What Is HIPAA Compliance and Why It’s Important

The Three Primary Rules of HIPAA

To further understand HIPAA, let’s look at its three main components:

1. Privacy Rule

The Privacy Rule is one of the key components of HIPAA. It governs how protected health information (PHI) can be used and disclosed. PHI is any information an organization can use to identify an individual, including everything from the name and address to medical records and test results.

The Privacy Rule sets strict limits on who can access PHI. For example, covered entities such as hospitals and insurance companies must get patient consent before using or disclosing PHI. In addition, the Privacy Rule requires covered entities to take steps to protect the confidentiality of PHI, such as storing it in a secure location or transmitting it using encryption.

The Privacy Rule also gives patients the right to access their PHI and request corrections of inaccurate or incomplete information. Finally, the Privacy Rule establishes penalties for covered entities that violate its provisions, including fines of up to $50,000 per violation.

2. Security Rule

The Security Rule establishes national standards to protect medical records and other personal health information held by covered entities. It requires covered entities to take reasonable measures to safeguard this information from unauthorized access, use, or disclosure.

One way to comply with the security rule is to implement physical safeguards such as locked cabinets and doors. This prevents paper-based information from being accessed by unauthorized individuals.

Covered entities must also ensure that only authorized personnel can access ePHI. For example, they might do this by using usernames and passwords, assigning unique identification numbers to each employee, or requiring employees to log out of the system once they’ve finished using it.

Covered entities must have procedures in place for responding to security incidents. This might include notifying law enforcement, conducting an investigation, and taking corrective action to prevent future incidents.

3. Breach Notification Rule

The Breach Notification Rule is part of the Health Insurance Portability and Accountability Act (HIPAA). Under this rule, HIPAA covered entities must provide notification following a data breach that compromises PHI.

Under the rule, healthcare providers and other covered entities must notify affected individuals, the Secretary of the HHS, and, in some cases, the media. The notification must be made without unreasonable delay and no later than 60 days after the breach is discovered.

A data breach occurs when there is unauthorized access, use, or disclosure of PHI. The incident compromises the privacy and security of any information that can be used to identify an individual. This information is created or received by a covered entity in connection with the provision of healthcare services. This includes information like names, addresses, birthdates, Social Security numbers, and medical records.

An example of a data breach would be if a hospital employee read the medical records of a patient without permission. If it was determined that there was a reasonable risk of harm to the patient as a result of the unauthorized access, then the hospital needs to implement the Breach Notification Rule.

The notification would include information about what happened and the steps the hospital takes to mitigate the risk of harm. Patients would then have the opportunity to take steps to protect themselves from identity theft, fraud, or other criminal acts that could result from unauthorized access to their PHI.