Healthcare providers, health plans, healthcare clearinghouses, and their business associates who handle protected health information (PHI) must comply with the requirements of the Health Insurance Portability and Accountability Act (HIPAA) and the Health Information Technology for Economic and Clinical Health Act (HITECH). Some of the key requirements for compliance include:
- Privacy Rule: The HIPAA Privacy Rule requires covered entities to protect individuals’ PHI by implementing administrative, physical, and technical safeguards. Covered entities must also provide individuals with a Notice of Privacy Practices that explains their privacy rights and how their PHI may be used and disclosed.
- Security Rule: The HIPAA Security Rule requires covered entities to implement reasonable and appropriate safeguards to protect electronic PHI (ePHI) from unauthorized access, use, or disclosure. Covered entities must also conduct periodic risk assessments, implement security policies and procedures, and provide workforce training on security awareness.
- Breach Notification Rule: The HIPAA Breach Notification Rule requires covered entities to notify affected individuals, the Department of Health and Human Services (HHS), and, in some cases, the media, if there is a breach of unsecured PHI.
- HITECH Act: The HITECH Act requires covered entities to implement additional safeguards and requirements related to the use of electronic health records (EHRs). For example, covered entities must provide individuals with an electronic copy of their PHI upon request and implement audit controls to track who has accessed ePHI.
Overall, to ensure compliance with these requirements, covered entities must have policies and procedures in place that address HIPAA and HITECH requirements, conduct regular training for employees and workforce members, and perform regular risk assessments to identify and address potential security risks. Failure to comply with these requirements can result in significant penalties and fines.
Breach Notification Under HIPAA And HITECH
A breach is the unauthorized acquisition, access, use, or disclosure of PHI that compromises the security or privacy of the information. Covered entities must conduct a risk assessment to determine if a breach has occurred, and if so, they must provide notification as required by the Breach Notification Rule.
The timing and content of the notification must comply with specific requirements. Covered entities must provide notification to affected individuals without unreasonable delay and no later than 60 days following the discovery of a breach. The notification must include a brief description of the incident and the types of PHI. The steps individuals should take to protect themselves from potential harm. A brief description of what the covered entity is doing to investigate and mitigate the breach, and contact information for individuals to ask questions and receive additional information.
Penalties For Violations
HIPAA violations can result in penalties ranging from $100 to $50,000 per violation, with a maximum of $1.5 million per year for identical violations. The HITECH Act increased the penalties for HIPAA violations and also mandated audits of covered entities and their business associates.
The HITECH Act established four tiers of violations, with penalties ranging from $100 to $1.5 million per violation.
The tiers are as follows:
- Tier 1: A violation where the covered entity did not know and could not have known of the violation. Penalty: $100 to $50,000 per violation.
- Tier 2: A violation due to reasonable cause and not willful neglect. Penalty: $1,000 to $50,000 per violation.
- Tier 3: A violation due to willful neglect, but the violation is corrected within 30 days. Penalty: $10,000 to $50,000 per violation.
- Tier 4: A violation due to willful neglect and is not corrected within 30 days. Penalty: $50,000 per violation.
Above all, it’s important for covered entities and their business associates to understand the potential penalties for non-compliance and take steps to prevent HIPAA and HITECH violations. By complying with HIPAA and HITECH regulations, covered entities can help maintain trust in the healthcare system and protect patient privacy rights.
In conclusion, the Health Insurance Portability and Accountability Act (HIPAA) and the Health Information Technology for Economic and Clinical Health Act (HITECH) are critical pieces of legislation that set the standard for safeguarding protected health information (PHI) in the healthcare industry. Violations of HIPAA and HITECH can result in significant penalties, so it’s essential for covered entities and their business associates to understand the requirements and take appropriate steps to prevent non-compliance. If you are looking to implement any of the Infosec compliance frameworks such as SOC 2 compliance, HIPAA, ISO 27001, and GDPR compliance, Impanix can help. Book a Free consultation call with our experts or email us at [email protected] for inquiries.