Folks working in the healthcare industry are legally obligated to follow HIPAA guidelines. HIPAA is required, and it’s important, but for those who aren’t familiar, it can be complex and confusing to grasp. Every company will have a specifically appointed HIPAA officer, but it’s still important for employees to understand the rules on an individual level. If you’re looking to learn more about HIPAA guidelines, we’ve outlined them below.
The Health Insurance Portability and Accountability Act (HIPAA) was passed into law on August 21, 1996. Since that point, HIPAA has set the standards for the exchange, privacy, and security of patients’ health information.
There are 5 main rules that define the policies and procedures healthcare entities must follow:
The HIPAA privacy rule is probably one you’re familiar with. In essence, this rule protects all medical information that is directly tied to a patient from being distributed to those outside of the need-to-know basis. Additionally, it gives patients the right to ask for and be granted access to their medical records when requested.
This rule gives HIPAA-covered entities information on how to handle, maintain, and distribute data. It also sets forth the different types of data security healthcare offices should have in place, including administrative, physical, and technical safeguards. If you’re serious about protecting your sensitive data, these tools will do the trick.
The omnibus rule, created in 2013, outlines the rules of HIPAA as they apply to business associates working with a healthcare business. Before this time, business associates were not included under the rules of HIPAA.
This rule requires HIPAA-covered entities to notify HIPAA officials if electronic personal health information (PHI) is breached. Companies must report both minor breaches (affecting less than 500 people) and major breaches (affecting more than 500 people). The protocol for reporting both types is different, so it’s important that you understand how to do so if you end up in this situation.
The enforcement rule gives the Department of Health and Human Services (HHS) and the Office of Civil Rights (OCR) the right to enforce HIPAA rules and investigate HIPAA violations.
Ideally, you want to be HIPAA compliant at all times. Being a HIPAA-compliant organization means your company is following all safety and security guidelines that protect sensitive health data. If you follow these steps, you’ll be in good shape to secure your spot as a trusted, HIPAA-compliant healthcare establishment.
To reach HIPAA compliance, businesses must formally document, distribute, and explain these policies to their employees. These policies should be communicated to the staff on a regular basis and updated as necessary.
When a new employee is hired, your company must train the new employee, making sure they fully understand the rules and regulations they must follow while being employed at your practice. HIPAA also requires that you hold training once a year, where employees can ask any questions they may have. In the end, they have to formally acknowledge that they understand the policies and procedures as they have been explained.
HIPAA requires all covered entities to hire a privacy and security officer to create, implement, and oversee policies. These officers can either be internal employees who are willing to take on the job or outside prospects. In their work days, they’re required to develop policies and distribute them across the company, stay up to date on any changes under HIPAA and adjust internal policies as needed while also scheduling and running training sessions within the organization.
According to the HIPAA security rule, your company needs to implement administrative, physical, and technical safeguards in order to be HIPAA compliant. The administrative safeguards generally include everything covered under the previous two sections. If you’ve developed and implemented your policies, you’re compliant.
Additionally, you need to monitor who physically has access to the facility where your PHI is stored. This means individual workstations and any other space that houses sensitive data. Finally, there should be electronic safeguards in place that limit the amount of data each user can see; every employee should only have access to the data they need in order to do their job.
Health and Human Services require all HIPAA-covered entities to complete annual audits of all company policies in place. This is an opportunity for your business to find any gaps in compliance and improve your business. If your business does find areas where compliance isn’t properly met, these issues need to be documented, along with plans to show how you’ll fix these violations.
If you’re working with business associates, you need a formal written agreement with them stating that they can and will protect all information that is shared with them. This agreement should be reviewed and updated each year to ensure it stays relevant to current business practices.
If your business experiences an internal breach, you’re legally obligated to report it to OCR. Reporting the breach doesn’t necessarily mean you’ll be fined, but not reporting the breach almost certainly puts your business in a bad position. That being said, your company is required to have a policy in place detailing how you’ll report a breach when it occurs.
It won’t matter that you’re following HIPAA compliance through and through if you don’t have those efforts documented. The OCR needs to be able to review formal documents detailing your policies and procedures, especially if there’s a complaint or violation. Making sure you keep everything documented and up to date is paramount to your success as a healthcare provider.
The bottom line is if you get caught up in an unintentional HIPAA violation, having documentation of your policies and procedures will prove to the OCR that you have done everything in your power to prevent such situations.
When you’re dealing with sensitive PHI, you can’t risk a data breach. That’s why you need non-emergency medical transportation scheduling software that safeguards all your data with encryption and advanced security measures.
If this is an investment you’re ready to commit to, we’d love to help you find the perfect system for you. At iSi Technology, we specialize in NEMT, NY Medicaid billing, and homecare billing software. Plus, every demo is free.
Reach out to our team and book yours today.
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