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What is HIPAA Compliance? A Complete Guide For 2022

hipaa compliance a complete guide

HIPAA (Health Insurance Portability and Accountability Act) is a law in force in the United States that ensures to provide data privacy & security provisions to shield medical information.

As you all must be aware that cyber attacks can happen to anyone, in the same way, the law has emerged more prominently in recent years with many health data breaches due to cyber-attacks & Ransomware attacks on health insurers and providers.

Many companies have created different types of software to prevent this. HIPAA compliance software is one of those tools that businesses large and small can use to reach their goals in a short amount of time.

New changes to HIPAA guidelines make businesses directly responsible for the proper storage and authorized sharing of patient health information.

HIPAA-compliant software has been recognized as the best solution for businesses working towards reducing the risk of unauthorized patient disclosure.

How do you comply with HIPAA?

As we told you that HIPAA compliance has become a very important topic that all small and big companies have to follow so that they can avoid future hazards. In this article, we will tell you all the things related to HIPAA, so continue reading.

HIPAA requirements have far-reaching implications, not only for health care professionals in hospitals, clinics and dental practices but also for providers who have access to personal health information such as call center agents, medical device providers and insurance workers.

It has also been observed that over the years, law enforcement has not been strict, with some penalties imposed on companies that do not meet HIPAA privacy and security requirements for handling patient data.

However, all this is slowly changing, and the companies that come under the HIPAA Act have been subjected to strict audits and heavy fines by the government.

If you work in an environment where there is a need to understand HIPAA guidelines and policies, here are 3 ways to quickly get on the right track to HIPAA compliance.

Here are 3 Steps to HIPAA Compliance

First, you need to assign a HIPAA Compliance Officer. Keep in mind this person must have completed a HIPAA compliance training course and be responsible for maintaining and enforcing HIPAA requirements.

You must also ensure that all staff members understand HIPAA provisions and policies as they may impact your company.

You also need to understand that ongoing staff training on HIPAA requirements must be made available to all employees. Training should be customized based on the level of access to patient data the staff member has.

Make sure all patient data is present in good security. Only authorized personnel should be allowed access to information and records.

Computer systems containing sensitive data should be tightly controlled and loaded with up-to-date antivirus software. All electronic data should be backed up regularly in order to avoid any damage.

If you follow all of these steps it will generate a framework to make sure that all HIPAA requirements are met.

Well, the most significant part of this process is choosing a HIPAA compliance officer & ensuring that he or she receives the best HIPAA requirement training.

If HIPAA compliance training is important to your company, following these simple steps will assist you to guide your workers. There will be a framework to equip you with all the information needed to comply with HIPAA requirements.

Know what are the main components of HIPAA?

HIPAA health insurance reform

This component protects health insurance coverage for persons whose jobs have either been lost or changed.

It prohibits group health plans from denying coverage to persons with particular diseases and pre-existing conditions, & setting lifetime coverage limits.

HIPAA Administrative Simplification

 It directs the US Department of Health and Human Services (HHS) to set up general standards for the processing of electronic health care contact.

It also needs health care organizations to apply secure electronic access to health data and to be in compliance with the privacy system set forth by HHS.

HIPAA tax-related health provisions

 This rule contains tax provisions & guidelines for medical care.

Application and enforcement of group health plan requirements

It defines further health insurance improvement, including provisions for persons with pre-existing conditions and those seeking continued coverage.

Revenue offset.

This includes life insurance taken by the corporation and your U.S. tax for income tax purposes Including provisions for the management of those who have lost nationality.

In healthcare sectors, complying with HIPAA Title II is what most individuals mean when they refer to HIPAA compliance. Also recognized as Administrative Simplification Provisions, Title II comprises the following HIPAA compliance needs:

  • National provider identifier standard

 All healthcare entities, including persons, companies, health plans & healthcare services, should have a unique 10-digit National Provider Identifier Number, or NPI.

  • Transactions and code sets the standard

 Healthcare organizations should follow a standardized method for electronic data interchange (EDI) for submitting & processing cover claims.

  • HIPAA Privacy Rules

Officially recognized as the Standards for Privacy of Personally Identifiable Health Information, this rule establishes nationalized standards for the safety of patient health information.

  • HIPAA safety rules

The Security Standards for the Protection of Electronically Protected Health Information (ePHI) set standards for patient data safety.

  • HIPAA enforcement rules

 This law establishes guidelines for investigating HIPAA compliance violations.

Who needs to comply with HIPAA?

Do you know if you are HIPAA compliant or who really should? Many people do not understand the answer to any of these questions. But you need to know the answer so that you can decide whether it applies to your company.

So let’s start with what exactly HIPAA is. It is mainly the protection of electronic health data or ePHI. This protection protects this information in three different ways.

Here’s what it offers:

1. Privacy – This rule means that ePHI will be accessible only to those who are authorized to view it.

2. Integrity – This rule will protect information from being altered or destroyed without prior authorization.

3. Availability – This rule ensures that only authorized people are given access as they need it more.

Hopefully, now that you understand a little about the purpose of HIPAA, you need to understand what this law affects.

Those that must comply with HIPAA are:

1. Health plans – These are individual or group insurance plans that provide or pay for the cost of health care.

2. Health Care Clearing Houses – These are entities that are responsible for processing health care transactions for other entities.

3. Covered Health Care Providers – These are providers of medical or other services and supplies for health care that transmit health information electronically.

4. Business Associates – Business Associates were included in this Health Care Protection Rule on February 17, 2010. They must follow this rule as if they too are a covered body.

To help you recognize more about what business associates are by this term; they are a person or organization that is an associate of the entities involved other than a workforce that offers services; or who assists covered entities & who also has access to confined health information.

If you want to totally understand HIPAA, you must take the time to do your homework on it.

If you are someone who is covered under this security protection rule, you must not delay as this protection plan is already in place and you want to ensure that you are complying with it so that you do not get into any legal trouble to avoid getting trapped.

Now that you understand what it means to be HIPAA compliant & who it affects, you can effortlessly see why it’s so important.

Make sure you understand everything about this safety rule If it affects you can be certain that you or your company is following it at all times.

What are the 4 standards of HIPAA?

HIPAA is intended to regulate the way all health care organizations automatically exchange sensitive patient data & to protect patients from unofficial disclosure of their medical records (whether document or electronic).

Under HIPAA, there are particular standards that all health care businesses are needed to adhere to.

These standards comprise an Administrative Simplification Title that is aimed at stopping health care fraud and abuse.

Within this title, there are numerous laws & proposed standards counting Electronic Health Transactions Standards, Privacy & Confidentiality Standards, Unique Health Identifiers, and Security & Electronic Signature Standards.

These HIPAA laws & standards directly apply to the different groups of health care entities:

  • Health plans,
  • Public and private payers,
  • HMOs,
  • Medicare,
  • Health care insurers,
  • Medicaid,
  • Group health plans,
  • Health care clearinghouses,
  • Somebody that facilitates the processing of non-standard formatted health information and Should convert the non-standard data into
  • Standard transactions, or associate versa,
  • Health Care Providers,
  • Providers who convey health information automatically,
  • Providers who receive individual health information, &
  • Providers who automatically sustain health information are used in electronic transmissions between entities.

Standard #1: Facility Access Control Limits a person’s physical access to ePHI and where it is located.

Establish emergency operations to sustain physical safety and appropriate access as a result of a disaster or emergency.

Make a facility security plan that documents the safety measures that protect the facility and ePHI from illegal physical actions

Have access control & validation actions in place to control & validate access based on a person’s role or utility

Standard #2: Workstation Use and lenient behavior of such must be addressed and accepted. This helps Covered Entities make sure their employees’ workstations are actually and virtually safe.

Standard #3: Workstation Security should also be addressed to identify how the workstation will be physically protected from illegal users.

Standard #4: Device and Media Controls need that any item storing electronic information should be properly handled, documented, saved, disposed of & accounted for.

What is not protected under HIPAA?

Isn’t that considered PHI? Please note that not all individually identifiable information is counted as PHI. For instance, employment records of a covered entity that is not linked to medicinal records.

Similarly, health data that is not shared with a covered body or can be individually identifiable does not count as PHI.

A Simple Test for PHI

If the device or application stores, records or transmits a user’s individually particular health data to any Covered Entity, you are dealing with PHI and, so, necessary to conform to HIPAA Is.

If you are building wearable devices or applications that can effortlessly collect health information but do not share health information with a covered entity at some time, you do not need to be HIPAA compliant.

For instance, the Nike Fuel Band (it’s a health band) doesn’t really track data that are measured as protected health information or PHI because you can’t transmit that necessary data from the device to some covered unit.

HIPAA Checklist

A number of websites offer guidance in achieving compliance with HIPAA rules. HHS has issued common rules to assist CE in data management of their electronically protected health information (ePHI).

Mainly, health care entities should protect the privacy of ePHI throughout the creation of digital documents & through their maintenance and conduction, and guard all data from access and change by unofficial parties.

All workforce entities working with health care management are necessary to sustain compliance with these fundamentals and make sure that all employees comply with HIPAA guidelines.

A business or complex entity should ensure that all of its components are in compliance with HIPAA, not just the corporation or health care group’s administration.

FLEXIBILITY

Health care providers differ in size & scope. HIPAA is flexible in the sense that size, level of infrastructure, cost & compliance risks are the criterion that decides the extent of safeguards necessary.

Every health care unit will differ in the application of its fulfillment solution, although it needs to be emphasized that HIPAA regulation applies evenly to all CEs and all BAs, regardless of how they work.

A practical checklist

There are many specifications that can be added to some compliance checklist that assesses the application of HIPAA regulation for a specified practice or business, but the following are the supreme basics that organizations must look for.

To decide what a health care provider must do to comply with HIPAA, one should usually evaluate these factors on a constant basis:

  • Has there been a hazard study of some of the EPHI agreements?
  • Has there been a handling or mitigation plan intended to address the risks or vulnerabilities recognized in the risk analysis?
  • Have policies and processes been established for the completion of safety measures for the provider’s records?
  • How will a supplier determine when a record has been breached & require intervention by a compliance officer?
  • Who will be responsible for preparing the provider’s personnel for HIPAA rule compliance? When and how must the training be done?
  • How will safety protections be monitored & amended as new threats to safety develop?
  • What kinds of sustainable compliance solutions are accessible for your organization?

HIPAA Compliance Certification

Being HIPAA certified means that you have effectively finished a course designed to educate and teach the information needed to allow your business or organization to turn out to be HIPAA compliant.

This does not mean that you are compliant, but that you have also been trained in the terms of the Health Insurance Portability and Accountability Act and the familiarity required to implement them in your organization.

Remember that no institution is presently accredited by HHS with a satisfactory certification, so you must do your research when seeking a good training corporation.

To become HIPAA certified you should take HIPAA certification courses, and there are several such courses accessible, both online and offline, yet none are renowned by HHS as of 2015.

Online courses are particularly suitable because they can be taken when you are flexible.

You can also experience HIPAA certification training in particular aspects of the Act, ranging from a holistic understanding of its common, requirements, to training in the particular regulations covered by the Act, such as those associated with security, authority and auditing.

It helps to teach specialists who will eventually be responsible for managing these features of HIPAA in their health care units or organizations.

It is not just organizations that are directly associated with HIPAA who should receive HIPAA certification training, but also those who do business with them.

Features of HIPAA Compliant Solutions

An easy and centralized compliance management solution makes sure that health care businesses’ compliance policies are compliant with HIPAA and HITECH rigid controls.

Most of these solutions are cloud-based which can be tailored as per the business requirement & are accessible on demand. Major features of these compliance management solutions comprise:

• Immediate real-time reports on the health care business’s risk position.

• Much simpler deployment and administration while reducing the time & cost necessary to stay compliant.

• Incorporation capabilities to manage compliance for business contacts and vendors

• Simple adaptability and teamwork capabilities with all other frameworks so making the environment more protected

HIPAA compliance examples

The Health Insurance Portability and Accountability Act (HIPAA) of 1996 were passed to protect an employee’s health insurance exposure when they lose or adjust jobs.

It also has provisions to make sure the privacy and confidentiality of Protected Health Information (PHI). Here are some common HIPAA violation examples & scenarios.

HIPAA Violations by Nurses/Medical Personnel

There are several ways nurses or other medical workers can commit HIPAA violations. From not being cautious about where secret conversations are held to making social media posts in which patients might be identifiable, anybody who works with patients or in medical facilities should be very careful.

HIPAA Violations associated with Medical Records

The safety of medical records is serious business. HIPAA violations can effortlessly occur as a result of failing to correctly secure or store medical records.

Examples of Employer HIPAA Violations

While employers don’t give healthcare, they do handle documentation associated with group health insurance and medical records employees authorize their doctors to offer the company for specific purposes.

Conclusion

HIPAA compliance protects users’ data, ensuring their privacy and safety. To attain these goals, organizations must foster a security culture.

Conducting preparation workshops & implementing security awareness practices helps the employees integrate the most excellent practices.

Organizations must protect their network environment with safety tools. Software such as firewalls and endpoint security can secure the boundary from attackers.

In addition, monitoring & controlling access to the data is necessary to stop insider threats. With data breaches on the rise, compliance with HIPAA is not just a matter of regulatory needs, but of protecting the business and the users.