Patients have to disclose their personal information when getting medical assistance or registering with healthcare providers. This information must be handled with care, or service providers may end up paying millions of dollars as HIPAA penalties.
What is HIPAA Compliance?
HIPAA is the Health Insurance Portability and Accountability Act. It maintains that a patient’s private and identifiable information must be kept confidential. This bounds everyone dealing with the patient’s data to be extra vigilant and take preventive measures while handling records.
What Does HIPAA Protect?
The main concern of HIPAA is the Protected Health Information (PHI) which consists of:
- The patient’s personal information like name, age, and profession.
- Identifiable information of the patients like their photographs, fingerprints, contact number, and address.
- Record of the patient's medical history and ongoing treatments.
- It also includes family medical histories and sometimes social structure as well.
Who needs to be HIPAA Compliant?
HIPAA compliance is imposed on everyone dealing with the PHI. It restricts not only healthcare providers like doctors, nurses, and psychologists, but also regulates insurance companies, law firms, and other businesses that have access to the patient’s information.
There are two types of organizations that need HIPAA Compliance:
The people directly involved in the process of collecting and dealing with PHI are called covered entities. This includes healthcare providers, medical staff, and health insurance companies.
Business associates are not directly linked with the patient, but they have access to PHI. They work with covered entities in handling data and include IT teams, administrators, lawyers, and accountants.
What Are the HIPAA Compliance Requirements?
If you or your organization is linked with the healthcare industry, then you must maintain your compliance with HIPAA. It is quite strict about its rules and imposes greater fines as compared to GDPR penalties. Just last year it penalized more than 28 million dollars in just 10 data breach cases. Therefore you must be extra vigilant.
HIPAA Privacy Rule
HIPAA has a strict Privacy Rule for PHI, and it has set well-defined limitations of how and when it can be accessed.
Doctors and other medical staff are not allowed to share any personal information of the patient without his or her consent, not even to law or insurance firms. A signed consent form from the patient is necessary for granting any outside person access to PHI.
HIPAA Security Rule
HIPAA Security Rules outline standards for the security and maintenance of electronic handling of PHI. These rules require both the covered entities and business associates to provide physical, technical, and administrative safeguard while handling and processing electronic Protected Health Information (ePHI).
HIPAA implies that the organizations dealing with PHI must allow only limited access to PHI. They should also train their staff according to the HIPAA Security Rule. The tools and software used for handling the data must be well protected and operated with care. These all are necessary requirements of the HIPAA Security Rule that organizations must implement to stick to HIPAA compliance.
HIPAA Omnibus Rule
HIPAA Omnibus Rule is specifically for Business Associate Agreements (BAAs). It deals with all of the contracts and agreements between covered entities and business associates, as well as between different business associates.
This rule implies that no transaction of PHI must be carried out without the two parties in agreement on HIPAA compliance. It also restricts business associates from using PHI for marketing or any other purpose.
HIPAA Breach Notification Rule
HIPAA Breach Notification Rule implies that if a covered entity or business associate fails to maintain the confidentiality of PHI, then they must disclose the data breach to any patients involved, as well as to the Department of Health and Human Services (HHS).
If more than 500 PHI records are accidentally exposed to unauthorized people, then the organization must immediately inform HHS and involve OCR. They must admit and clarify the data breach in a press release. If the number of exposed entities is less than 500, then the organizations can report it annually in a collective report to HHS.
A Step-By-Step Checklist for HIPAA Compliance
Here is a quick checklist that all covered entities and business associates must follow to maintain HIPAA Compliance.
- Track and trace all the files that contain PHI.
- Allow only limited access to PHI.
- Include HIPAA compliance rules in policies and procedures.
- Document all the compliance policies and procedures to maintain a record of compliance, in case there are any issues.
- Regularly self-assess the data security measures that are in place, with a goal of detecting whether there are any loopholes in it.
- Prepare a proper remedial plan in case of any physical, technical, or administrative gap in the compliance.
- Make sure any other business associates or covered entities under Business Associates Agreements (BAAs) are in compliance with HIPAA.
- Pre-plan the procedure and documents in case of any breach in HIPAA compliance.
HIPAA compliance is quite strict, but you can maintain its compliance by following all the rules imposed by HIPAA for handling Protected Health Information.
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