HIPAA Assessment

Fines can be up to $250,000 for violations or imprisonment up to 10 years for knowing abuse or misuse of individual health information.

Information collected from an individual by a covered entity that relates to the past, present or future health or condition of an individual and that either identifies the individual or there is basis to believe that the information can be used to identify, locate, or contact the individual...and thus must be protected. PHI is a subset of PII.

Any healthcare entity that electronically processes, stores, transmits, or receives medical records, claims or remittances.

HIPAA Privacy Rule addresses appropriate PHI use and disclosure practices by healthcare organizations. The same rules, regulations and policies that regulate Privacy do not necessarily extend to the Security Rule. The HIPAA Security Rule revolves around safeguarding the systems that house or transmit PHI.

Every individual (office manager, doctor, etc.) is held responsible for health information they should, can, or do access. Individuals and companies can independently face criminal charges for mishandling PHI.

Basic rules regarding the use of PHI pertain to disclosures as well. Essentially, your practice may use and disclose PHI for your own TPO activities. The regulation also requires that you put in place policies regarding use and disclosure (e.g., who in your practice will be permitted to disclose PHI).\"

The civil penalties for noncompliance ranging from $100 to $250,000 and, in extreme cases, criminal penalties and imprisonment.

HIPAA regulation identifies two different types of entities that must adhere to the federal mandates.

Covered Entity (CE) : Organization that uses or creates PHI over the course of healthcare payment, treatment, or operations. That includes healthcare providers, healthcare clearinghouses, and health insurance plans.\"

Business Associate (BA) : Organization that is hired by a CE or another BA that will necessarily encounter PHI over the course of the work they have been hired to perform.

Both covered entities and business associates must be HIPAA compliant to protect any PHI they encounter.

All exchange of information between two parties to carry out financial or administrative activities related to health care are covered in HIPAA.

The new standards are being developed to protect the confidentiality, integrity and availability of individual health information. HIPAA requires that most providers and health plans take steps to keep medical information secure and confidential. There are four types of security standards :
●  Administrative Procedures - These ensure the enforcement of company-wide standards in regard to the handling and treatment of member information by employees.
●   Physical data safeguards - Ensures the protection of computers and buildings containing member information, from theft, invasion, or environmental threats.
●   Electronic data access security - Ensures only authorized people have access to member information, and that information is maintained for the required period of time.
●   Network security - Ensures the information is transmitted to and received by only the intended recipients, unaltered.

The Privacy Standard defines the requirements for the use and disclosure of protected health information. It establishes individual patient rights and defines protected health information. The Privacy Standard also requires covered entities to adopt policies for safeguarding such information.

HIPAA is the Health Insurance Portability and Accountability Act of 1996 that specifies laws for the protection and use of Personal (or Protected) Health Information (PHI) which is essentially your medical record. It ensures that no massive threat to health records and personal information, which are usually at risk of hacking, leaks, and unauthorised alteration takes place

In 2010, The Health Information Technology for Economic and Clinical Health Act (HITECH) released in 2010, was passed in order to update HIPAA rules and provided federal funds for deploying electronic medical records (EMR), also referred to as electronic health records (EHR). The HITECH upgrade was meant to reinforce HIPAA because medical records were now in digital form, and hence required new rules for protection and availability.

Considering an ideal scenario where the client closes the identified gaps in the stipulated time period, it would take 40-45 days to complete the assessment.

Any business entity that must by law comply with HIPAA regulations, which include healthcare providers, insurance companies, and clearinghouses. In this context, health care providers include doctors, medical, dental, vision clinics, hospitals, and related health caregivers.

The validity of an assessment is for 1 year.

Administrative Simplification is defined in the Title II of the Health Insurance Portability and Accountability Act of 1996.  The goal of administrative simplification is to reduce health care administrative costs and promote quality and continuity of care by facilitating electronic data interchange (EDI). HIPAA establishes standards for 10 electronic health care transactions, national code sets, and unique identifiers for providers, health plans, employers and individuals. It also establishes standards for ensuring the security of electronic health care transactions.