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For healthcare organizations and their business partners, the world of HIPAA compliance can be a confusing and intimidating place. While no one wants to be on the wrong side of an OCR audit, mistakes happen, and seemingly small slip-ups with compliance can quickly lead down an undesirable path of audits and fines. A skilled healthcare law attorney can help healthcare organizations successfully navigate the muddy waters of the HIPAA compliance world and provide the guidance needed to stay in compliance.
What is HIPAA?
HIPAA is short for the Healthcare Insurance Portability and Accountability Act. It was first passed by congress in 1996, and it has seen several revisions since that time. The essence of HIPAA is focused around achieving compliance in three areas: privacy, security, and electronic transmissions.
In the context that HIPAA requires, privacy places restrictions on who uses “protected health information” and how that information is shared. Protected health information includes any patient data that could be used to identify an individual. This can range from treatment dates to medication doses prescribed. Under HIPAA, this data must be protected and can only be shared in instances where the individual has given authorization, except when required by law. It also gives patients the right to request and copy their own medical records.
The security aspect of HIPAA pertains to how electronic protected health information, or ePHI, is cared for and guarded. This aspect ensures that the data is properly managed and is not accessed by unauthorized individuals. It requires that the organization has someone who is deemed responsible and accountable for compliance in this area. The organization has to retain the confidentiality, integrity and availability of ePHI in order to be in compliance with the security aspect of HIPAA.
All electronic transmissions of ePHI must be kept secure and follow HIPAA guidelines to remain in compliance with the law. This means that the transmissions need to be secured and cannot be sent to unauthorized individuals. When a billing company does work for a healthcare organization, they are then considered a business partner and must be HIPAA compliant as well.
Why is HIPAA Compliance Important?
HIPAA compliance is important for many reasons. First, by being HIPAA compliant, an organization is protecting data that is vital to its patients. It increases patient safety and instills confidence in the organization. In addition to this, compliance is important because it prevents organizations from costly information breaches and the associated fines.
In 2009, the HITECH Act was added to the HIPAA legislature. The HITECH Act had impact on the medical field in several ways. First, it made business partners accountable for HIPAA compliance. Next, it created regulations regarding how breaches and information disclosures must be handled. The regulations for breach notifications were clarified in the Breach Notification Rule.
The Breach Notification Rule clearly states when organizations must take action if a disclosure or breach has occurred. It also defines who the breach must be reported to. This can range from notifying individuals to notifying the press that a breach has occurred. Along with this, very specific timelines were specified for when notifications must take place.
These factors combine to create an environment that can be very tricky to navigate. Healthcare organizations want to ensure they report when required to, but they also need to take care to avoid over-reporting incidents that do not need to be reported.
What is the OCR?
The OCR is the Office of Civil Rights, a division of Health and Human Services. They are the governing body for overseeing HIPAA and HITECH compliance. They are the organization that has the right to audit healthcare organizations and their business partners and fine these organizations if they are out of compliance.
When breaches are reported, the OCR will often conduct an individual audit of the organization that was breached. This can result in having to follow corrective action plans and paying large fines.
How to get Help
The world of HIPAA compliance can be confusing, and a skilled healthcare attorney can potentially save organizations from over or under reporting costly breaches. It is hard to navigate the murky waters of HIPAA compliance, so it is best to use the services of an experienced and skilled healthcare law attorney.