HIPAA stands for Health Insurance Portability and Accountability Act. It is a key healthcare reform bill that was approved by Congress in the United States in 1996. The Act’s main goal is to strengthen the regulations governing healthcare billing, the management of patient health information, and the privacy of health information.
HIPAA has expanded access to long-term health services, streamlined the administration of health insurance, promoted the portability of health insurance coverage, and successfully fought health insurance fraud.
To help you learn more about how to carry out the HIPAA compliance audit for your business, in this article, we’ll cover the following:
Table of Contents
What is Meant by Protected Health Information?
Data or information on a patient or client using healthcare services is referred to as protected health information (PHI). Names, addresses, phone numbers, Social Security numbers, medical data, financial information, and full-face pictures are a few common examples of PHI.
Electronically protected health information, or ePHI is transferred, stored, or accessed electronically and is subject to HIPAA regulatory criteria.
What are HIPAA Compliance objectives?
HIPAA, officially known as Public Law 104-191, serves two primary objectives: Firstly, it covers employees with health insurance whether they move jobs or leave their jobs, and it eventually lowers healthcare costs by standardizing the electronic transmission of administrative and financial activities.
Its other objectives include preventing misuse, fraud, and waste in the provision of healthcare and insurance, as well as enhancing access to long-term care services and insurance.
HIPAA Compliance in India
In India, HIPAA is applicable to companies that collaborate with those that produce, receive, transfer, store, or retain protected health information (HIPAA business associates and covered entities).
Individually identifiable health information is what HIPAA business associates and covered organizations refer to as protected health information (classified into 18 identifiers by the HHS).
You must set up a successful HIPAA compliance program if you want to be sure that PHI is being protected appropriately. Start working on these steps:
1. Begin with self-audits
The HHS mandates that you perform five self-audits each year as a HIPAA business partner. These audits evaluate the PHI security measures you have in place on an operational, physical, and technical level.
2. Identify gaps and remediate them
By performing self-audits, you might find weaknesses in your safety precautions. You must take corrective actions to close your gaps in order to be HIPAA compliant. Your administrative, physical, and technical protections will be brought up to HIPAA compliance through remediation activities.
3. Work on the company’s policies and procedures
The right use and disclosure of PHI by your organization must follow policies and procedures. Additionally, they establish a framework for how your business will comply with the HIPAA Security, Privacy, and Breach Notification Rules.
4. Train the employees
You must teach any employee who could come into contact with PHI in order to guarantee that they are aware of their HIPAA obligations and that they follow your organization’s policies and procedures. Annual employee training must include the fundamentals of HIPAA, your company’s rules and procedures, cybersecurity, and social media etiquette.
Who is Required to be HIPAA Compliant?
Covered entities, as defined by HIPAA, include:
- Healthcare providers: This includes doctors, nurses, hospitals, clinics, and other healthcare providers who transmit health information electronically in connection with certain transactions, such as billing.
- Health plans: This includes health insurance companies, HMOs, company health plans, and government programs that pay for healthcare, such as Medicare and Medicaid.
- Healthcare clearinghouses: This includes entities that process nonstandard health information they receive from another entity into a standard format or vice versa.
Business associates are entities that perform functions or services on behalf of a covered entity. Examples of business associates include billing companies, claims processors, and other companies that handle PHI on behalf of a covered entity.
Business associates are also subject to HIPAA regulations and are required to protect the privacy and security of PHI just like covered entities.
It’s important to note that HIPAA applies to electronic PHI (ePHI) and not to paper records.
Covered entities are required to have policies and procedures in place to safeguard ePHI and to train their workforce on these policies and procedures.
Steps You’ll Need to Follow to Achieve HIPAA Compliance
The steps to achieve HIPAA compliance in India would include:
1. Conducting a Risk Assessment
Identify and evaluate potential threats and vulnerabilities to the security and confidentiality of PHI, and implement appropriate safeguards.
2. Developing and Implementing Policies and Procedures
Develop written policies and procedures to protect the privacy and security of PHI in compliance with HIPAA regulations.
3. Training Staff
Ensure that all employees who handle PHI are trained on the organization’s policies and procedures, as well as HIPAA regulations.
4. Implementing Physical and Technical Safeguards
Implement physical and technical measures to protect PHI from unauthorized access, use, or disclosure, such as firewalls, antivirus software, and encryption.
5. Regularly reviewing compliance
Regularly monitoring compliance efforts and making necessary adjustments to ensure ongoing compliance with HIPAA regulations.
6. Having Business Associate Agreement
If the organization has any business associates in the US, they must have a Business Associate Agreement (BAA) in place, as per HIPAA regulations.
However, do keep in mind that compliance with HIPAA regulations can be complex and organizations should seek guidance from legal and compliance experts as well as HIPAA experts.
As a U.S law, it does not apply in India directly, India has its own laws and regulations for protecting the privacy and security of health information, such as the Information Technology (Reasonable Security Practices and Procedures and Sensitive Personal Data or Information) Rules, 2011 under the Information Technology Act, 2000.
However, some healthcare providers and organizations in India may still need to comply with HIPAA if they handle the PHI of U.S. individuals or if they have business associates in the U.S. that are subject to HIPAA regulations.
Also, India has a growing number of medical tourists, and many US citizens travel to India for medical treatment. Indian healthcare providers are expected to protect the PHI of these US citizens as per HIPAA regulations.
Therefore, for those in the healthcare business in India, becoming HIPAA compliant can be pretty beneficial.
About IS Auditr
IS Auditr is a team of experienced ISO and Audit experts. We offer several end-to-end services, provide certifications to businesses and help them enhance their day-to-day operations. If you want to know more about how HIPAA compliance is achieved in India, feel free to contact us.