HIPAA Network Compliance Checklist

HIPAA compliance was introduced over 20 years ago in 1996, when the Clinton Administration passed the Health Insurance Portability and Accountability Act. Since then, HIPAA compliance requirements have become the definitive standards for health care providers who transmit and maintain private medical records. The requirements are comprised of the following criteria that are widely known as the “HIPAA compliance checklist”.

1. Transactions and Code Sets

To ensure that communications remain efficient and clear, HIPAA stipulates that all providers must use the same terminology for certain information. This requirement established by the HIPAA Standards and Code Sets Rule. The rule establishes code sets for descriptions of data, including health conditions, pharmaceuticals, and names of medical procedures. The rule also sets formats of communication that are used to transmit the information.

Satisfying the Transactions and Code Sets requirement is simple. Healthcare providers should select a HIPAA compliant electronic health record (EHR). Most up to date EHRs will apply the right transmission and coding formats automatically. To be certain that an EHR has these automations, ask the seller to confirm that it does. The first item on the checklist deserves a high priority among HIPAA compliance requirements. It establishes terminology for essential information, particularly a patient’s health condition and history of treatment.

2. Identifier Standards

To ensure that healthcare providers aren’t misidentified in the HIPAA network, they are required to have unique “identifiers”. This requirement is established by the “Identifier Standards” rule. A unique identifier is a ten-digit number that is known as a National Provider Identifier (NPI). NPIs are included in each transmission of encoded data. There are two types of unique identifiers: Type 1 NPIs, which are for individual doctors, and Type 2 NPIs, which apply to organizations such as hospitals, centers for recovery, and public clinics.

Addressing the second item on the checklist is simple. Every HIPAA-compliant provider in your office or organization must a unique NPI. If you have providers who need an NPI, send a request for the identifiers to the National Plan and Provider Enumeration System (NPPES).

3. Privacy Rule

If there is one aspect of using medical records that HIPAA considers gravely serious, it is preserving integrity the of private information. The HIPAA Privacy Rule was created to maintain the privacy of personal medical records, which are officially known as “protected health information” (PHI). The rule’s parameters leave nothing for providers to infer about the use and presentation information. The rule also gives patients the right to know the reason why providers use their medical records, and well as gives them an opportunity to control use.

The third item on the HIPAA compliance checklist has a long to-do list compared to most others. If you are starting from step one to reach Privacy Rule compliance, consider reading a summation of the Privacy Rule to get acquainted with its scope, and see how the traits of single elements seem to each have other’s back and eventually cohere for full compliance.

4. Security Rule

The HIPAA Security Rule offers a framework for implementing some of the more obscure elements of the Privacy Rule. This why both rules are often referenced concurrently; their respective information helps clarify their requirements. The biggest difference between the rules is their scope of application. Unlike the Privacy Rule, which applies to all PHI, the Security Rule applies to only PHI that a healthcare provider “receives, maintains, or transmits in electronic form.”

Complying with the Security Rule is another detail-oriented process on the HIPAA compliance checklist. It requires providers to perform a risk analysis that features safeguards for mitigating risks. As with the Privacy Rule, reading a concise summary of the Security Rule can make compliance more intuitive by revealing the big picture: the scope of securitizing PHIs in electronic form.

5. Enforcement Rule

The Enforcement Rule is an item on the HIPAA compliance checklist that dramatically emphasizes the importance of fulfilling all HIPAA compliance requirements. Certain violations can blight your record with felonies, including crimes that have jail time in the sentencing guidelines. Most violators don’t end up in a cell, but some are hit with high-dollar fines that make it feel like they went to debtor’s prison instead. $50,000 per day for a single violation could be the mounting tab.

Satisfying the Enforcement Rule is as logically simple as it is technically arduous: be sure that you satisfy all other requirements to reduce the chance of violations as much as possible. In fact, HIPAA doesn’t recommend taking proactive measures. Providers are advised to handle business as normal unless an investigation for violations commences. Again, making sure that you satisfied each compliance need is the best way to keep your white collar clean.

6. Breach Notification

The HIPAA Breach Notification Rule requires providers to report detected breaches of PHI. As defined by the Security Rule, a breach is a prohibited disclosure of PHI information. Notification requirements depend on the nature of the breach. In some cases, patients whose PHI is breached must be notified, while other breaches must be reported the media. The different types of breaches and notification requirements can be reviewed in a summary of the Breach Notification Rule.

Like the HIPAA Enforcement Rule, The HIPAA Breach Notification Rule entails serious circumstances that don’t have well-known preventions. Again, unless a problem is found, you are told not to fret. But if you find yourself worrying about breaches, and you need some reassurance against calamity, there is a piece of advice that could pass for proactive intervention against breaches: they seldom happen when the Privacy Rule and Security Rule are in compliance.

IT Assistance for HIPAA Compliance

HIPAA compliance is challenging in various respects. There is the obstacle of understanding the technical information your HIPAA compliance checklist, and putting it into action from there. It might require a substantial overhaul to your hardware, software, and the resources designed to support them.

If you need assistance with developing a comprehensive plan for the digital dimension of HIPAA compliance, including hardware selection, network security, and establishing a timeline and list of priorities for implementation, NIC would be happy to lend our expertise. To learn how we can help you address the IT side of HIPAA compliance requirements to satisfy the HIPAA compliance checklist, please contact us today to request a consultation.

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