HIPAA requirements are a minefield for medical professionals. Not only are they complex, but even simple mistakes can result in costly fines. HIPAA regulations require providers, insurers, and payers to revamp internal guidelines and make extensive computer system changes to guarantee privacy compliance.
Getting into and staying in compliance has been costly to healthcare centers and practices, especially at a time when insurance reimbursements have been slowing down. In addition, a lot of staff time has been spent on educating employees on the new laws and ensuring they understand them.
The four primary HIPAA requirements include the Privacy Rule, Security Rule, Breach Notification Rule, and Enforcement Rule. The Privacy Rule establishes restrictions on uses and disclosures of patients’ Protected Health Information (PHI). It requires covered entities (healthcare providers, healthcare clearinghouses, health plans, and their subsidiaries) to obtain a patient’s authorization before using their PHI for treatment, payment, or for certain business activities like research or marketing.
Medical professionals must have a unique National Provider Identifier (NPI) for each of their patients to identify them in the system and on documents. It’s a 10-digit alphanumeric code, but it doesn’t contain any embedded intelligence and cannot be used to track or link an individual.
The Privacy Rule also limits the use of PHI for marketing purposes and requires all data to be securely stored and transmitted. To do this, the Privacy Rule mandates that covered entities have backup and disaster recovery systems in place. It also requires all employees to be trained on proper handling of PHI. Lastly, the Privacy Rule stipulates that all individuals must properly dispose of documents and records containing PHI by shredding or burning them.
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