Healthcare providers and insurers are subject to strict guidelines called the Health Insurance Portability and Accountability Act (HIPAA), which governs how they handle confidential patient information. When providers engage with sensitive patient data, it's crucial to ensure the privacy of the patients. Although the majority of individuals are aware that medical records are confidential, many do not know why or how. Doctor’s offices and clinics, referred to as HIPAA Covered Entities, have unique rules regarding the privacy of client Protected Health Information (PHI), including the HIPAA Enforcement Rule.
What is HIPAA and the Enforcement Rule?
HIPAA is a United States law that was enacted in 1996 to provide data privacy and security provisions for safeguarding medical information. The law is made up of several unique rules and regulations that have been revised and added over the past 25 years, including the Enforcement Rule, Privacy Rule, Security Rule, Breach Notification Rule, Minimum Necessary Rule, and more.
The HIPAA Enforcement Rule is a set of regulations specifying how the Department of Health and Human Services (HHS) would assign blame and assess fines for healthcare providers who are found guilty of breaking any HIPAA standards after an inquiry and administrative hearing. The regulations were enacted on March 16, 2006, and infractions may result in fines of up to $100 per violation, with a yearly cap of $25,000.
What is Protected Health Information?
Protected Health Information, or PHI, is defined by HIPAA as any individually identifiable health information pertaining to a person's past, present, or potential future physical or mental state. PHI may also contain demographic data that is directly linked to such health data. This implies that any information gathered by a physician, hospital, clinic, pharmacist, or health plan is covered by HIPAA's protections. ePHI (Electronic Protected Health Information), or PHI that has been generated, acquired, maintained, or communicated electronically, is also included. If PHI is shared by a covered entity in violation of HIPAA standards, HHS may determine that the healthcare organization must pay for that violation (up to $100, or a yearly cap of $25,000).
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Who is Affected by the HIPAA Enforcement Rule?
Any organization that gathers, produces, or transmits PHI is referred to as a covered entity. Included are all healthcare providers, both private and public. This term encompasses urgent care facilities, medical clinics, and hospital outpatient divisions. The HIPAA Enforcement Rule only applies to covered entities, such as doctor's offices and clinics, because they are the ones who handle PHI.
To maintain compliance, organizations should also have a Business Associate Agreement (BAA) in place. A BAA is a contract that outlines the obligations of each party to the connection, including how PHI is protected.
A business associate is any organization that comes into possession of PHI during the course of work it has been contracted to perform on behalf of a covered entity. Business associates may include medical billing offices and insurance agencies, and are not liable under the enforcement rule because they generally do not handle PHI directly. However, they are still required to comply with other aspects of HIPAA, such as the Privacy and Security Rules, and can face other penalties for noncompliance.
How Does the HIPAA Enforcement Rule Impact the Healthcare Industry?
The HIPAA Enforcement Rule has increased the compliance burden on healthcare providers by requiring them to adhere to strict regulations regarding the privacy and security of protected health information. This includes implementing administrative, physical, and technical safeguards to protect against unauthorized access and disclosure of sensitive patient information. As a result, healthcare providers must invest in resources and training to ensure compliance with the HIPAA Enforcement Rule.
What is the difference between the security and privacy of Protected Health Information? Control over one's own personal information, including who sees it and how it is used, is a key component of privacy. Protecting personal information from harmful risks, such as data breaches, is what security is all about. A crucial aspect of privacy is having control over one's own personal information, including who can access it and how it is used. Security is all about shielding private data from risky situations like data breaches.
Maintaining Compliance with HIPAA Training
HIPAA compliance training is required for all executives, managers, employees, providers, administrative personnel, and anyone else who might be engaged in processing PHI on behalf of a covered entity. It is in everyone's best interest for new employees to take HIPAA training from the very beginning of an employment contract, even though it isn't technically required by law. To ensure HIPAA compliance, the training should include the acceptable uses and sharing of PHI, patient privacy, data security, internal privacy and security policies, and violation regulations, including the HIPAA Enforcement Rule. All of these policies are covered by EasyLlama's 100% online training.
With the help of an intuitive dashboard and engrossing courses, EasyLlama enables both covered entities and business associates to quickly satisfy the HIPAA training requirements for all personnel. HIPAA certification demonstrates to clients that your organization takes patient privacy very seriously, which is why EasyLlama also provides a printable certificate of completion to every trainee who completes our online HIPAA course. Certificates are available via our central dashboard where employers can easily access a bulk certificates export function, real-time tracking and progress reports, automatic employee reminders, management for different locations, and much more!
EasyLlama’s HIPAA training options include courses uniquely designed for covered entities, business associates, and state-specific regulations (TX and FL). Access our free course preview today to learn more about enforcing HIPAA standards in your organization.
