HIPAA Compliance: Why HCPs Should Care

The Health Insurance Portability and Accountability Act (HIPAA) is a federal law enacted in 1996 to protect sensitive patient health information. These national standards shield said information from being disclosed to a third party without consent or knowledge

To implement the requirements of HIPAA, the HIPAA Privacy Rule was created. The Privacy Rule is a standard to address covered entities’ health information use and disclosure. Covered entities include individuals and organizations that have protected health information. A goal of the Privacy Rule is to ensure that each individuals’ health information is protected while still allowing for the flow of health information that’s needed to provide and promote high-quality health care. 

All in all, HIPAA’s mission is to protect the public’s health and well-being and permits important uses of information while protecting the privacy of the covered entity seeking care and healing.

Why should Healthcare Professionals be aware of HIPAA?

HCPs are one of many entities that are required to be compliant with HIPAA. Any individual or business that works in healthcare or with healthcare clients that require access to health data must be HIPAA compliant. This also includes any outsourced enterprise.

HIPAA compliance requires medical professionals to protect Protected Health Information (PHI). This includes any PHI stored electronically or physically through the use of appropriate administrative, physical and technical safeguards to ensure the information remains confidential. If a healthcare worker neglects to be HIPAA compliant and violates HIPAA provisions, they can receive two kinds of punishment. Most often, one will receive a financial penalty, and in severe cases, it can lead to criminal penalties and/or loss of license.

Penalties and fines are classified into four tiers:

  • Tier 1: The covered entity is unaware of and could not have realistically prevented the violation, but reasonable care had been taken to safeguard the PHI. This tier carries a fine between $100 – $50,000. 
  • Tier 2: The covered entity should have been aware but could not have avoided the violation, and it could not have been prevented with reasonable care measures. This tier carries a fine between $1,000 to $50,000. 
  • Tier 3: There is willful neglect of the HIPAA rules, and the covered entity must attempt to correct the violation. This tier carries a fine between $10,000 and $50,000. 
  • Tier 4: There is egregious neglect of the HIPAA rules leading to a violation, and no attempt to correct the situation has occurred. This tier carries a minimum fine of $50,000 with possible jail time.

So, how do I achieve HIPAA compliance?

HIPAA compliant networks mitigate the risk of violating HIPAA compliance laws. Financial or criminal penalties could arise for those who are not HIPAA compliant. When you join trusted, HIPAA-compliant networks, physicians and healthcare providers rest easy knowing they are not violating the Health Insurance Portability and Accountability Act.

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