HIPAA Compliance

HIPAA stands for Health Insurance Portability and Accountability Act. It was formed in 1996 and, among other things, protects patient health information.

The HIPAA Rules apply to two groups: covered entities and business associates. A covered entity is a health plan, health care clearinghouse or health care provider who electronically transmit any health information. Examples of covered entities are:

• Doctors
• Dentists
• Pharmacies
• Health insurance companies
• Company health plans

A business associate is a person or entity that performs certain functions or activities that involve the use or disclosure of protected health information on behalf of, or provides services to, a covered entity. Examples of business associates (whose services involve access to PHI) are:

• CPA
• Attorney
• IT providers
• Billing and coding services
• Laboratories

For more detailed information on the definition of a covered entity and businesses associate visit The Department of Health and Human Services (HHS) website.

The HIPAA Privacy Rule provides federal protections for personal health information and gives patients rights to their own protected health information (PHI). The Privacy Rule permits the disclosure of PHI needed for patient care and other important purposes. The Privacy Rule applies to all healthcare providers, including those who do not use an Electronic Health Record (EHR) system, and includes all mediums: electronic, paper, and oral.

Privacy Rule Basics:

• Spells out administrative responsibilities
• Discusses written agreements between covered entities and business associates
• Discusses the need for privacy policies and procedures
• Describes employer responsibilities to train workforce members and implement requirements regarding their use and disclosure of PHI.

Privacy Rule Examples:

• Train all employees on its privacy policies and procedures
• Properly dispose of documents containing protected health information
• Secure medical records with lock and key or pass code
• Create procedure for individuals to know to whom they can submit a complaint about a covered entity's compliance with the Privacy Rule

The HIPAA Security Rule requires covered entities, business associates, and their subcontractors to become HIPAA compliant by implementing safeguards to protect electronic protected health information (ePHI) that is created, received, or maintained. It specifies a series of administrative, physical, and technical safeguards to ensure the confidentiality, integrity, and availability of ePHI. Most violations of the HIPAA Security Rule result from businesses not following policies and procedures to safeguard ePHI, thus preventing them from becoming HIPAA compliant.

Security Rule Basics:

• Establish a national set of security standards for ePHI
• Protects health information held or transmitted in electronic form
• Requires administrative, physical, and technical safeguards to secure ePHI
• Supports the Privacy Rule requirement to reasonably safeguard PHI in all forms

Security Rule Examples:

• Designate a security officer who is responsible for compliance
• Create policies and procedures that explain proper use of workstations and electronic media
• Ensure all employees have unique passwords
• Limit physical access to covered entity's facilities