HIPAA Compliance 101

Whether you run a hospital or a small clinic, you need to be HIPAA-compliant. Problem is, the Health Insurance Portability and Accountability Act of 1996 is quite detailed and complicated. Failure to comply is a costly, serious offense, so it’s better to get a grasp of what HIPAA is all about. We hope this overview will ease your mind and make your transition to compliance less of a hassle.

What exactly is HIPAA?

The Health Insurance Portability and Accountability Act is the U.S. legislation that provides protection of sensitive patient data. Any person or company that handles protected health information (PHI) is required to ensure its security and protection from unauthorized eyes.

Who are covered by the HIPAA?

It is crucial to know if you or your business falls under any of the following:

  1. Covered entities — These specific entities include the following:
    1. Health plans — HMO, company health plans, health maintenance companies, Medicare, Medicaid, employers and schools who handle PHI when they enroll employees and students in health plans
    2. Health care clearinghouses — billing services and community health management information system
    3. Health care providers — physicians, surgeons, dentists, laboratory technicians, optometrists, as well as hospitals, clinics, nursing homes, and pharmacies
  2. Business associates of covered entities — These are vendors and subcontractors of covered entities who need to have a business associate agreement (BAA) with a HIPAA-covered entity in order to remain compliant. One of the most common HIPAA violations is the lack of a BAA.

Business associates include data transmission providers, data processing firms, data storage or document shredding companies, electronic health information exchanges, medical transcription services, medical equipment companies, consultants hired for audits, coding reviews, and the like, and external auditors or accountants.

Seven elements of an effective HIPAA-compliance program

The Office for Civil Rights (OCR) came up with seven elements to make sure that entities under HIPAA cultivate a culture of compliance. Luckily, you don’t need a crash course in the finer details of HIPAA to be able to fulfill their requirements. A managed service provider (MSP) like Spectrumwise has the experience and expertise to provide healthcare IT support to companies in and around Charlotte, NC that need to be HIPAA-compliant:

#1 Implement policies, procedures, and standards of conduct

An expert MSP will make sure that your business follows the four general rules of HIPAA:

  1. HIPAA Privacy Rule — This safeguards the privacy of a patient’s personal health information and sets rules on the use and disclosure of such information. These rules give patients the right over their health information, including obtaining copies, making corrections, and ensuring their information is not shared without their consent.
  2. HIPAA Security Rule — This pertains to the numerous technical, physical, and administrative safeguards that need to be in place in order to ensure the integrity and confidentiality of PHI. Such safeguards include access control, authentication, workstation security, data storage and backups, and other security measures.
  3. HIPAA Enforcement Rule — This provides in detail the numerous investigations, penalties, and procedures for hearings of HIPAA violations.
  4. HIPAA Breach Notification Rule — This details the requirements and procedures in case of a breach in the security of PHI, including notifying the entities affected by the breach, as well as the media and the public should the breach affect more than 500 patients.

#2 Create a compliance committee and designate a compliance officer

Together with the MSP, the officer and committee will take the lead in assessing, planning, and implementing the appropriate systems and procedures.

#3 Conduct regular training and education

Regular training ensures that all your employees are familiar with your HIPAA policies and are aware of the latest updates and changes with the regulations.

#4 Establish clear lines of communication

To ensure the proper implementation of policies and procedures, your company needs to have clear lines of communication, whether internally among your staff or externally with vendors and subcontractors.

#5 Monitor and audit internal processes

Constant systems monitoring and auditing is necessary to ensure compliance. Keep in mind that changes to your technology also mean your internal processes need to be adjusted accordingly.

#6 Ensure everyone knows the disciplinary guidelines

All pertinent staff members should know what the penalties for HIPAA violations are, so that they take compliance seriously.

#7 Enforce disciplinary action promptly

When HIPAA rules are violated, consequences should be carried out swiftly and fairly.

Being HIPAA-compliant is a complicated task. The OCR does not distinguish between a 1000-bed hospital or a single-physician practice, and in their eyes, having third-party consultants is not enough to ensure complete compliance. But rest assured, Spectrumwise is committed to meeting and even surpassing OCR’s standards in HIPAA-compliance. Contact our experts today, and see how our customized services, including data backup and IT consulting, can help you.


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