HIPAA Compliance 101: What You Need to Know

As you may already know, there are several cybersecurity regulations targeting different industries. For healthcare organizations, one of them is Health Insurance Portability and Accountability Act (HIPAA). This regulation aims to ensure the privacy of protected health information (PHI). This regulation was first announced back in 1996, but just like any other standard, the technologies and the risks have changed drastically since then. 

This article will provide a basic guide on HIPAA regulation as well as explain why is it important for healthcare organizations and some third parties related to them. We’ll talk about the legal side of ensuring HIPAA compliance as well as the scope of the regulation. Remaining HIPAA compliant is critical to any healthcare organization, and we’ll see why in this simple guide. 

What Is HIPAA?

The Health Insurance Portability and Accountability Act (HIPAA) of 1996 is a US law that is legislated to ensure the privacy of protected health information of citizens. The regulation draws the legal framework on how to protect this information and ensure PHI is controlled solely by the patients. It also provides suggestions and to-do’s to help healthcare organizations set up the proper measures. 

HIPAA consists of two main parts: privacy and security rules. The privacy rule explains how PHI is stored, used, and shared. It also ensures that disclosing PHI is only possible with the consent of the patient so they have complete control over their personal information. The security rule, on the other hand, sets the standards for the technologies and hardware needed to protect PHI. Some of these requirements include authentication, data integrity, access control, and transmission security. 

The governmental bodies enforcing HIPAA are the US Department of Health and Human Services (HHS) Office for Civil Rights (OCR) and the Office of Inspector General (OIG). Since these have the capability to penalize organizations within their scope, non-compliance with HIPAA can result in monetary penalties from these offices or criminal prosecution.

Compliance Requirements

Privacy Rule

Privacy rule is a critical part of compliance since it handles the ways PHI is disclosed, used, accessed, and stored. It clearly states the express consent of the individuals before these activities. The main philosophy behind this rule is that HPI is the property of an individual as it is personal information, and the sole control of it belongs to them. Therefore, ensuring the privacy of the HPI is a mandatory step of compliance. 

Security Rule

HPI also has to be protected properly from the current digital threats; this means that the organization must have the means to fight cybercriminals. These means are both technical and physical. HIPAA suggests that trustworthy and known technologies be implemented into the networks where HPI is stored. 

Enforced technologies include authentication tools, technologies adopted to control access to sensitive data, or a robust system to encrypt this information when it is transmitted. If you don’t have a dedicated team to achieve this, you can get help from online solutions such as NordLayer offering these kinds of tools. 

Physical means correspond to the data centers of these organizations and the hardware set up in their offices. If that organization has remote workers, ensuring the physical security of their work devices can also be a great example of physical security measures. 

Breach Notification Rule

HIPAA regulation also set standards on how to handle a data breach even if all the measures we just talked about are taken. There are always risks no matter how secure your network is, so you need to know your responsibilities if HPI is breached. 

The breach Notification Rule enforces organizations to let patients know that their HPIs have been accessed without their consent. The timeline of this notification is stated as “prompt and without any unreasonable delays”, and definitely no later than 60 days after the initial breach. There is another aspect to this rule; if the breach affects more than 500 patients, the corresponding office and the press should also be notified about the breach.

Omnibus Rule

The Omnibus rule is set to ensure that the partners, contractors, and other third parties engaged with the healthcare organizations. Since there might be some knowledge transfer between these parties, they also have to ensure the security and privacy of the HPI they might have accessed. 

It is also stated in this rule that in case of any potential data breaches resulting from the wrongdoings of the business associates, the covered entities will be held responsible. In short, this rule enforces that even the associates and contractors have to do their risk assessments, implement required technologies, and keep their networks up to date in order to prevent breaches. 

HIPAA Enforcement 

Why does HIPAA compliance matter? This is a common question and it does have a very simple answer. Any healthcare organization that is not HIPAA compliant may be penalized by the authorities, and they may even receive criminal charges for this. 

The main body to enforce these regulations and otherwise penalize the organizations is the U.S. Department of Health and Human Services (HHS). In addition to the federal-level penalties, non-compliant organizations may also be charged by state authorities and receive monetary penalties. 

Enforcement of the HIPAA standards simply means that the organizations and their associates adopt the rules specified in the regulation and that they are capable of protecting HPI they store. Any violation of these rules will harm the compliance status and the above-mentioned organizations have the power to enforce them. 

But in addition to the legal issues, it is also important to consider the trust factor of the patients. HIPAA is not there to penalize organizations after a breach, its main purpose is to minimize the risks. If you are not compliant with HIPAA, your network will likely be more vulnerable to threats. Experiencing a data breach will also harm your organization with a ruined reputation and negative publicity. For this reason, we can say that HIPAA compliance also prevents potential business loss. 

Final word

Health Insurance Portability and Accountability Act (HIPAA) is a set of standards that is announced in 1996 to protect the health information of individuals. Health-related personal data is considered highly sensitive, so this act ensures its privacy and security by enforcing standards for healthcare organizations. 

The main goal behind this regulation is to state the technical, physical, and legal requirements needed to protect PHI, and act as a guideline for organizations. By being a federal law, it has the potential to result in penalties for non-compliant entities. 

HIPAA compliance is thus accepted as a mandatory practice throughout the healthcare industry, and understanding how it works is critical for both the organizations and the patients so they know their rights and responsibilities.


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