According to the HIPAA, individuals’ health information should be safeguarded, while allowing the flow of health information needed to provide high-quality health care and protect the public’s health and well-being. Passed on August 21, 1996, HIPAA dual goals are to make health care delivery more efficient and increase the number of Americans with health insurance coverage.
What is HIPAA?
The HIPAA security rule applies to organizations or individuals who must follow the rules set by the Health Insurance Portability and Accountability Act (HIPAA) to protect the privacy and security of health information. These entities typically fall into three main categories:
What are the five sections to HIPAA?
The Health Insurance Portability and Accountability Act of 1996 is divided into five sections, known as titles:
- Title I: HIPAA Health Insurance Reform
- Title II: HIPAA Administrative Simplification
- Title III: HIPAA Tax Related Health Provisions
- Title IV: Application and Enforcement of Group Health Plan Requirements
- Title V: Revenue Offsets
What is the HIPAA Privacy Rule?
Under the HIPAA Privacy Rule, there are clear nationwide standards aimed at protecting individual health records and private health data, which it calls “protected health information.” This rule applies to health plans, healthcare clearinghouses, and healthcare providers that handle certain electronic transactions.
The rule requires these entities to use appropriate safeguards to keep protected health information private. It also sets rules on when and how this information can be shared without a person’s permission. Additionally, it grants people certain rights regarding their health information, such as the right to see and get copies of their health records, to ask for corrections, and to have their information sent electronically to a third party.
A key element of the Privacy Rule is the “minimum necessary” principle, which means that only the smallest amount of information needed for a specific purpose should be used, shared, or requested.
The HIPAA security rule applies to organizations or individuals who must follow the rules set by the Health Insurance Portability and Accountability Act (HIPAA) to protect the privacy and security of health information. These entities typically fall into three main categories:
Healthcare providers: This includes doctors, clinics, hospitals, psychologists, dentists, chiropractors, nursing homes, and pharmacies that conduct certain transactions electronically, such as submitting health insurance claims.
Health plans: This category encompasses health insurance companies, HMOs (Health Maintenance Organizations), company health plans, and government programs like Medicare and Medicaid that pay for healthcare.
Healthcare clearinghouses: These are entities that process nonstandard health information they receive from another entity into a standard format or vice versa.
Business associates: They must adhere to certain parts of the HIPAA regulations. These business associates include any organization or person who works in partnership with, or provides services to, a covered entity and handles protected health information in the process. Examples could include billing companies, consultants, IT providers, and attorneys.
What information is protected under HIPAA privacy standards?
Protected Health Information (PHI) encompasses all “individually identifiable health information” held or transmitted in any format—electronic, paper, or verbal—by a covered entity or its business associate. Individually identifiable health information goes beyond the basics. It includes any details that provide insights into:
- A person’s health history or current health status.
- The health care services they’ve received.
- How their health care has been or will be paid for.
This type of information can identify the individual directly or indirectly through various identifiers such as name, address, birth date, and Social Security Number.
**Disclaimer:** This summary is designed to provide a general overview of the Privacy Rule and does not address every detail of HIPAA regulations.
To learn more about how UserWay can help you comply with HIPAA compliance requirements and privacy standards, please contact us.