The Health Insurance Portability and Accountability Act (HIPAA)
What is HIPAA Compliance?
The Health Insurance Portability and Accountability Act (HIPAA) is a piece of legislation established to protect the confidentiality of Protected Health Information (PHI). It is the primary federal law for protecting confidential medical information. The laws set fourth by HIPAA only apply to Covered Entities (CEs) and their Business Associates (BAs). As such, HIPAA law requires that these entitles implement and maintain technical, administrative, and physical safeguards to protect sensitive data.
The Privacy and Security Rule
There are three general rules outlined under HIPAA, The Privacy Rule, The Security Rule, and The Breach Notification Rule. The two rules that are the most relevant to data security, however, are The Privacy and Security Rule.
The Privacy Rule:
Did you know that 41% of Americans have never seen their medical records? Moreover, 27% of people are unaware of their right to a copy of that medical information.
The purpose of The Privacy Rule is to give patient’s positive control over what legally belongs to them. Therefore, The Privacy Rule defines what data is sensitive, who can access it, and what rights a patient has regarding that data. It applies to doctors, insurers, and their contractors.
Moreover, a patient has the right to access and change their medical records as per HIPAA’s Privacy Rule.
The Security Rule:
While The Privacy Rule defines what kind of medical information is protected, The Security Rule defines how that medical information needs to be protected. It a set of standards and security measures HIPAA covered entities are required to follow to protect health information. Although standards for securing data may vary- The Security Rule is ultimately enforced to minimize the risk of data breaches.
What is Protected Health Information (PHI)?
To define HIPAA compliance, understanding what Protected Health Information (PHI) means first is crucial. Before a a patient receives medical care, healthcare organizations need to collect a plethora of confidential information from them. This information is personal, but necessary for a physician to know so they can provide proper patient care. It can include a patient’s full name, birthdate, SSN, physical address, employment information, and detailed medical history.
Theses factors make a patient’s medical information personally identifiable and as such, are protected under HIPAA. Storing this data securely through encryption and access controls is a necessary standard all HIPAA covered entities must comply with.
HIPAA Covered Entities
HIPAA regulations apply exclusively to Covered Entities (CE) and Business Associates (BA). A CE is any kind of healthcare provider or insurance organization that comes into contact with PHI.
A BA, on the other hand, is not directly related to a healthcare organization. Rather, it is a third party business that provides a service on behalf of a healthcare organization. As a result, the BA may come into contact with PHI while conducting a service for the CE.
To maintain HIPAA compliance, both parties will need to sign a Business Associate Agreement (BAA). This is a legally binding contract that ensures HIPAA compliance is maintained.
Who Enforces HIPAA Compliance?
The HIPAA Privacy and Security Rules are enforced by the Office for Civil Rights (OCR). This is a branch of the Department of Health and Human Services (HHS). Even though the OCR is the primary enforcer of HIPAA laws, other branches of government can also interfere.
In 2009, the HITECH Act gave state attorney’s general the authority to bring civil lawsuits against healthcare organizations that violate HIPAA.
In addition to overseeing the national standard for data security, the OCR will also investigate complaints for non-HIPAA compliance. Every year, the HHS Office for Civil Rights conducts 3,000 audits for HIPAA compliance. That number will continue to increase as they receive additional funding.
What is a Key to Success for HIPAA Compliance?
HIPAA laws are enforced to positively regulate how healthcare data is used. Implementing tactics such as encryption and access controls is the best way to maintain HIPAA compliance within your healthcare organization. It will not only make audits from the OCR seamless, but also establish a strong reputation or your medical practice.
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