A covered entity under HIPAA is an institution or an organization that must comply with the HIPAA Privacy Rule, the HIPAA Security Rule, and the HIPAA Breach Notification Rule.
If you are a business owner in the Austin, Texas area, you may have heard of the concept of covered entity under HIPAA, the Health Insurance Portability and Accountability Act of 1996.
HIPAA is a federal law that protects the privacy and security of health information and gives patients certain rights regarding their health records. HIPAA also sets standards for how health information is transmitted and stored electronically.
But what does HIPAA and its covered entity mandate mean for your business? Do you have to comply with HIPAA rules? How can you avoid HIPAA violations and penalties? These are some of the questions that we will answer in this blog post, written by a local expert HIPAA consultant.
What is a Covered Entity Under HIPAA?
The first thing you need to know is whether your business is a covered entity under HIPAA. A covered entity is one of the following:
- A health care provider, such as a doctor, dentist, pharmacist, hospital, clinic, nursing home, or home health agency, that transmits health information electronically in connection with certain transactions, such as billing, claims, or referrals.
- A health plan, such as a health insurance company, HMO, Medicare, Medicaid, or employer-sponsored health plan, that provides or pays for health care.
- A health care clearinghouse, such as a billing service, that processes health information from other entities and converts it into a standard format.
If your business falls into one of these categories, you are a covered entity under HIPAA and you must comply with the HIPAA Privacy Rule, the HIPAA Security Rule, and the HIPAA Breach Notification Rule.
What Are HIPAA Covered Entity Rules?
The HIPAA Privacy Rule establishes the rights of patients to access, amend, and request an accounting of their health information, and limits how covered entities can use and disclose health information for purposes such as treatment, payment, and health care operations. The HIPAA Privacy Rule also requires covered entities to provide patients with a notice of privacy practices, obtain written authorization for certain uses and disclosures, and designate a privacy officer and contact person.
The HIPAA Security Rule requires covered entities to implement administrative, technical, and physical safeguards to protect the confidentiality, integrity, and availability of electronic protected health information (ePHI). The HIPAA Security Rule also requires covered entities to conduct a risk analysis, develop a security policy and procedures, train staff, and monitor and audit security activities.
The HIPAA Breach Notification Rule requires covered entities to notify affected individuals, the Department of Health and Human Services (HHS), and in some cases, the media, of any breach of unsecured ePHI. A breach is defined as an impermissible use or disclosure of ePHI that compromises the privacy or security of the information. A breach is presumed unless the covered entity can demonstrate that there is a low probability that the ePHI has been compromised.
How to Comply with Covered Entity Rules
There is no definitive answer to how long it takes to become HIPAA compliant, as it depends on various factors such as the size and type of your business, the current level of compliance, the findings of the initial audit, and the extent of remediation plans needed. However, some general estimates are:
- With a full-time staff member devoted to HIPAA, it should take a typical office less than 6 months to become compliant.
- If you can only afford a few hours per week, HIPAA compliance will take longer, possibly over a year.
- To achieve HIPAA certification, which is a voluntary process that demonstrates your compliance to a third-party auditor, you may need additional time and resources.
The best way to speed up your HIPAA compliance journey is to follow a systematic and comprehensive approach that covers all the relevant aspects of the HIPAA rules, such as:
- Conducting a security risk assessment
- Implementing safeguards
- Designating a HIPAA compliance officer
- Completing HIPAA training for all staff that interface with PHI
- Collecting Business Associate Agreements (BAAs)
- Establishing a breach notification process
- Documenting evidence of compliance
To comply with the HIPAA Rules, covered entities need to implement a comprehensive HIPAA compliance program that covers all aspects of the rules, including policies, procedures, training, documentation, risk assessment, security measures, breach response, and audit readiness.
What are the Consequences of Noncompliance with HIPAA?
Noncompliance with HIPAA can result in serious consequences for covered entities, such as:
- Civil penalties imposed by HHS, ranging from $100 to $63,973 per violation, up to a maximum of $1,919,173 per violation category, per year.
- Criminal penalties imposed by the Department of Justice, ranging from a fine of up to $50,000 and/or imprisonment of up to one year for a simple violation, to a fine of up to $250,000 and/or imprisonment of up to 10 years for a violation involving intent to sell, transfer, or use ePHI for commercial advantage, personal gain, or malicious harm.
- Lawsuits filed by individuals or state attorneys general, seeking damages, injunctions, or other remedies for violations of privacy rights or state laws.
- Loss of reputation, trust, and goodwill among customers, partners, and the public.
How Can You Get Help with HIPAA Compliance?
HIPAA compliance can be a complex and challenging task for any business, especially for small and medium-sized businesses that may not have the resources, expertise, or time to handle it on their own. That is why it is advisable to seek professional help from a qualified and experienced HIPAA consultant.
A HIPAA consultant can help you:
- Assess your current level of compliance and identify any gaps or risks
- Develop and implement a customized HIPAA compliance plan that meets your specific needs and goals
- Provide ongoing support, guidance, and monitoring to ensure your compliance is maintained and updated
- Assist you in case of a breach, audit, or investigation by HHS or other authorities
If you are looking for a reliable and reputable HIPAA consultant in the Austin, Texas area, look no further than Tech Prognosis, a leading provider of HIPAA consulting and IT services. Tech Prognosis has over 10 years of experience in helping businesses of all sizes and industries achieve and maintain HIPAA compliance. Tech Prognosis offers a full range of HIPAA services, including:
- HIPAA risk analysis and gap assessment
- HIPAA policy and procedure development and review
- HIPAA training and awareness programs
- HIPAA security and encryption solutions
- HIPAA breach notification and incident response support
- HIPAA audit and compliance testing
Tech Prognosis has a team of certified and knowledgeable HIPAA experts who can help you navigate the HIPAA rules and regulations and ensure your business is compliant and secure. Tech Prognosis also offers a free consultation and a 100% satisfaction guarantee.
Conclusion
HIPAA compliance is not only a legal obligation, but also a competitive advantage for your business. By complying with HIPAA, you can protect your business from costly penalties, lawsuits, and reputation damage, and also enhance your customer loyalty, trust, and satisfaction. HIPAA compliance can also help you improve your operational efficiency, quality of care, and profitability.
However, HIPAA compliance is not a one-time event, but an ongoing process that requires constant attention and effort. That is why you need a trusted partner like Tech Prognosis to help you achieve and maintain HIPAA compliance. Tech Prognosis can provide you with the best HIPAA consulting and IT services in the Austin, Texas area, and help you take your business to the next level.
To learn more about how Tech Prognosis can help you with HIPAA compliance, contact us today for a free consultation. We look forward to hearing from you and serving your HIPAA needs.
