient or a client. In simpler words, this information might include name, address, contact details, and photos for easy identification of a patient. PHI also includes electronically shared, stored, or accessed data known as ePHI under HIPAA Security Rule which was added as an addendum to the primary HIPAA law.

HIPAA Compliance Icon Graphic with Medical Security Symbol

Who Needs HIPPA Compliance?

HIPAA extends mainly to two types of organizations- Covered Entities and Business Associates. The former refers to any entity that is involved in the collection, transmission, or creation of protected health information. Health care providers, health insurance organizations, and health care clearinghouses are some of the examples of covered entities.

The term Business Associates is a wider umbrella and covers everything from cloud storage providers, billing companies, to IT providers, and more.

Main HIPAA Rules You Should Be Aware Of?

Violation of HIPAA mandates call for hefty fines and in some circumstances even imprisonments and so, you need to be thorough with all the major rules to dodge the liabilities. Have a look at the rules you must be aware of:

1.   Privacy Rule-

This rule sets standards for privacy protection of patients’ PHI and only applies to Covered Entities. For instance, Notice of Privacy Practices, requesting access or amendment of medical records, the introduction of special privacy protection, and Issuance of Release forms.

2.   Security Rule

This rule deals with the maintenance, transmission, and handling of electronic Protected Health Information. It extends to both the types of organizations explained in the previous section. Under this, a healthcare organization must train its staff over HIPAA compliance and record/document the same with their attestation.

3.   Breach Notification Rule

When a healthcare organization breaches the rules set by HIPAA, it has to follow certain guidelines and procedures for divulging the same to Health and Human Services (HHS) Office for Civil Rights (OCR). Though the procedure might differ based on the nature of the violation, reporting the same is mandatory.

4.   Omnibus Rule

This rule regulates the contracts entered between BAs and healthcare organizations or between more than one business associate and was added as an addendum to the HIPAA rule. Under this, Business Associates are also required to be HIPAA compliant.

HIPAA helps maintain the integrity and security of patients’ sensitive information.

To ensure that your organization is fully compliant with HIPAA, designate appropriate communication officers and conduct systematic training and education programs to get your employees familiarized with its rules.

Always remember- annual audits are your best friends in recognizing the loopholes in HIPAA compliance and you must devise effective remediation strategies beforehand to prevent legal consequences!