Breaking Down HIPAA-Covered Entities
The Health Insurance Portability and Accountability Act is the U.S. version of Canada's healthcare legislation. It requires covered entities, like hospitals or doctors, to maintain certain levels of privacy and security on patient information.
This article will cover a short HIPAA Guide for businesses and individuals as well as the security rules to prevent violations.
What Are the Covered Entities Under HIPAA?
HIPAA protects patients in the treatment setting by imposing strict technical safeguards for electronic privacy and security and record-keeping requirements for all disclosures from patients' records of protected health information (PHI) to covered entities. It also grants patients rights to their electronic health records.
A Health Care Provider
The first covered entity is any health care provider-like doctors, hospitals, or clinics that interact with patients. That means they must follow HIPAA rules to protect your data and keep it safe from unauthorized use or disclosure. HIPAA regulations also apply to billing services and pharmaceutical companies.
A Health Plan
A Health Plan is a covered entity that includes medical insurance, health maintenance organizations (HMOs), and managed care organizations. Therefore, HIPAA regulations are also applicable to health plans.
A Health Care Clearinghouse
A Healthcare Clearinghouse is a covered entity responsible for processing any medical claims data electronically. A clearinghouse can be any organization that stores or transmits important healthcare data electronically, such as electronic billing records, electronic prescription records, and specific clinical quality measures.
HIPAA Security Rules
The HIPAA Security Rules refer to a protocol used to ensure that any electronic data is protected from hackers or unauthorized use. It lays out how health care providers and organizations should store, handle, or protect their patient's health information.
The Privacy Rule
HIPAA's Privacy Rule is designed to protect the privacy of personal health information, which is any information that relates to an individual's past, present or future physical or mental health and condition. This includes things like medical records and billing statements.
HIPAA's Security Rule refers to a protocol used to ensure that any electronic data is protected from hackers or unauthorized use. It lays out how health care providers and organizations should store, handle, or protect their patient's health information.
The Security Rule generally states that any business with your medical records must take "reasonable" steps to protect your data from being stolen, disclosed, or used without permission. Those reasonable steps are defined in more detail by the Security Rule itself.
Breach Notification Rule
In addition to the HIPAA Security Rules, there are also HIPAA Breach Notification Rules in place. These rules require covered entities like hospitals to notify you directly of any breaches that have occurred-if coverage has been affected by the breach.
The HIPAA Breach Notification Rules contain a specific protocol for how providers should report any breaches. The protocol is designed so that patients will be notified as soon as possible and in a way that will minimize any negative consequences.
The HIPAA Administrative Simplification
The HIPAA Administrative Simplification Rule is a set of rules implemented to help streamline the process of transferring medical records between healthcare providers and insurance companies.
In part, the administrative simplification rule was created to help improve the efficiency of health insurance claims processing by ensuring that all parties involved are on the same page regarding patient information. The rule also helps to ensure that patients' privacy rights are protected by requiring specific actions from health care providers.
In conclusion, HIPAA is a complex issue and can be challenging to understand. It is important to remember that the rules depend on whether or not your business is considered a covered entity under HIPAA.
Consider with an attorney before making any modifications to your company if you're unclear whether it fits into this category. If you enjoyed this article and want more content like this, check out our blog now!