An Outline of HIPAA Compliance

An Outline of HIPAA Compliance
5 min read
07 August 2023

The field of medicine requires patient information for reimbursement of insurance. As a result, healthcare providers must be careful with the sensitive data of the individuals they treat. Keeping this responsibility limited to practices may result in adverse effects leading to data breaches. That is why enforcing HIPAA under Civil Rights is mandatory for all healthcare providers and practices that use Protected Health Information (PHI). For a healthcare provider, providing the best patient care and safeguarding patient interest are both of great importance.   

HIPAA is vital to maintain the privacy of health information and protect it from potential cyber-attacks. HIPAA Compliance is a must to ensure the safety of information and failure to do so can subject entities to hefty amounts of penalties.  

Let’s understand its meaning and other important information related to it.  

HIPAA Compliance 

The Health Insurance Portability and Accountability Act, commonly referred to as HIPAA, is a set of regulatory standards that creates a framework to lawfully handle and disclose PHI (Protected Health Information). It is supervised by the Department of Health and Human Services (HHS) and enforced by the Office for Civil Rights (OCR).  

Protected Health Information (PHI) 

PHI is any information related to the identity of a patient that can be stored electronically, orally or on paper. Only HIPAA-compliant entities are obligated to hold PHI. Transmission and storage of PHI and ePHI (Electronic Protected Health Information), both are protected under regulatory standards.  

Need to be HIPAA Compliant  

There are two types of organizations that need to be HIPAA Compliant, and they are: 

  • Covered Entities  

According to HIPAA regulation, the entities that use electronic methods to gather and transfer PHI are called covered entities. It includes healthcare providers, healthcare clearing houses and healthcare insurance providers.  

  • Business Associates  

These organizations manage PHI on behalf of a covered entity. It includes billing companies, practice management firms, EHR platforms, third-party consultants, IT providers, physical storage providers, cloud storage providers, email hosting services, attorneys, accountants, and many more.  

HIPAA Compliance Rules  

Here are the three main rules to be taken care of: 

  • Privacy Rule  

This rule only applies to covered entities and not business associates. It is to establish standards for the patient’s right to access PHI and the healthcare provider’s right to deny access to PHI. Under this rule, the organizations are required to record all the HIPAA Policies and procedures and train the employees for the same.  

  • Security Rule 

This rule is an extension of the privacy rule for the protection of PHI. It applies to both covered entities and business associates. Safety rules are set for the management of e-PHI (Electronic Protected Health Information) and outline standards for the physical, administrative and technical safety of patient information.  

  • Breach Notification Rule 

This rule is a follow-up procedure if a covered entity or a business associate is exposed to a data breach of PHI or ePHI. The rules are standard for reporting the breach and specific protocols that the organization must follow. Notifying the breach is a must irrespective of the size or scope of the data violation.  

HIPAA Compliance Requirements  

Following are the requirements of HIPAA that every covered entity and business associate must address: 

  • Entities must conduct regular audits to navigate the shortcomings of the privacy and security standards followed by the organization. It is important for risk assessment of the technical, administrative and physical aspects of PHI or ePHI. 
  • After successful self-audits, entities are required to take remedial action for compliance violations. It is important to document all the remedial plans along with the errors that are rectified. 
  • All entities are obliged to set policies and procedures for HIPAA compliance. Also, to train the staff for the same. 
  • Organizations that are required to follow HIPAA compliance must also document all their efforts in following the rules as it is vital for HIPAA investigation and external audits. 
  • In case of a data breach, entities are required to document the breach and notify the patients according to the HIPAA notification breach rule.  

To summarize 

The significance of HIPAA compliance is not only for the protection of patient information, but also necessary for the organization. With HIPAA policies, entities can enhance operations, reduce the overall cost and simplify the administrative tasks while taking care of patient health information.  

However, HIPAA training and compliance are not easy tasks and outsourcing a compliance partner is going to be beneficial. If you are an entity looking for professional help in handling HIPAA, then Cyber Cops is here to assist you.  

Cyber Cops offers IT security, compliance consultation and awareness training. Our team helps to easily secure the information provided by clients and the future of your business as well. 

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