HIPAA Compliance: General Provisions and Description

HIPAA stands for Health Insurance Portability and Accountability Act. Enacted in 1996, this law modifies healthcare information flow. It achieves this by specifying how healthcare facilities and insurance entities handle personal information that can identify an individual. In addition, this law prevents all healthcare facilities from disclosing patient details unless authorized.

HIPAA Compliance

HIPAA compliance specifies protocols, rules, and standards that govern the collection, storage, and management of essential patient details. For any organization to be recognized as HIPAA compliant, it must adhere to the policies, rules, and security requirements of HIPAA. Failure to adhere to these rules can lead to penalties.

Most entities and businesses involved in the delivery of healthcare services must comply with HIPAA regulations. Some of these businesses and professionals include those responsible for clinical operations, accepting payments, and other healthcare services. In addition, all companies that provide axillary healthcare services must also comply with HIPAA. Examples of such entities include subcontractors, public institution managers, and private companies. Therefore, it will benefit a company to follow the HIPAA checklist to become HIPAA compliant.

Privacy Rule of HIPAA

Several provisions of HIPAA have been updated to account for changing realities. The PHI (Protected Health Information) is the most essential change for this law. In particular, PHI is defined as any details that allow for the identification of a patient. These details include the following.

  • Full name
  • Full addresses;
  • Contact details
  • Medical records
  • Biometric details
  • Financial details
  • Social Security Number

PHI was created to allow an individual to have autonomy over their personal information. Therefore, individuals or businesses that require this information must seek permission from the person before they can access it. In addition, a patient can deny access to private information from healthcare insurers when private funds are used.

Yet, the privacy rule contained in the HIPAA does not apply to all entities. The actors it covers include health plans, healthcare providers, and healthcare clearinghouses. Also, entities need to become HIPAA certified before they can integrate the privacy rules into their operations.

General Provision

An entity is considered HIPAA compliant if it reasonably safeguards personal information.

Reasonable Safeguards

Reasonable Safeguards require an entity to use technical and administrative resources to protect patient information. In general, 100% security is usually not a requirement. Also, reasonable safeguards differ between different entities. As such, an assessment of compliance is made on a case-by-case basis. Thus, each institution is required to adhere to HIPAA while using reasonable administrative and financial resources. The key factor for ensuring reasonable safeguards include the following

  • Use of encrypted devices when accessing PHI at all times.
  • Provide adequate security in locations that house PHI.
  • Avoid using patients’ names and personal information in public spaces.
  • Speak quietly whenever healthcare personnel is talking about family members within public spaces.

Nonetheless, no matter how careful a company is, unintentional HIPAA violations will occur. When this happens, a violation may or may not require reporting.

Minimum Necessary

All covered institutions must implement processes and policies that ensure minimum necessary disclosure. Therefore, the policy of an entity should specify who has access to what information and the conditions for requiring patient details.