The Health Insurance Portability and Accountability Act (HIPAA)
A monumental piece of legal history instituting protections for patient health information.
In today's unequally interconnected world, healthcare providers face a double-edged threat of delivering the highest quality of care while also protecting the sensitive information of their patients. The rise of electronic health records (EHRs), mobile health applications, wearable devices, and AI diagnostics, has put immense strain on the concept of data privacy in healthcare. It is essential for healthcare organizations to adhere to their legal obligations in order to protect the privacy of their patients.
This article will present a research-level breakdown of HIPAA: it's important aspects, the privacy and security rules, penalties for violations, and how Intelation's privacy-first, AI-enabled data privacy platform assists healthcare organizations in meeting their legal obligations via privacy-first technologies, automated audit trails, data access control, and encryption in real time.
What does HIPAA stand for?
A historically significant U.S. federal statute
HIPAA was passed in 1996 to enhance the portability of health care insurance coverage, combat healthcare fraud, and safeguard the security and privacy of protected health information (PHI).
- Healthcare providers (hospitals, clinics, physicians)
- Health plans (insurance companies, HMOs)
- Healthcare clearinghouses
- Business associates (third-party vendors that have PHI)
Protected Health Information (PHI)
HIPAA protects specific types of sensitive health information.
- Patient names and addresses
- Medical histories, diagnoses, and test results
- Social Security numbers
- Insurance information
The Four Primary HIPAA Rules
Provides national standards for the protection of PHI. It outlines how healthcare data should be collected, used, and disclosed by covered entities.
Key components include:
- Only the minimum amount of PHI that is needed should be accessed or disclosed.
- Right of patients to access and change their health records.
- Required notices of privacy practices (NPPs).
Establishes technical security and administrative safeguards to protect electronic PHI (ePHI).
Technical safeguards include:
- Access control (RBAC)
- Authentication
- Decryption and encryption
- Access control, including audit controls and activity logs
Requires covered entities and business associates to provide notification following a breach of unsecured PHI.
Key requirements include:
- Notify affected individuals within 60 days of discovering the breach
- Notify the Department of Health and Human Services (HHS)
- If the breach affects more than 500 individuals, notify prominent media outlets
Establishes procedures for investigations, penalties, and hearings related to HIPAA violations.
Key components include:
- Civil monetary penalties ranging from $100 to $50,000 per violation (up to $1.5M per year)
- Four tiers of violation severity based on knowledge and corrective action
- Authority of HHS Office for Civil Rights (OCR) to investigate and enforce compliance