HIPAA, or the American Health Insurance Portability and Accountability Act of 1996, is a set of rules that medical providers must follow to ensure that all patients' charts, accounts, and records are handled correctly. While HIPAA covers all patient information, whether stored on paper or transmitted verbally, some rules apply only to electronic medical transactions. Because most medical facilities store, process, or transmit medical information electronically, they must ensure HIPAA compliance.
To comply with HIPAA, medical providers must give patients access to their medical records and allow them to correct any errors. Patients must also be informed about privacy policies and how their personal information will be used. HIPAA regulations have resulted in significant changes in the way many companies dealing with patient information manage their recording and billing systems.
What information does HIPAA safeguard?
HIPAA protects individually identifiable patient information, whether it is stored or transmitted on paper, orally, or electronically. HIPAA protects any information relating to a patient's health history or current conditions, payment for medical treatment, treatment history, or plans for future treatment, as well as patient identifiers. The patient's name, address, or social security number are examples of patient identifiers. If health information is not linked to a specific patient, it can be shared or disclosed at will.
HIPAA Compliance
Although HIPAA requires every covered entity to comply, the procedures are relatively flexible. Some HIPAA fulfillment providers are small, with only one physician in a single office. Other covered entities include health plans with offices across the country. Covered entities are responsible for examining their specific needs and implementing solutions that work for them when implementing HIPAA compliance.
Privacy
Covered entities must develop written privacy policies and procedures in accordance with HIPAA's Privacy Rule. These policies and procedures must be managed by an administrator. All covered entity employees must be trained in privacy policies and procedures.
Complaints
A contact person or team must be established by the covered entity to handle complaints and provide information about the entity's policies and procedures. If any use or disclosure of PHI violates the policies and procedures and has a negative impact, the organisation is liable for mitigating the damage.
Documentation
Everything, including privacy policies and procedures, complaints, and actions designated by the Privacy Rule, must be documented for six years from the last effective date. Organizations that use comprehensive, easy-to-use software to manage patient data should have more efficient recording procedures.
Entities Protected
The rules of HIPAA apply to health plans, healthcare providers, and healthcare clearinghouses that transmit protected health information, or PHI, electronically in connection with specific HIPAA transactions.
Health Insurance Plans
Health plans are groups or individuals who pay for medical care, such as health, vision, and dental insurance providers. A company is not a covered entity if it establishes and manages a group health plan for fewer than 50 employees. HIPAA regulations do not apply to community health centres.
Healthcare Professionals
HIPAA applies to all healthcare providers, whether they are large or small practises. Even if a healthcare provider uses a third party to transmit information related to a HIPAA transaction, the provider is still responsible for adhering to the regulations. The third party is referred to as a business associate and must also follow HIPAA regulations. Hospitals, dentists, chiropractors, and other practitioners who provide medical care in exchange for payment are examples of healthcare providers.
HIPAA Violation is basically a failure to comply with any of the HIPAA Rules and requirements.
This would include failing to comply with HIPAA Privacy Rule, HIPAA Security Rule, HIPAA Omnibus Rule, and the HIPAA Breach Notification Rule.
Keeping up with the HIPAA regulations is essential for any institute or organization that falls in the scope of compliance.
Failure to comply can be expensive with the HIPAA violation fines range from $100 to over $4 million.
There are two types of HIPAA violations – civil or criminal and each of them has a different fine structure that is explained below.
