HIPAA Compliance: A Complete Guide

Quick Summary: HIPAA compliance is an essential requirement for organizations in the healthcare sector. There are strict penalties for organizations if they fail to abide by this regulation. In this blog, we are going to deeply understand this regulation to know its significance. It will help you make the right decision to avoid legal actions or penalties.

Digital technology has become the backbone of every industry today and healthcare has not been left behind. Today, there is a wide range of digital platforms and solutions used by healthcare organizations, like EMR, telemedicine, websites, mobile apps, and more.

While the adoption of digital technology has made the healthcare sector more efficient, agile, and flexible, it has also made it susceptible to cyber risks. For sectors like healthcare that process highly sensitive data, ensuring compliance with industry standards and regulations is indispensable.

HIPAA is one of the most important compliances that organizations in the healthcare sector must abide by. This regulation establishes provisions that protect patient’s data, privacy, and confidentiality. It provides the rules and guidelines that help strengthen cybersecurity in healthcare.

Keep reading to learn more about HIPAA regulation and how your organization can stay compliant with it.

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What is HIPAA Compliance?

HIPAA (Healthcare Insurance Portability and Accountability Act) is a regulation governing organizations and institutions in the healthcare sector that manages protected health information (PHI). This law ensures that the sensitive information of patients is protected.

There are various standard rules and guidelines in HIPAA regulations that help protect patients’ data. It provides provisions for data privacy and security. Any entity that handles PHI is required to adhere to the rules strictly to avoid penalties and stay compliant with HIPAA.

There are different professionals, businesses, and other entities that are covered under the HIPAA compliance mandate. Especially, it involves those who offer medical treatment, accept payments, or conduct clinical operations.

Why is HIPAA Compliance Necessary?

Today, healthcare is one of those sectors that are prime targets of attackers. Plus, the average cost of data breaches in healthcare is the highest compared to any other industry, as per IBM’s DBIR. Furthermore, the cost rose sharply in the previous year.

Data breaches not only cause loss of sensitive data, but they also result in reputational damage and heavy penalties from legal authorities. Besides, a data breach incident in healthcare is a more sensitive issue that could cause serious legal and reputational damage to an organization.

When organizations adhere to HIPAA guidelines and rules, they ensure that PHI and PII (Personally Identifiable Information) are protected with proper security controls and measures. HIPAA compliance necessitates healthcare providers to ensure the privacy and protection of patients’ data.

Who Needs to Comply with HIPAA Regulations?

HIPAA security rules and guidelines apply to any entity that is involved in creating, receiving, transmitting, and maintaining protected health information (PHI) or electronic protected health information (e-PHI). So, it covers doctors, healthcare organizations, insurance companies, and other organizations doing the same.

Apart from this, associated businesses and third-party entities that process billing, those providing IT services, and transcriptionists also need to comply with HIPAA standards and regulations. Organizations that do not process e-PHIs, like restaurants and retailers, are not required to meet HIPAA compliance.

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Four Essential Rules to Ensure HIPAA Compliance

There are four important rules that cover diverse aspects and define the structure of compliance-related requirements. These rules are:

• The Privacy Rule
• The Security Rule
• The Breach Notification Rule
• The Omnibus Rule

Let’s discuss each of these rules in detail.

The Privacy Rule

The first rule is the HIPAA privacy rule which defines the national standard to safeguard the health data of individuals like medical records and other PHI. It also establishes the standard for privacy rights. The rule obliges covered entities to implement adequate security measures while maintaining or transmitting data in whatever format it is received, stored, maintained, or transmitted.

Apart from this, the rule puts limits on the usage and disclosure of such sensitive information, enforcing the prior approval of the concerned individual in this matter. There are many other rights of individuals described in this rule, such as the right to get a copy of PHI stored by a covered entity.

There are 10 essential rules to achieve compliance with the regulations, as mentioned in the HIPAA privacy rule checklist below.

• Create and introduce written procedures and policies.
• Get patient approval of the patient in case of certain disclosures of data.
• Appoint a privacy officer.
• Provide training to employees.
• Ensure adequate safeguards for PHI.
• Deploy a system to review and verify requests for PHI.
• Answer patients’ request to access PHI
• Notify patients when there is a security breach.
• Define protocols to share data with third parties and business associates.
• Set unique identifiers for groups and individuals.

The Security Rule

The next rule is the HIPAA security rule, which defines the standards that ensure the integrity, confidentiality, and availability of data or PHI. It is divided into three types of safeguards, as mentioned below.

• Administrative Safeguards
• Physical Safeguards
• Technical Safeguards

The HIPAA security rule checklist given below describes the ten essential guidelines to protect data and stay compliant with the regulation. Failing to comply with these rules results in HIPAA violations that attract heavy penalties and legal actions. Let’s check out the rules in detail below.

• Implementing policies and procedures to maintain and monitor the security of PHI.
• Conducting risk assessments to discover threats to PHI.
• Access to PHI must be restricted to authorized individuals with proper authentication.
• Data must be stored/transmitted securely with proper encryption.
• Employee training in HIPAA security policies and procedures.
• Creating a contingency plan to handle emergency situations affecting PHI.
• Creating an incident response plan.
• Conducting regular security audits.
• Performing periodic evaluations of security measures and procedures.
• Ensuring that third-party contractors and vendors follow HIPAA compliance.

The Breach Notification Rule

Every organization that maintains or handles PHI or e-PHI is required to meet the established rules under the breach notification rule. It also applies to organizations that are not covered by the privacy and security rules.

According to the breach notification rule, organizations must notify the breach of unsecured PHI to relevant individuals, federal agencies, and even the media in some cases. However, the organization has to decide if the breach is reportable to avoid unnecessary investigation and business disruption.

The Omnibus Rule

This new rule extends the reach of the HIPAA regulation to organizations that don’t fall under the covered entities. So, it applies to business associates and contractors that are not directly involved in processing patients’ medical information. The entities covered under the HIPAA regulation will be held responsible for the violation of this law by the non-covered entities.

Understanding the Role of Security Audit in HIPAA Compliance

When an organization meets HIPAA compliance requirements, it can be said to have strong security measures to protect patients’ data. However, achieving compliance with HIPAA requires a thorough assessment of your digital assets like web applications, APIs, networks, etc.

Hence, security audit plays a vital role in ensuring compliance with HIPAA as well as other regulations and standards. Regular security audits help you evaluate your assets for common security vulnerabilities and exposures to prevent potential data breaches.

Conducting security audits involves systematic steps to identify weaknesses that could make your assets, like web apps, APIs, and networks, susceptible to cyberattacks. It helps enhance overall security posture and enables your organization to fulfill the requirements prescribed by the HIPAA regulation.

Continuous security audits offer a proactive approach to cybersecurity. It means your organization can always focus on detecting and mitigating security risks instead of responding after a breach. This way, your organization can ensure optimal protection of patients’ data, adhering to HIPAA compliance.

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To Wrap Up

Data breaches are rising globally today and not only impact an organization’s reputation, but they also make them subject to strict legal actions as they have to adhere to various standards and laws. HIPAA is a crucial regulation for any organization operating in the healthcare sector.

Security and compliance audits can help identify gaps in your organization to avoid data breaches and align with HIPAA’s regulatory requirements. This process can be automated with ZeroThreat to continuously scan your assets for vulnerabilities and compliance issues.

As an AI-powered vulnerability scanner, it can deeply analyze your web applications and APIs to uncover vulnerabilities and mitigate complex security risks with 98.9% accuracy. It offers scheduled scanning that allows your organization to perform automated scans at regular intervals.

It provides detailed vulnerability and compliance reports to take prompt action. Get more information about it to know how it can help you mitigate cyber risks and stay compliant with regulations.