All You Need to Know About HIPAA Compliance

HIPAA compliance is fundamental in the healthcare sector: if you want to know all about it, then this article is a must-read.

HIPAA compliance

If your organization handles electronic Protected Health Information (ePHI), then you’ll need to review your HIPAA compliance checklist. This checklist is used to ensure your organization complies with the HIPAA regulations that cover personal patient data privacy and security. 

Failing to comply with these regulations may result in your organization facing substantial fines, civil action, or criminal charges. 

But what are the HIPAA rules, and what exactly constitutes a HIPAA violation? What are the laws that apply to digital health medicine and to the development of medical apps?

In this article, we’ll look at HIPAA compliance and what it means to your organization. 

What Does HIPAA Stand for?

HIPAA stands for the Health Insurance Portability and Accounting Act. This is something that affects every healthcare organization in the United States. The act came into being back in 1996, and it governs how protected health information is handled. 

This legislation was originally put in place to move their health insurance between different companies as they moved between jobs or locations. The act also makes the transferal of medical records easier while protecting sensitive patient data. 

HIPAA makes sure that individual healthcare plans are portable, renewable, and fully accessible. The act sets the standard for how medical data is shared throughout the United States healthcare system. 

Since 1996 the act has been modified to include processes that focus on the safe sharing of patient data through digital means. The act also lays down provisions that are aimed at lowering administrative costs and improving efficiency. 

The Health Information Technology for Economic and Clinical Health Act (HITECH) expands on HIPAA privacy. The act was established to address security and privacy and promote health information technology.  

There are several aspects of the HIPAA regulations that you need to adhere to at all times. These include: 

  • The HIPAA Privacy Rule 
  • The HIPAA Breach Notification
  • The HIPAA Security Rule 

All of these things have been put in place to ensure the privacy of your customers or patients. 

What Is the HIPAA Privacy Rule?

The HIPAA Privacy Rule sets out a series of conditions and limits on the various uses and disclosures that can be made with or without the patient’s consent. 

The Privacy Rule also gives patients the right to obtain and inspect copies of their medical records and to request corrections to their files. The forms that go with this rule include: 

  • A request for Accessing Protected Health Information (PHI) 
  • Privacy Complaint Form
  • Authorization for Use or Disclosure Form
  • Notice of Privacy Practices (NPP)
  • Request for Accounting Disclosures Form
  • Request for Restriction of Patient Health Care Information

The HIPAA Privacy Rule requires appropriate safeguards to be put in place to protect PHI.

What Is the HIPAA Breach Notification Rule?

The HIPAA Breach Notification Rule requires that covered entities notify any individuals affected by a breach. In addition to this, they must also contact the Department of Health and Human Services, and in some cases, the media.

The covered entity must notify anyone affected by the breach within 60 days.

What Is the HIPAA Security Rule?

The HIPAA Security Rule defines the standards and procedures relating to the protection of PHI. The rule operationalizes the Privacy Rule. 

There are three different safeguard levels of security: 

  • The administrative safeguards deal with assigning a HIPAA security compliance team
  • The technical safeguards deal with authentication and encryption methods 
  • The physical safeguards relate to the protection of electronic systems and data within an organization

The need for a risk assessment falls under this rule. 

HIPAA violation

How Do You Maintain HIPAA Compliance?

To maintain HIPAA compliance, all healthcare organizations need to maintain the strictest security measures to protect electronic information. To do this, they should:

  • Develop a cohesive privacy policy
  • Hire the right staff
  • Have a policy of internal auditing processes
  • Establish exhaustive training protocols 
  • Understand and comply with the requirements of the breach notification rule

To aid with compliance, many healthcare organizations will outsource HIPAA administrative and technical aspects to a third-party specialist. You may want to hire an IT specialist to ensure your data security measures are up to scratch. 

Another area that you may wish to outsource is training. Hiring an external company to come in and teach your employees how to remain compliant may be essential to some organizations that don’t have the internal infrastructure in place. 

What Are the Consequences of a HIPAA Violation?

Of course, it is always essential to keep in mind that there will be consequences should you ever commit a HIPAA violation

A HIPAA violation occurs when you fail to comply with one or more of the HIPAA regulations. 

The criminal penalties for committing HIPAA violations can be quite severe.

There are four tiers of penalty. These are: 

  • Tier 1: A violation that you were aware of and couldn’t have avoided
  • Tier 2: A violation that you should have been aware of but couldn’t have avoided
  • Tier 3: A violation as a result of wilful neglect where an attempt has been made to remedy the situation
  • Tier 4: A violation as a result of wilful neglect where no attempt was made to remedy the situation

The fine structure is as follows: 

  • Tier 1: $100 – $50,000 per violation
  • Tier 2: $1,000-$50,000 per violation
  • Tier 3: $10,000- $50,000 per violation
  • Tier 4: A minimum fine of $50,000 per violation

If a criminal violation happens because of negligence, this can result in a one-year jail term. Obtaining medical records under pretenses could result in a five-year jail term. Knowingly and intentionally violating the HIPAA regulations can land you with a jail term of up to 10 years. 

Ensuring HIPAA Compliance in Your Organization

HIPAA compliance is mandatory for all covered entities. It means that if you run a healthcare organization or a business that handles PHI, such as an insurance company, you must follow these rules. 

For more informative healthcare articles, please explore the rest of the site. 

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