Does your organization need to utilize HIPAA-protected information? If part of your duty includes processing or handling any patient-related data, you may unknowingly violate HIPAA, for which the penalties can be severe. The violation of HIPAA compliance results in significant fines of up to $1.5 million and imprisonment of around ten years, depending on the violation.
Report source: HIPAA Journal 2023
The sad fact is that penalties can occur as a result of what may seem like an honest mistake. Read on to learn more about why HIPAA compliance is important and the steps for achieving the regulation.
Significance of HIPAA Compliance for a Healthcare Organization
HIPAA (Health Insurance Portability and Accountability Act) is a federal law that provides standards to protect health information (PHI).
An organization that uses PHI should adhere to HIPAA rules to protect sensitive patient information. The three main rules are,
- Privacy rule that details how PHI can be used or shared. The rule ensures that the PHI is properly protected, while allowing it to be freely shared in the health-care ecosystem, for important uses.
- Security rule that details necessary stands and safeguards to be implemented to protect electronic PHI (ePHI) (i.e., PHI held or transferred in electronic form). It requires organizations to have reasonable and appropriate administrative, technical, and physical safeguards to protect e-PHI. As this rule doesn’t provide specific measures, you can implement safeguards (like access controls, audit controls, integrity controls, etc) proportional to the risk of your data processing activity.
- Breach notification rule that tells how to react and whom to inform if your systems or the systems of your third-party vendors have been breached. It requires organizations to notify patients and authorities in case of a breach.
What happens if you violate any of these rules?
Malicious entities could use PHI for,
- Marketing purposes such as advertising by targeting people with specific diseases.
- Scams by medical firms.
- Exploiting people who are going through a trial and selling false cures and medicines to them.
Therefore, there are huge penalties if you fail to comply with HIPAA compliance. And this will be on top of operational, reputational, and financial losses that come with a cyber attack.
Based on the seriousness of HIPAA violation, we can categorize the HIPAA violation into four tiers.
TIER 1: Unaware of the HIPAA violation and by exercising reasonable due diligence, would not have known HIPAA rules had been violated.
TIER 2: Reasonable cause that the covered entity knew about or should have known about the violation by exercising reasonable due diligence.
TIER 3: Willful neglect of HIPAA rules with the violation corrected within 30 days of discovery.
TIER 4: Willful neglect of HIPAA rules and no effort made to correct the violation within 30 days of discovery.
For each tier, the maximum penalty is $1.5 million.
What Do You Need to Do to Be HIPAA Compliant?
The following are the steps to achieve HIPAA compliance for your healthcare organization.
- Define the scope and applicability of HIPAA compliance in your organization by hiring a consultant who can help you with the entire process.
- You can Implement the controls by analyzing currently where your organization stands and where you want it to reach.
- Governance, Risk, and Compliance (GRC) tools will help with continuous monitoring of all the activities you need to do. You need to perform a risk analysis to determine what security measures are reasonable and appropriate for your organization.
- Get audited by the consultant.
Let’s deep dive into each of the activities in the risk analysis process:
- Security Management Process: You must identify and assess potential risks to PHI /ePHI, and implement security measures that reduce risks and vulnerabilities to a reasonable and appropriate level.
- Security Personnel: You must hire a security official who is responsible for developing and implementing security policies and procedures.
- Information Access Management: Authorize access to PHI/e-PHI by implementing policies and procedures for limiting access only to roles that require the data for performing their duties (role-based access).
- Workforce Training and Management: You must provide training for appropriate authorization and supervision of workforce members who use PHI/e-PHI for performing their responsibilities. You should train all workforce members regarding security policies and procedures with respect to PHI/e-PHI and must have and apply appropriate sanctions against workforce members who violate any of these policies and procedures.
- Evaluation: You should conduct a periodic assessment of how well the security policies and procedures meet the requirements of the Security Rule.
In conclusion, HIPAA compliance is of paramount importance for healthcare organizations, as it safeguards sensitive patient information and protects individuals from various forms of exploitation and harm. Failure to comply with HIPAA regulations can result in severe penalties, both in terms of fines and imprisonment, highlighting the critical nature of adherence to these standards.
HIPAA compliance involves a comprehensive approach, encompassing the Privacy Rule, Security Rule, and Breach Notification Rule. Healthcare organizations must define the scope of their compliance, implement necessary controls, and undergo regular audits and monitoring to ensure continuous improvement.
The risk analysis process, a fundamental component of HIPAA compliance, helps organizations identify and mitigate potential security risks to ePHI. This process involves security management, designating a security official, managing information access, providing workforce training, and periodic evaluations.
Ultimately, healthcare organizations must prioritize HIPAA compliance not only to avoid legal repercussions but also to protect patient data, maintain their reputation, and minimize the risk of cyberattacks. Embracing these standards is not just a legal obligation but a moral and ethical responsibility in the healthcare industry.
Frequently asked questions from our customers
- Is Hevo’s free trial HIPAA compliant?
We are HIPAA compliant, but we don’t permit the processing of PHI during free trials.
- Does Hevo provide a customized pricing plan other than a business plan for customers who would want BAA and HIPAA certificate?
No, Hevo provides it only for business plans, as there is a legal fee associated with it.
- How Hevo shows the RTA while processing PHI?
We have our uptime status page that shows timely updates on this.