List of HIPAA Requirements (Find out Why is it Required)

Gowsika

Gowsika

Jan 14, 2024

HIPAA Requirements

HIPAA sets the national standard for the protection of sensitive health information. As a healthcare service provider, HIPAA compliance is crucial to demonstrate that your organization is aligned with the highest infosec standards. 

The penalties for HIPAA non-compliance are severe. When we say severe, it is not just monetary penalties, but also legal consequences. Additionally, your business gets listed on the Office of Civil Rights (OCR) Wall of Shame along with the violation details when non-compliance is detected. You can now imagine what that does to your brand reputation.

In this article, we have elaborated on all the HIPAA requirements you should consider to be HIPAA compliant.

What are HIPAA Requirements?

HIPAA requirements are a set of rules and best practices that healthcare providers and businesses should follow to protect patients’ sensitive data from unauthorized access.

Types of organizations that should comply with HIPAA

1. Healthcare Providers

2. Health Insurance Companies

3. Business Associates of covered entities

4. Research Institutions

5. Public Health Authorities

6. Care Facilities

7. Pharmacies

If you have more questions on whether you are a covered entity, we have a simple checklist for you to make the decision:

Here’s a video on HIPAA compliance checklist you must check out:

List of HIPAA Requirements

The exact compliance requirements vary as per the organization’s structure and method of operations. However, there are three primary requirements/rules that form the foundation of everything related to HIPAA compliance.

1. The HIPAA Privacy Rule

The HIPAA Privacy Rule focuses on patients’ right to privacy. Under this, healthcare providers and related entities must ensure the privacy and security of Protected Health Information (PHI), which includes names, addresses, medical records, financial information, social security numbers, contact information, etc.

PHI can only be used for treatment, research, payment, and legal purposes. Covered entities must get written authorization/consent from patients before using their personal data for any purpose other than the ones mentioned above. Also, PHI handlers should keep the information collected and stored to the bare minimum required to process said information.

Added to that healthcare entities should keep patients informed of their rights and how their PHI is being used. By doing so, patients will have greater control over their sensitive health information.

2. The HIPAA Security Rule

The HIPAA Security Rule focuses on protecting electronic Protected Health Information (ePHI) from being accessed, tampered with, copied, or destroyed by unauthorized entities. This rule standardizes the measures that ensure the confidentiality, integrity, and availability of ePHI.

To comply with the security rule, covered entities need to maintain three safeguards:

  • Administrative: Administrative safeguards are a major part of the HIPAA compliance requirements that establish security measures including risk assessment, implementing security controls, getting equipped to protect ePHI, and staff training.
  • Physical: Physical safeguards control access to the physical facilities where ePHI is stored. This includes implementing policies for securing the workstations, servers, routers, and devices through which ePHI can be accessed or transmitted.
  • Technical: Technical safeguards address the risks associated with technology. They essentially introduce policies for hardware, software, and technology that control the access to ePHI. Some examples include antivirus software, audit control, data encryption policies, etc.

Also check out: List of HIPAA encryption requirements

3. The HIPAA Breach Notification Rule

Nothing is completely secure—irrespective of how secure systems seem, there’s always a chance of a security breach. The breach notification rule addresses what to do when a breach occurs. The organizations must be ready with policies and plans to inform the public and specifically, individuals affected by the breach about what occurred and what to do next.

The HIPAA requirements under this rule include:

  • Notifying the affected individuals formally through mail or email about the data breach within 60 days of discovering the breach. (Find out how to send HIPAA complaint Gmail)
  • Posting a notice about the breach on the website for 90 days or notifying the public via a news broadcast (if the contact information of more than 10 affected individuals is not available)
  • Providing public notice about the breach through local news outlets (if more than 500 individuals are affected by a HIPAA breach)
  • Informing the Secretary of Health within 60 days of the discovery of a breach if more than 500 individuals are affected. If this number is less, then the organization can provide notice by the end of the year.

Also check out: HIPAA compliance checklist

HIPAA Requirements on a Strategic Level

HIPAA Requirements on a Strategic Level

Now that we understand the three pillars of HIPAA regulation, let’s sum up the requirements that can help you achieve HIPAA compliance.

  • Create and implement policies: The very first step in securing ePHI is to develop and implement efficient cybersecurity policies and standards. Administrative systems and workstations must follow HIPAA requirements while your staff is trained on policies. Policies will also have to be documented and distributed across teams.
  • Implement safeguards: To be HIPAA compliant, you need to implement the safeguards discussed above. They ensure the physical and digital safety of PHI. Only individuals and systems with authorization should be able to access ePHI.
  • Conduct risk assessments and internal audits: HIPAA requirements include conducting an annual risk assessment audit. This covers the administrative, physical, and technical aspects of the organization. Through risk audits, you can identify and patch the gaps in security and avoid penalties associated with non-compliance. (also check out a detailed article on HIPAA audit)
  • Report and investigate violations: Certainly, security breaches are inevitable, and when such violations occur, you need to act on them quickly. Affected individuals will have to be notified and a root cause analysis will have to be conducted to understand why and how the breach occurred. Then, you can work on the remediation and take further actions to resolve the issue and prevent it from happening again.

Also find out: How to implement HIPAA certification process

Why Do Organizations Need to Follow HIPAA?

Why Do Organizations Need to Follow HIPAA?

If you are in the healthcare industry, you need to comply with HIPAA because it is a federal law that mandates the protection of patients’ personal health information. But apart from being a federal compliance requirement, there are several ways HIPAA helps.

Avoid legal trouble

Failure to comply with HIPAA can result in significant penalties (civil and criminal fines). Also, your business can receive a ban from taking part in federal healthcare programs.

Maintain patient trust

Patients always trust hospitals and healthcare providers to keep their personal health information safe. HIPAA serves as a way to demonstrate your business’s ability to protect patient data.

Proper handling of patient information

HIPAA helps secure patient data by implementing administrative, technical, and physical security requirements. It provides patients with complete control over their medical data. Patients are empowered to request and correct their medical data and are notified when their medical data is disclosed.

Patient centricity and higher satisfaction scores

Patient information is sensitive and it should not land in the wrong hands. HIPAA compliance demonstrates a commitment to patients’ privacy. In the event of a cyberattack, HIPAA-compliant systems can contain data breaches and respond appropriately, thus improving the brands’ perception among its patients and thereby building higher satisfaction.

Well, it is quite clear that following HIPAA guidelines is beneficial for organizations in the healthcare industry. But what are the requirements that you should follow? Let’s check it out!

Also, it’s good to have a fair idea of certification cost as well, here’s a quick guide to HIPAA certification cost

Final Thoughts

On paper, HIPAA requirements might look straightforward to implement and follow. However, that is often not the case, as complying with a huge body of regulation can get overwhelming.

Sprinto helps you automate the compliance journey and breaks down the requirements into simple tactical steps that helps you achieve HIPAA compliance quickly. Get in touch with our HIPAA experts and kickstart your compliance journey today. Get started here.

FAQs

1. What are three HIPAA implementation requirements?

The three HIPAA implementation requirements under the HIPAA Security Rule. They are administrative measures that cover procedural security steps, physical measures that limit the access to ePHI, and technical safeguards that address risks associated with the use of technology. 

2. What is HIPAA’s minimum necessary requirement?

The minimum necessary standard requires covered entities to implement policies and procedures that limit unnecessary usage and disclosure of protected health information.

3. What’s the official definition of a Covered Entity (CE) under HIPAA?

A Covered Entity is any business entity that falls under the compliance mandate of HIPAA regulations. The covered entities include healthcare providers (hospitals, private clinics, etc.), insurance providers, and clearinghouses.

4. Is staff/employee training a requirement under HIPAA?

Yes, staff training is a requirement under the HIPAA Privacy Rule. Organizations need to ensure that proper training is provided annually to all employees on HIPAA’s best practices.

Gowsika

Gowsika

Gowsika is an avid reader and storyteller who untangles the knotty world of compliance and cybersecurity with a dash of charming wit! While she’s not decoding cryptic compliance jargon, she’s oceanside, melody in ears, pondering life’s big (and small) questions. Your guide through cyber jungles, with a serene soul and a sharp pen!

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