HIPAA
What is HIPAA?
HIPAA stands for the Health Insurance Portability and Accountability Act. A federal law in the US that came into effect in 1996, this act standardizes the procurement, management, use, and disclosure of administrative and financial information in healthcare. Although designed to improve the efficiency and effectiveness of healthcare data management, HIPAA is more widely known for its provisions related to the privacy and security of health information.
Created by the US Department of Health and Human Services (HHS), the HIPAA rules and regulations are designed to protect sensitive patient health information from being disclosed without their permission. The Office for Civil Rights (OCR) is responsible for enforcing HIPAA and makes sure that all healthcare organizations and businesses that support the execution of healthcare services comply with HIPAA rules and regulations.
The Purpose of HIPAA
HIPAA was created in response to increasing concerns about the confidentiality and security of patient records and other health information, as well as the acknowledgement that patients should be able to switch Insurance providers and take their information with them. As healthcare shifted toward electronic data systems in the 1990s, there was a growing need for standardization, regulation, and protection of medical information.
The law serves five primary purposes:
- Improve the portability of health insurance coverage when individuals change or lose their jobs.
- Combat healthcare fraud and abuse.
- Set industry-wide standards for healthcare information on electronic billing and other processes.
- Ensure the privacy and security of protected health information (PHI).
- Provide patients with the right to access and control their health information.
What are the different HIPAA rules?
HIPAA Compliance requires healthcare organizations and business associates to follow 7 main categories of HIPAA rules. These are:
Privacy Rule: This rule concerns identifying protected health information, governing its uses and requirements for disclosure. This rule applies primarily to covered entities. It gives patients rights over their health information, including the right to access and amend their health records.
Security Rule: Sets standards for the protection of electronic PHI (ePHI), including administrative, technical, and physical safeguards.
Breach Notification Rule: Requires covered entities to notify affected individuals, the HHS, and in some cases the media, if unsecured PHI is breached.
Enforcement Rule: Describes the procedures for investigations, penalties, and hearings related to non-compliance.
Omnibus Rule: A 2013 update that strengthens privacy protections and expands responsibilities for business associates.
Transaction Rule: Mandates that specific healthcare-related electronic transactions follow standard formats and code sets.
Identifier Standard Rules: Ensures that healthcare entities and providers are uniquely and consistently identified in all HIPAA-standard transactions.
Why HIPAA Matters Today
In today’s digital age, where healthcare systems and teams are increasingly interconnected with digital tools and data is stored in the cloud, HIPAA plays a critical role in protecting individuals from data misuse, cyberattacks, medical identity theft, and unauthorized disclosures.
Organizations that follow HIPAA standards demonstrate that they prioritize data privacy, cybersecurity, and patient rights. It also helps mitigate business risks by reducing the chances of costly patient data breaches and reputational damage.
Related Terms
Two Factor Authentication
End-to-End Encryption
Privacy Policy