Write an article about how HIPAA (Health Insurance Portability and Accountability Act) is a law that affects the way health care providers and payers use personal health information. It was enacted to ensure that healthcare providers protect patients’ privacy, while still making sure they provide quality care. The best thing about it is that it’s enforced by both federal regulations and state laws-not just self-policing. If you’re interested in learning more, read on!
1. HIPAA’s Origins
Before HIPAA was enacted, health care providers and payers (insurers) had to decide which information was relevant when looking through patient records. This could lead to some serious consequences like misdiagnosis or insurance fraud if they didn’t catch this mistake soon enough. With the introduction of getting a certificate, the HIPAA made sure that there were clear rules for handling patient data – no more fishing for information that could be used to improve care. It also made sure that patients had a say in how their data was used and who could see it.
HIPAA compliance is mandatory for any healthcare provider or payer who deals with protected health information (PHI). PHI is any information that can identify a patient, including name, Social Security number, date of birth, and address.
PHI can be shared with other healthcare providers if it’s needed to provide treatment or coordinate care. Otherwise, PHI must be kept confidential.
2. How to Comply with HIPAA
There are a few ways to make sure your organization is HIPAA compliant:
– Comply with state laws that are stricter than HIPAA
– Sign a business associate agreement with any outside company involved in patient care (like an EMR provider, billing service, or lab)
– Hire a security expert to audit your organization’s systems and procedures for keeping PHI secure.
HIPAA also requires healthcare providers to have employees who are trained on how to handle PHI. The HHS offers free training on their website. There are four levels of training: physical safeguards, electronic safeguards, administrative safeguards, and transmission security.
This is the first step you must take if you want to become HIPAA compliant. You’ll learn more about this next!
3. When Does HIPAA Apply?
The following diagram shows who must be HIPAA compliant. You’ll notice that many are associated with the patient’s care, but payers are also included.
HIPAA applies to health plans, healthcare clearinghouses, and any healthcare providers who conduct financial transactions electronically. This includes physicians, hospitals, pharmacies, laboratories, insurance companies, medical device manufacturers, billing services or coders, medical supplies companies or suppliers, home healthcare agencies, physician practices (not individual practitioners), ambulatory surgery centers, dental offices*, group homes that provide an overnight service for 5+ children under age 18 (*this requirement may apply under certain circumstances), outpatient rehabilitation facilities (e.g., physical therapy).
4. What Is HIPAA Enforcement?
There are two ways that HHS can find out if an organization is HIPAA compliant. First, health plans and healthcare clearinghouses are required to provide a “Security Report” every year. They must also report certain types of security incidents to HHS within 7 business days.
Second, the HHS Office for Civil Rights conducts compliance audits at least once every three years for larger organizations. If they find any issues with your organization’s HIPAA standards, they’ll let you know right away so that you can fix them.
5. What Are The Consequences For Non-Compliance?
HIPAA violation penalties vary based on which type of violation it is. Some violations have a maximum penalty of $50,000 per occurrence, while others have a higher cap of $1.5 million per year. There are also criminal penalties for certain HIPAA violations. For example, if you knowingly access or disclose PHI without authorization, you could be fined up to $250,000 and imprisoned for up to 10 years.
It’s important to remember that noncompliance can also lead to loss of business. Many healthcare providers choose to partner with companies that are already HIPAA compliant, so if your organization isn’t in compliance, you may be missing out on some lucrative opportunities.
It’s important for any healthcare organization to be HIPAA compliant. A violation of these standards can lead to a variety of consequences, including fines and imprisonment. It is essential that your employees are trained on how to handle PHI correctly in order to avoid such violations. HIPAA compliance protects a patient’s data from being mishandled and ensures that patients have a say in how their information is used.
There are a few ways to become HIPAA, but the first step is always training your employees on how to handle PHI correctly. Compliance can seem daunting, but with the right resources, it’s definitely achievable. For more information, be sure to check out the HHS website.