You haven’t been in the medical business long if you haven’t realized that HIPAA compliance is a big deal. If you don’t take extreme precautions with your patients’ personal medical information, you put yourself and your practice at major risk of getting sued- and for a good reason.
Personal health information in the wrong hands can spell disaster, so it’s essential that you know exactly what it takes to meet HIPAA compliance with every patient that you seek.
But first, let’s get back to the basics of this frequently misunderstood health policy.
What Does HIPAA Stand For?
HIPAA stands for the Health Insurance Portability and Accountability Act, and it’s a federal law that was passed by Congress in 1996 during Bill Clinton’s presidency. Originally, HIPAA was designed to protect employees in the midst of job changes to ensure that they could keep their health insurance.
Since then, however, the policy has expanded to protect a much more significant percentage of medical information, and the system especially monitors the spread of digital data between different medical practices and insurance companies.
At present, the HIPAA act contains five sections.
Title I: HIPAA Health Insurance Reform: protects health insurance for individuals who change jobs.
Title II: HIPAA Administrative Simplification: Allows the U.S. Department of Health and Human Services to establish national standards for electronic healthcare transactions.
Title III: HIPAA Tax-Related Health Provisions: Includes all tax-related provisions and regulations for healthcare.
Title IV: Application and Enforcement of Group Health Plan Requirements: Defines health insurance reform in greater detail and includes provisions for patients with pre-existing conditions.
Title V: Revenue Offsets: details how federal taxes impact company-owned life insurance.
Who Enforces HIPAA?
HIPAA is legislation from the federal government, meaning that its policies and provisions are enforced by a branch of the U.S. Department of Health and Human Services called the federal Office for Civil Rights (OCR). The OCR is responsible for upholding HIPAA regulations and has the power to sue medical practices for Privacy Rule violation, a right not granted to private citizens.
Through the HIPAA Privacy Rules, the OCR monitors a large number of medical businesses, including hospitals, clinics, nursing homes, urgent care centers, health insurance providers, government-funded healthcare plans, and healthcare clearinghouses. What they don’t cover are private employers, life insurance companies, and school districts.
Understanding HIPAA Compliance
Knowing what HIPAA means and understanding how to comply with its policies legally are entirely different situations. Often, medical practices are incredibly confused by HIPAA and unsure how to avoid getting sued for negligence. In fact, many doctors and hospitals are spending enormous amounts of money to comply with HIPAA in an attempt to offset their risk. However, there are better ways to be HIPAA compliant.
In essence, becoming HIPAA compliant requires that you protect the privacy and security of all protected health information (PHI) of your patients. This requires following four HIPAA rules:
- HIPAA Privacy Rule
- HIPAA Security Rule
- HIPAA Enforcement Rule
- HIPAA Breach Notification Rule
These four categories provide comprehensive coverage of all the ways that health information is used and shared between medical practices and their patients. Complying with these regulations covers issues like knowing what health information to pass on to insurance companies and outside medical practices, and what can only be shared through formal consent from the patient.
Legally following HIPAA regulations is critically essential for any healthcare company that doesn’t want to be sued out of existence, which is why creating a HIPAA checklist for your medical practice is so beneficial.
Following a HIPAA Security Checklist
The goal of a HIPAA security checklist is to make it second nature for all your employees to comply with HIPAA regulations with every patient. Failing to comply with HIPAA regulations often results in substantial fines or even criminal charges and civil action lawsuits, so these aren’t regulations to mess around with. Ignorance of HIPAA rules isn’t considered justification for failing to follow them, so it’s vital to follow checklists to ensure that every base is covered.
Ideally, these checklists will give detailed coverage for the protocol for a variety of procedures, like how to request formal consent, the best policies for sending secure health information to different entities, and how to safely store medical information in electronic formats.
There are numerous resources available for sale on the web for creating or following a HIPAA security checklists, but it’s important to pay attention to the dates because the Security Rule is subject to periodically being amended, which might make your compliance strategies out of date. For this reason, it’s important to regularly review the current rule requirements to ensure you stay up to date.