The Importance of Following the 3 Standard HIPAA Rules From HITECH

Written by
Rebecca Smith

Published
Oct 12, 2021

Oct 12, 2021 • by Rebecca Smith

Good company leaders know; HIPAA violations are no joke.

The Health Insurance Portability and Accountability Act (HIPAA) is complex. Whether you're an employer or a patient, you need to understand how these rules work. If you don't, you could fall prey to a life-altering breach of information.

If you aren't familiar with your company's responsibilities, or the role HITECH compliance plays, let us help you catch up.

Read on to learn why all of the HIPAA rules matter.

What Are the 3 Main Rules?

The 3 rules of HIPAA are privacy, security, and breach notification. Each rule operates in a special way to protect you as a patient.

It's a good idea to memorize these 3 rules or at least the principles they use. When you know your patient rights by heart, you'll be savvier in fighting for your rights! If a violation occurs, you'll learn something's wrong instead of wondering.

Privacy Rule

The privacy rule protects your personal health information (PHI) in any medical setting. This includes providers, hospitals, therapists, insurance companies, and pharmacies. Your health information must be kept private.

All of your medical care providers, pharmacies, and insurance companies can only share limited information about you with other people or companies. For instance, they could share data if it is necessary for your treatment or billing. If they violate the privacy rule by sharing too much information, there are civil and criminal penalties.

Security Rule

Next, the security rule is all about the technical safeguards, such as HITECH compliance measures, to secure your PHI. This includes protecting your information from cyber attacks.

For instance, the security rule also contains an exceptional standard for electronically protected health information (EPHI). This is a subset of PHI that includes email, instant messaging, and other digital communication.

In addition, the security rule requires electronic PHI to be encrypted as long as the encryption doesn't interfere with the provider's ability to treat you. Using HITECH compliance software, encryptions are easy.

Breach Notification Rule

Finally, let's go over the breach notification rule. If a breach occurs, the breach notification rule dictates that companies and providers notify you of the data security incident. In addition, they must contact their business associates who have access to PHI.

If the breach is severe, they must contact the U.S. Department of Health and Human Services' Office for Civil Rights. This triggers a more formal investigation into the violation. 

When Are Disclosures Allowed?

Other than billing, when can a health care company share your PHI? First, they can disclose it when you give consent for them to do so. 

Second, if the disclosure is required by law. Third, they may be allowed to share it in an emergency if notifying you would impede the treatment of someone else who needs immediate assistance.

What If Providers Violate HIPAA?

If a health care provider violates HIPAA, the consequences could be dire. They may have to pay harsh penalties for each violation. 

In addition, they can receive criminal penalties if there is intent to defraud or cause harm. Lastly, if your information is compromised due to a security breach or impermissible use, they must pay for identity theft protection services.

The severity of the punishment depends on the violation that takes place. The penalty tiers extend to cover serious jail time. 

The jail time can be as short as a year for the employer who commits the violation. However, severe violations could carry a much longer sentence.

The provider has to report the violation as soon as they find out about it. If you’re a patient suspecting a violation, you can file your complaint electronically. The application is simple and straightforward, and won't take very long to complete.

Why HIPPA Rules Matter to Patients

It's essential to know the rules and stay vigilant about privacy and security concerns. For instance, if there's a security breach or impermissible use of your PHI, you could suffer financial harm.

For instance, insurance companies may raise premiums or deny coverage altogether. Employers may find out you have a medical condition. Or, there could be a loss of reputation if the information gets into the wrong hands.

Effective HITECH Compliance Checklist

As you can imagine, HIPAA compliance is a significant issue for most medical care providers. They must be able to show they have adequate security measures in place. In turn, they need to train employees on the proper use of PHI and the right steps to protect it.

Most health care companies outsource their compliance efforts or hire a specialist to step in. The specialist can audit the company's policies and procedures to make sure they comply with HIPAA rules. In addition, they may recommend changes as needed.

Common Compliance Mistakes

There are a few mistakes health care companies fall prey to. Common health mistakes include failing to conduct an initial risk analysis. An initial risk analysis helps employers know how secure their current systems are.

In addition, there are encryption issues that can expose PHI if it isn't used correctly. Thankfully, by conducting a risk analysis, an employer can quickly identify these areas that need attention. For instance, if PHI is exposed to encryption errors or improper disposal techniques, it will highlight those problem areas.

The other common mistake occurs during training employees on HIPAA rules and employee rights. Employees must be fully aware of how to protect PHI, what they are allowed to do. 

If an employer violates HIPAA rules, the employer will be liable as well. The penalties will apply, even if the violation was just a mistake. No exceptions.

Are You up to Speed?

HIPAA Rules are there for you! However, the rules work best when you understand them. Take a minute to re-read this article and commit one of the 3 main rules to memory.

Finally, if you think a violation took place, get help! File a complaint, and reach out to a lawyer if necessary. 

If you're an employer, perform a risk analysis and review your HITECH compliance standards. For more tips, read another one of our guides.