HIPAA Privacy Regulations: Understanding and Complying with the Requirements

The HIPAA Privacy regulations establish federal standards to protect the confidentiality of personal health information and grant patients a number of rights with regard to that information, including the right to inspect and obtain a copy of their medical records as well as the right to request corrections.

Compliance with HIPAA privacy regulations is supervised by the Office of Civil Rights (OCR) of the U.S.,  Department of Health & Human Services (HHS).

HIPAA Privacy Rule

The Health Insurance Portability and Accountability Act of 1996 was passed to make it simpler for people to maintain health insurance, to set a minimum standard for the protection of private patient information, and to address vulnerable areas in the provision of healthcare and health insurance.

The most significant revision to the HIPAA compliance guidelines during the past 20 years was made on April 14, 2003, when it established a standard for what constitutes Protected Health Information (PHI).

The amendment defines PHI as any information that is stored by a business or healthcare facility and can be used to identify an individual or to represent their current health status, payment history, or healthcare services. PHI consists of demographic data like:

  • Names
  • Addresses
  • Phone numbers
  • Social Security numbers
  • Medical records
  • Financial information
  • Full facial photos

To give the linked individual control over their personal information, this HIPAA compliance definition was established. In this regard, before utilizing the prescribed data for marketing, fundraising, or research, healthcare practitioners and businesses that have PHI are required to obtain consent from the patient.

With this increased level of liberty, people could also decide to keep their medical information private from health insurance companies if their treatment is paid for out of pocket.

A federal norm for the protection of specific health information was established by the HIPAA Privacy Rule or Rules for Privacy of Personally Identified Health Information.

It’s vital to remember that business associates are not covered entities under the Privacy Rule; rather, covered entities are defined as health plans, healthcare clearinghouses, and healthcare providers.

To safeguard PHI from misuse or abuse, these covered entities must incorporate the Privacy Rule principles into their daily operations. Penalties may be imposed on a business for failing to comply with HIPAA on a civil or criminal level.

Now, the HHS is aware of the need for healthcare communication to ensure that a patient receives fast and thorough treatment, even if doing so increases the risk of PHI exposure.

There is a danger that some information will get lost because there are so many different settings in which healthcare treatment and processing can take place.

Hence, it is not necessary to completely eliminate all risks associated with an incidental use or inadvertent disclosure in order to comply with the HHS’s HIPAA compliance criteria.

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