What Is HIPAA and What Does HIPAA Stand For?

Is your business operating under the jurisdiction of HIPAA? If so, do you know what does HIPAA stand for? 

In premise, HIPAA stands for Health Insurance Portability and Accountability Act. This legislation has set security and data privacy provisions for the protection of medical information. Specifically for that which may be identifiable.

In this article, we will cover everything you need to know about HIPAA, and what is references. 

So if you want to ensure that your business is in order and free from penalization, keep reading.

What Does HIPAA Stand for?

As mentioned earlier, the answer to the question of “What does HIPAA stand for?” remains the same. The Health Insurance Portability and Accountability Act was proposed and enforced in 1996. The legislation ensures that security and data privacy is employed concerning personally identifiable health information. 

The act consists of five separate sections, each of which is a title. 

Title I references health insurance coverage for those who changed or lost their job. It also prevents health plans from limiting or denying coverage.

Title II provides the Department of Health and Human Services the power to develop national standards for the health industry in terms of electronic transactions. It also requires health care entities to secure access to health data electronically.

Title III references guidelines for medical care and tax-related provisions.

Title IV defines provisions for individuals with specific pre-existing conditions and elaborates upon health insurance reform.

Title V includes company-owned life insurance provisions and treatment for individuals who lose their citizenship for tax purposes.

Most HIPAA violations occur about Title II of HIPAA law. In particular, the points that contain patient health data and HIPAA compliance. To be exact, let’s take a look.

Privacy Rule

The HIPAA privacy rule covers the disclosure and use of protected health information. As well as the standards that have to be enforced to control how individually identifiable information is transacted in the organization. 

Security Rule

The HIPAA security rule sets out the standards that have to be in place for the protection of electronically protected health information. This includes physical and technical safeguards, as well as administrative decisions.

Enforcement Rule

The HIPAA enforcement rule sets out how HIPAA is subject to enforcement. As well as what will happen to organizations that do not comply with the law.

But that’s not all. There’s also quite an important provision that covers HIPAA transactions from the Affordable Care Act. It’s known as the administrative simplification, and it simplifies the business aspects of healthcare. 

The goal is to ensure organizations of all sizes can work within the same standards and be interoperable.

Who Is HIPAA for?

HIPAA regulations apply to all business associates of a covered entity, as well as the entity themselves. A covered entity is recognized as:

  1. A health plan, such as HMO, health insurance provider, or company health plan
  2. A health care service provider, such as a pharmacy, doctor, or clinic
  3. A clearinghouse which processes health information that it receives from another entity

Business associations are third parts that perform certain functions that involve PHI on the behalf of the organizations. They are:

  1. Email encryption service providers
  2. Lawyers who have access to PHI
  3. Administrative entities that help health insurers with the claims process
  4. And many more

In either case, it’s important to have an associate agreement that is signed to ensure that the associate is taking appropriate steps to comply with HIPAA law. Because if your business associates are found responsible for a violation, you and your organization are going to be obligated to take on some sort of punishment for not knowing better. 

That’s why it’s credibly important that you choose your associates wisely, and when you find someone you deem trustworthy, you must educate them upon the HIPAA compliance laws and regularly check to make sure they are following them.

And that’s about it. Let’s take a look at HIPAA violations.

HIPAA Violations

HIPAA violations are not something to look down on. They are quite severe and costly. At the simplest, a HIPAA violation occurs when a covered entity does not employ the safeguards for preventing unintentional/intentional disclose of PHI, according to HIPAA law.

Costs can influence any affected business associations and covered entities that must notify their patients about the breach. In addition to this, certain fines are employed by the Office for Civil Rights.

These violations can go up to one and a half million dollars, and they can also include jail time if a federal crime has been committed to relevant to the violation.

To avoid such violations, lots of planning is necessary. Covered entities and their associates can mitigate all risks by ensuring staff completes regular HIPAA training. Consultants can join the team and ensure that correct safeguards are in place to prevent and mitigate occurring data breaches.

HIPAA Compliance for You

Now that you know what does HIPAA stand for, as well as how it relates to the healthcare industry, you are well on your way to ensure that your organization is free from penalization and other nuisances. 

But just because you know about the law, it doesn’t mean you comply with its provisions. It can be hard to perform HIPAA functions with your current in-house team, that’s why it’s recommended that you outsource the most important tasks to certified specialists. 

In this case, that’s us. If you’re interested in taking your HIPAA compliance to the next level, get in touch with us and we will happily accommodate your needs.