The Health Insurance Portability and Accountability Act (HIPAA) is more important than ever to today’s healthcare industry. HIPAA compliance must be ensured to safeguard private and sensitive patient data by the Hospitals, insurance companies, and healthcare providers.
What is HIPAA Compliance?
The HIPAA is a federal law established to protect the privacy of health information created or maintained by healthcare providers. It made national standards for how medical information should be handled, and it also includes other provisions that apply to employers and healthcare providers.
The main goal of HIPAA is to ensure patient data remains private, secure, and confidential at all times. Its impact has been significant, including cybersecurity rules for storing and transmitting data.
To comply with HIPPA and avoid penalties, organizations that manage PHI must follow a stringent set of rules and security measures. Those subject to the HIPAA compliance mandates are typically called covered entities or business associates. In the healthcare industry, covered entities are those who provide treatment, accept payment, or perform clinical operations. Business associates are organizations that have access to PHI for payment, treatment, or operation purposes. Many companies, subcontractors, and public institutions that handle PHI must meet HIPAA compliance standards.
HIPAA regulations are established under HHS and enforced by the OCR.
Why is it Important for the Healthcare Industry?
With the advancement in technologies, hackers are always on the lookout for a breach, and HIPAA compliance helps protect against data breaches, which can be costly because they can lead to lawsuits or fines. The act is essential for the healthcare industry because the healthcare industry is now the biggest target for hackers. By the end of 2021, healthcare companies lost 6 trillion dollars in security breaches, and this risk is ever-growing.
Under the HIPAA privacy rule, covered entities and their business associates must protect all individually identifiable health information – commonly referred to as protected health information (PHI). This Privacy Rule ensures that PHI is protected, but it also allows the flow of information between providers who need to use the data for the best patient care. Hence, the Security Rule comes in.
The HIPAA Security Rule requires covered entities to protect electronically protected health information (ePHI) by maintaining reasonable and appropriate administrative, technical, and physical safeguards, which include:
- Securing the confidentiality, integrity, and availability of electronically protected health information (ePHI);
- Identifying, assessing, and responding to reasonably anticipated threats to the integrity or security of the information;
- To protect the confidential information from reasonably anticipated, impermissible uses or disclosures; and
- Ensuring workforce compliance.
The HIPAA Breach Notification Rule requires HIPAA-covered entities and their business associates to notify upon discovering a breach or compromise of protected health information. Under HITECH Act section 13407, the Federal Trade Commission (FTC) implements and enforces breach notification provisions for vendors of personal health records and their third-party service providers.
In accordance with the Omnibus Rule, any improper use or disclosure of personal health information should trigger official notification requirements unless the company conducts a risk analysis and concludes that no breach occurred.
What are the penalties for non-compliance?
In most cases, you can avoid any HIPAA-related fines, fees, or penalties if you take the proper steps. Yet you need to know the penalties, how they work, and the potential repercussions. A three-tiered system of fines and penalties can be imposed for intentional or unintentional breaches of PHI.
- Tier 1 violation: Occurs when the covered entity is unaware of the violation and cannot prevent it realistically. A reasonable effort had been made to safeguard PHI. A maximum fine of $50,000 may be assessed, with $100 per violation minimum.
- Tier 2 violation: Despite being aware of the violation, the entity could not avoid it. The violations could not have been prevented by reasonable care. There is a $1,000 fine per violation up to $50,000.
- Tier 3 violation: HIPAA rules were flagged as being “willfully neglected” due to the violation. Covered entities must take steps to correct the violation. $10,000 minimum fine up to $50,000 maximum.
- Tier 4 violation: An egregious example of willful neglect, as defined by HIPAA. There have been no attempts by the covered entity to correct the violation. $50,000 per violation is the minimum fine.
Making sure that there are no violations from the start is the key to avoiding fines and penalties. Make sure you know what Reasonable Care means in your particular case and that your PHI is protected accordingly. It’s also essential to be updated with any changes in the regulations. HHS CSC announced significant changes in its Newsroom and HIPAA Journal in 2021. The changes are mostly related to the HIPAA Privacy Rule. Please visit either the HHS CSC Newsroom or HIPAA Journal for more information
Taking Steps Toward Healthcare IT Compliance
HIPAA was created to ensure that patient and customer PHI stays private. The measures that HIPAA requires are meant to provide a means for a business, company, or healthcare organization to protect healthcare data. While HIPAA compliance may seem overwhelming, you can get there by taking a step-by-step approach.
Currently, there is no guidance regarding what should be included in a HIPAA risk assessment. IT providers can help organizations manage the daily management and compliance requirements of HIPAA by guiding the objectives. The HIPAA IT compliance requirement does not apply as a one-time task but is a continuous process that ensures continued compliance.
HIPAA compliance is an expensive and time-consuming process. Your organization’s data security is at risk, there are many security vulnerabilities, and you’re having trouble staying on top of all the changes.
The consequences of a data breach can be catastrophic for your business. There are heavy fines, legal penalties, and potential lawsuits if you don’t stay compliant with HIPAA.
An experienced, outside partner can help you see the bigger picture. Protected Harbor has the best practice knowledge on securing managed file transfers, HIPAA-compliant emails, data management, and security. We make sure your data is safe by using robust auditing and encryption technology that meets or exceeds HIPAA requirements for healthcare organizations.