What is HIPAA Compliance? Learn How to Comply with HIPAA

A general question that many citizens have is about HIPAA Compliance. To answer that question, we first need to understand what HIPAA is, who ensures its compliance, and who must comply. Once we learn about that, we can understand whether you are complying with HIPAA. So, without further ado, let us get started.

The Health Insurance Portability and Accountability Act (HIPAA) is a federal law that sets standards for protecting the privacy and security of personal health information. HIPAA compliance refers to meeting the requirements set forth by HIPAA and ensuring that protected health information (PHI) is handled and disclosed correctly.

This includes taking appropriate measures to safeguard PHI, such as implementing physical and technical security controls and ensuring that only authorized individuals can access PHI.

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What are PHI and HIPAA?

PHI stands for Protected Health Information. It is any information about an individual’s health or medical history that is created, collected, used, or disclosed by a healthcare provider, health plan, or other covered entity while providing healthcare services.

PHI is protected under HIPAA, which sets standards for handling and disclosing it. Examples of PHI include an individual’s medical records, health insurance information, and test results.

If you have noticed, a common practice is followed in all healthcare institutes — protecting patient information. Any information that can be used to identify a patient or a citizen is called Protected Health Information or PHI. This includes the individual’s name, contact numbers, addresses, Social Security Number, financial information, photos, and medical information.

what is hipaa compliance

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As per HIPAA or the Health Insurance Portability and Accountability Act (1996), several standard rules and regulations must be followed regarding PHI. For instance, it outlines the circumstances under which PHI can or cannot be disclosed or used. Authorities like the Office of Civil Rights and the Department of Health and Human Services ensure HIPAA compliance.

HIPAA covers a wide range of rules and regulations that are mandatory for concerned entities to follow, some of which are listed below:

  • Privacy Rule
  • Security Rule
  • Omnibus Rule
  • Breach Notification Rule

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To whom does HIPAA apply?

HIPAA applies to several entities, known as “covered entities” and “business associates.” Covered entities include healthcare providers (such as hospitals, doctors, and clinics), health plans (such as insurance companies and employer-sponsored health plans), and healthcare clearinghouses (such as billing companies and other organizations that process health information).

Business associates are individuals or entities that work with covered entities and have access to PHI, such as subcontractors and third-party vendors. HIPAA also applies to any individual or entity that receives PHI from a covered entity or business associates, such as a researcher or a data storage company.

Now that you know what HIPAA is and what it protects, we shall understand who must follow the HIPAA rules and regulations. HIPAA rules are mainly applicable to these two categories — Covered Entities and Associated Businesses. Let us understand their scope better:

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Covered Entities

The HIPAA states that any organization or entity that electronically creates, transmits, or collects PHI is covered. Organizations such as healthcare clearinghouses, care providers, and insurance providers all fall under covered entities.

Associated Businesses

On the other hand, business associates cover a broad spectrum of businesses and organizations. As per HIPAA, any organization associated with covered entities who comes in contact with or deals with PHI throughout their work are business associates. For example, practice management firms, billing companies, third-party consultants, MSPs, faxing companies, IT providers, etc.

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How can you comply with HIPAA?

To comply with HIPAA, you must take several steps to protect the privacy and security of PHI. Some of the critical requirements for HIPAA compliance include the following:

  • Conducting a thorough risk assessment to identify potential vulnerabilities and threats to PHI.
  • Implementing appropriate physical, technical, and administrative safeguards to protect PHI from unauthorized access, use, disclosure, and destruction.
  • Developing and implementing policies and procedures for handling and disclosing PHI following HIPAA requirements.
  • Providing ongoing training and education to employees and other individuals with access to PHI.
  • Establishing processes for monitoring and enforcing compliance with HIPAA requirements.
    Conducting regular audits and reviews to ensure that PHI is being handled and appropriately disclosed.
  • Establishing procedures for responding to incidents involving the unauthorized access, use, disclosure, or destruction of PHI.

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Perform Self-Audits

HIPAA asks concerned parties to perform self-audits to comply with HIPAA rules. Simply performing the Security Risk assessment is not enough, so make sure you meet the audit quota set by HIPAA.

Put Remediation Plans Into Action

One of the main reasons why the self-audits are implemented is for companies to recognize the gap in HIPAA compliance. Once the gaps are acknowledged, the companies need to put a redemption plan into action to fill in those gaps.

Remedy actions should involve revising procedures and policies while training employees to ensure that the organization can successfully comply with HIPAA rules. These actions should be well recorded for future reference and verification purposes.

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Emergency Management Plans

If unfortunately, a covered entity or business associate has a breach of their PHI, they should have an effective plan in place for immediate execution. Plans to retrieve the data, inform the patients, and ensure that the incident has been appropriately recorded should be executed.

Wrapping up

By taking these steps and following the requirements set forth by HIPAA, covered entities and business associates can ensure that they are complying with the law and protecting the privacy and security of PHI.

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