Hipaa 101: A Guide to Compliance

HIPAA, or the Health Insurance Portability and Accountability Act, is a federal law that sets standards for protecting patient health information. It's a complex law, but don't worry, we'll break it down in a way that's easy to understand.

Covered entities, such as healthcare providers and insurance companies, must comply with HIPAA regulations. This includes implementing administrative, technical, and physical safeguards to protect electronic protected health information (ePHI). In other words, they need to have systems in place to keep patient data safe.

HIPAA compliance is not just about protecting patient data, it's also about ensuring that patients have control over their own information. Patients have the right to access and request changes to their medical records, and covered entities must provide them with this information.

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HIPAA stands for the Health Insurance Portability and Accountability Act, a federal law that protects the confidentiality, integrity, and availability of sensitive patient health information.

The law requires healthcare providers, insurance companies, and other covered entities to implement administrative, technical, and physical safeguards to protect patient data.

Covered entities must also provide patients with notice of their rights under HIPAA, including their right to access and request corrections to their medical records.

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HIPAA is a set of federal regulations that protect the confidentiality, integrity, and availability of protected health information (PHI). PHI is any individually identifiable health information created or received by a covered entity.

Covered entities include healthcare providers, health plans, and healthcare clearinghouses, as well as their business associates. These entities must comply with HIPAA rules to safeguard sensitive patient information.

The Health Insurance Portability and Accountability Act of 1996 was enacted to improve the efficiency and effectiveness of the healthcare system. HIPAA aims to reduce administrative costs and improve the quality of patient care.

Protected health information includes medical records, billing information, and any other health-related data that could be linked to a specific individual. This information must be handled and stored securely to prevent unauthorized access or disclosure.

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HIPAA was created to resolve the issue of "job lock" in the health insurance industry. This meant that employees risked losing health insurance benefits if they changed jobs, or being denied insurance in a new job if they had developed a medical condition in their previous job which was excluded from coverage.

Prior to HIPAA, the health insurance industry was regulated by a mixture of state and federal laws. Most commercial group health plans were governed by state laws, while most employer-sponsored and individually purchased health plans were subject to ERISA and COBRA.

This created a scenario where employees were stuck in their jobs, unable to change careers or industries without risking their health insurance benefits. Employers also struggled to attract skilled workforces in evolving industries like technology.

HIPAA aimed to increase the portability of health insurance between jobs and prohibit practices that denied or limited access to health care benefits, such as increased premiums for employees with pre-existing conditions.

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HIPAA is divided into five main parts, or titles, each tackling a different insurance-related area.

Title I focuses on protecting health insurance coverage for those who lose or change jobs, and disallows healthcare plans from withholding coverage to patients with preexisting conditions.

Title II requires the HHS to establish national standards for processing electronic healthcare transactions, and also states that healthcare organizations must conduct transactions securely and comply with Privacy Rule regulations.

Here are the five main components of HIPAA in a concise list:

HIPAA is divided into five main parts, or titles, each tackling a different insurance-related area.

Title I: HIPAA Health Insurance Reform focuses on protecting health insurance coverage for those who lose or change jobs, and disallows healthcare plans from withholding coverage to patients with preexisting conditions.

Title II: HIPAA Administrative Simplification requires the HHS to establish national standards for processing electronic healthcare transactions, and states that healthcare organizations must conduct transactions securely and comply with Privacy Rule regulations.

Title III: HIPAA Tax-Related Health Provisions focuses on exemptions, deductions, and other tax-related areas.

Title IV: Application and Enforcement of Group Health Plan Requirements defines health insurance reform and specifies regulations for group health plans.

Title V: Revenue Offsets touches on HIPAA regulations for company-owned life insurance and discusses the treatment of people who lose U.S. Citizenship for income tax purposes.

Here are the 5 main components of HIPAA at a glance:

HIPAA's rules are primarily enforced by the Office for Civil Rights (OCR), which may conduct compliance reviews, investigate breaches, and even refer cases to the Department of Justice (DOJ).

The OCR takes HIPAA violations seriously, often establishing corrective action or a resolution agreement to resolve the case, or requiring the violating organization to pay hefty fines, like the recent case of a large health system that agreed to pay $1.25 million.

A breach of HIPAA can result in costly fines and reputational damage, so entities must be aware if HIPAA covers them.

HIPAA applies to any healthcare entity that possesses patient records, including health plans, healthcare clearinghouses, and certain healthcare providers that conduct certain financial transactions electronically.

The rules still apply even if these entities contract out to a Business Associate (BA).

Individual patients have a right to access and control their protected health information (PHI), obtain copies of their records, and be notified if there is a privacy breach with expediency.

Here are the 3 Key Players in HIPAA:

HIPAA is a law that protects the health information of individuals, and it's enforced by the Department of Health and Human Services (DHHS) Office of Civil Rights.

In daily practice, HIPAA means that healthcare providers must follow rules to keep your health information safe, like protecting it from unauthorized access and interception.

The HIPAA Privacy Rule protects your health information, which includes your medical records, from being shared without your consent.

To prevent breaches, it's essential to train your employees on cybersecurity best practices, such as using strong passwords and not sharing login credentials.

HIPAA also has a Security Rule that establishes standards to ensure the integrity, confidentiality, and availability of electronic Protected Health Information (ePHI).

Healthcare providers who don't follow the HIPAA rules can face audits and investigations, which can be costly and damaging to their reputation.

Compliancy Group's HIPAA IT training provides employees with useful tips on how to keep your organization's information safe, which is a great resource for healthcare providers to stay compliant.

Health care reform is a significant part of HIPAA, which requires national standards for electronic health care transactions and national identifiers for providers, health insurance plans, and employers.

The HIPAA Administrative Simplification provisions aim to reduce administrative costs and improve the efficiency of the health care system.

To achieve this, the Department of Health and Human Services (DHHS) must adopt national standards for unique health identifiers, security, electronic health care transactions, and code sets.

Health providers must have a signed disclosure from individuals before releasing any information related to their health care to anyone, including their parents.

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This means that health providers must take responsibility for the authorized disclosure of Protected Health Information (PHI).

In the event of a security breach, the Health Information Technology for Economic and Clinical Health (HITECH) Act requires health providers to notify individuals whose information was breached.

If 500 or more individual's information is breached, notice must also be sent to the DHHS and the media.

The HITECH Act also increases the civil penalties for non-compliance and provides for more enforcement.

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The HITECH Act is a crucial part of HIPAA regulations. It was signed into law as part of the 2009 economic stimulus bill, known as the American Recovery and Reinvestment Act (ARRA).

HITECH stands for The Health Information Technology for Economic and Clinical Health, and it revises certain provisions of the HIPAA laws as they relate to privacy and security protections.

HIPAA HITECH increases the scope of protections for individuals and increases penalties for non-compliance. It provides more enforcement of established rules and specifies that healthcare providers must implement a system of Electronic Health Records (EHRs).

Healthcare providers must show "meaningful use" of their established EHRs to receive monetary incentives. After 2015, they will be penalized for failing to show such use.

Individuals are entitled to an electronic copy of all ePHI that pertains to them. HITECH regulations require that breaches of health information be provided to impacted individuals via first class mail with an explanation of the breach.

If a breach impacts 500 or more individuals, healthcare providers must notify those individuals and also the DHHS, the media, and the State Privacy Officer.

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