A Quick Look At HIPAA Compliance Checklist

Organizations that deal directly with medical records, like insurance companies and law offices, need strict guidelines on handling these sensitive records. The best way to ensure that your activities comply with HIPAA guidelines is to adopt a checklist that contains the essential bases connected to a patient’s data.

Patients have a right to privacy over their medical documentation; hence, sensitive information must be handled with utmost care. A breach in the HIPAA regulations comes with a penalty that can be fine, civil action lawsuits, or criminal charges.

Over the years, healthcare providers have adopted electronic medical records for patients globally. This is so because HIPAA has created standards to help safeguard a patient’s medical details, and these standards are updated from time to time.

What does HIPAA mean?

HIPAA is an abbreviation for Health Insurance Portability and Accountability Act, and it is accompanied by regulations that have been established to have a unified and national standard to control the handling of PHI (Protected Health Information), which captures the following;

  • The mental and physical health of an individual’s past, present, or future.
  • Information regarding the treatment of an individual.
  • Payment arrangements to cover an individual’s health care.

HIPAA is a creative idea that contains protocols and standards governing how the storage of sensitive patient information is handled. Therefore, organizations that manage this protected health information must abide by a set of security rules and measures to ensure compliance with HIPAA.

The different entities subject to HIPAA compliance mandates are referred to as business associates or covered entities. Covered entities are people in the healthcare sectors offering treatment, performing clinical operations, or accepting payment. Business associates are subsidiary organizations that provide support in delivering treatment, operations, or payment.

The HIPAA Privacy Rule

The Health Insurance Portability and Accountability Act’s ( HIPAA) Privacy Rule is a federal law established in 2003 to restrain businesses, health care providers, and their employees, such as pharmacies and laboratories, administrative staff, health insurers, and much more, from revealing your health information without your consent or permission.

The Privacy Rule first came into effect after tennis star Arthur Ashe’s HIV status was publicly disclosed. The health records of country music star Tammy Wynette were sold to tabloids, which caused people to begin worrying about their genetic privacy.

Exceptions to HIPAA Rule

The bulletin, which was established by the Office of Civil Rights in the U.S Department of HHS(Health and Human services) to reflect the guidelines on how covered entities and businesses are to handle the various patient health details, has also specified exemptions to the HIPAA Privacy Rule where PHI can be shared without the consent or authorization of the patient under the following circumstances.

Treating The Patient

PHI may become necessary to disclose where the patient’s treatment needs to be carried out. Treatment includes the management or coordination of healthcare and other related services by one or more healthcare providers, referral of patients for treatment, and consultation between providers.

Avoiding a Serious and Imminent Threat

One of the grounds upon which PHI may be disclosed is if the intention is to lessen or prevent an impending and serious threat to the health and safety of a person or perhaps the public based on the professional judgment made by the health care provider under 45 CFR 164.512(j).

The disclosure, however, may be to anyone in a position to lessen or prevent the occurrence of the serious and imminent threat. Qualified persons to whom disclosure may be revealed include caregivers, family, friends, and law enforcement.

Ensuring Public Health and Safety

PHI may be disclosed to public health authorities, such as the Centers for Disease Control and Prevention or a state or local health department authorized to collect or receive information to prevent disease, injury, or disability.

This allows disclosure of prior, current, and prospective patients diagnosed with COVID-19; PHI may be disclosed at the direction of a public health authority and to persons at risk of contracting or spreading COVID-19 so long as state law authorizes the disclosure.

Notifying Members Involved in Care

PHI may be disclosed to persons identified by the patient as those taking part in the patient’s care, such as friends, families, and others like the press, police, or public. Although verbal permission of the patient should be obtained, the patient is incapacitated so that PHI can be disclosed but restricted to the right persons.

Notifying the Media and the Public

In disclosing the PHI of a patient to the public, health care providers must acquire a written HIPAA authorization from either the patient or a legally authorized representative by the patient before disclosing certain detailed PHI to the public or media.

Disclosure Of Basic, General PHI

Where the patient has not restricted or objected to the release of the PHI, health care providers can disclose the basic information about the patient’s general condition upon request.

What Information Is Protected Under HIPAA?

IThe data protected under HIPAA is known as Protected Health Information. It may be spoken, written, or in an electronic format. The specific types of PHI covered under HIPAA include;

Contact Details
  • Name
  • Full Address
  • Telephone numbers
  • FAX number
  • Electronic contact information
E-mail Address
  • Web URL (web address)
  • Internet Protocol (IP) address numbers
  • Social Security Number
  • Fingerprints, pictures, voice recordings (analog or digital)
Dates Related To A Patient Or Their Care
  • Birth or death date
  • Admission or discharge date
  • Health plan beneficiary number
  • Medical record number
Identifying Numbers
  • Device or vehicle numbers
  • Certificate/license number
  • Account number
  • Device identifiers or serial numbers
  • Any vehicle or other device serial number
  • Any other means of identifying the individual

Who Must Comply With HIPAA Privacy Standards?

Healthcare Providers include clinics, psychologists, doctors, hospitals, nursing homes, chiropractors, dentists, and pharmacies.

Health Insurers include HMOs, health insurance companies, company health plans, and government programs like Medicaid and Medicare.

CONCLUSION

Establishing the HIPAA compliance checklist will assure individuals of the total security of their medical details due to the measures that have been put in place. In addition, where there is a breach, they have a voice that will be heard, and adequate steps will be taken to compensate them.



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