Due to the massive amount of personal data and information stored electronically today, everybody is concerned about their patient information privacy. That is why you may find yourself questioning what your doctor is doing to ensure the protection of your healthcare information.

Health plans, health care providers, health care clearinghouses, and their business associates have to abide by set industry standards when it comes to the storage and transmission of your healthcare information. However, some entities don’t have to follow these regulations. These include:

  • State agencies such as child protective services
  • Law enforcement agencies
  • Life insurance companies
  • Schools
  • Employers
  • DTC (direct to consumer) genetic testing companies
  • Alternative medicine practitioners
  • Workers compensation carriers
  • Health and fitness mobile application

HIPAA Privacy and Security Rules

The HIPAA privacy Rules were established in 1996 to protect personal healthcare information in the United States. Over the years, these rules have undergone changes and revisions to cope with the growth and development of technology.

HIPAA stands for Health Insurance Portability and Accountability Act. The act protects sensitive patient data through the creation of high electronic exchange standards as well as ensuring the security and privacy of all patient information within the healthcare industry.

HIPAA Administrative Simplification Rules protect patient confidentiality and ensure that any medically necessary information that is shared must adhere to a patient’s rights to privacy. The essence of the HIPAA Privacy Rules was to simplify and protect the handling of healthcare information and the confidentiality of sensitive patient data within the industry.

HIPAA has four Compliance Rules for health care providers:

  • HIPAA Privacy Rule: Protects the type of data communicated.
  • HIPAA Security Rule: Protects data and databases to ensure security.
  • HIPAA Enforcement Rule: Indicates the procedures for enforcement, hearings, and penalties.
  • HIPAA Breach Notification Rule: Required to take available steps to “mitigate” the harm of disclosure, which may mean notifying the individual whose information was disclosed.

Information Protected by HIPAA

The HIPAA privacy rule protects all your identifiable health information that is transmitted or held by an entity covered by HIPAA or its respective business associate. Protected health information refers to all such information in any media or form, whether paper, oral, or electronic.

Individually identifiable information cannot be shared without your consent. This includes any data relating to your past, future, or present mental and physical health; your provision of healthcare; or past, future, or current payment related to your healthcare. Identifiable information has a reasonable basis that can lead a third party to identify you, and it includes common identifiers such as your name, address, social security number, or birth date.

Protected information also includes:

  • Information that your healthcare providers put in your medical records.
  • Any conversation that your doctor has concerning your treatment and care.
  • Your medical information held by your health insurer.
  • Other medical information concerning you that is held by entities bound by HIPAA.

Recent Developments in HIPAA Audits

The rapid increase of HIPAA violation cases and complaints led the Office for Civil Rights’ department of Health and Human Services to conduct on-site audits with the pilot program done between 2011 and 2012. The second set of desk audits were performed in 2016 and site audits done in 2017. This has forced HIPAA covered entities and their business associates to ensure strict compliance with all rules.

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