How to Become HIPAA Compliant in Philadelphia

How to Become HIPAA Compliant in Philadelphia

Healthcare organizations in Philadelphia have had to follow HIPAA regulations for almost three decades. The purpose of the original legislation was to ensure patient health record safety by putting into place clear standards that organizations could follow. It’s important that all healthcare organizations in Philadelphia understand how to become HIPAA compliant.

Managing your Philadelphia practice within HIPAA regulations can be challenging, especially since HIPAA rules can be changed and updated regularly. In this guide, we’re going to take an in-depth look at why regulators created HIPAA, why healthcare offices need to comply, and what strategies healthcare organizations in Philadelphia can use to remain compliant. 

Why Were HIPAA Regulations Introduced? 

HIPAA, or the Healthcare Insurance Portability and Accountability Act, was created in 1996 to better regulate practices within healthcare facilities. The act was incredibly wide-ranging and included provisions to improve the accountability of health insurance coverage and prevent fraud, but ultimately HIPAA has been most dedicated to mandating protection of sensitive patient information.

In 2003, regulators introduced the first HIPAA Privacy and Security Rule. This rule defined Protected Health Information‚ or the kind of patient information that healthcare providers are required to protect. Protected data includes any information held by a healthcare organization that concerns the “healthcare status, provision of healthcare, or payment for healthcare” of any patient in their care. 

The purpose of these regulations is to help protect patient data against growing threats and most particularly, cyberattacks. These regulations also ensure that healthcare providers and insurers cannot abuse information or apply unfair terms and policies to patients by making their data publicly available.

Why Do Healthcare Organizations in Philadelphia Need to Be Compliant? 

In the early years of HIPAA, many healthcare organizations did not follow the Privacy and Security Rules. Legislators, therefore, introduced the Enforcement Rule in March 2006, which gives the HHS the authority to investigate complaints against providers that did not abide by the rules. 

The Enforcement Rule also allowed the Department’s Office for Civil Rights to bring criminal charges against any healthcare organization that repeatedly flouts the rules, increasing the stakes for executives and managers considerably. 

The fines for non-compliance are quite substantial. There are four tiers of penalties that authorities can impose on individual practices based on their level of knowledge of a breach and the actions that they could have taken to prevent it:

1. First Tier: $100 – $50,000 Fine Per Incident 

Authorities can fine healthcare organizations between $100 and $50,000 per incident if the provider did not know and had no reasonable way of knowing about the breach. 

2. Second Tier: $1,000 – $50,000 Fine Per Incident 

Second-tier fines apply to organizations who knew about a breach or who could have taken reasonable steps to counter to the violation but who did not act with “willful neglect.”

3. Third Tier: $10,000 to $50,000 Per Incident 

Third-tier fines apply when healthcare providers act with willful neglect but correct the issue within a 30-day time period. 

4. Fourth Tier: $50,000 Per Incident 

Fourth tier fines apply to healthcare providers who act with willful neglect and do not make corrections within 30 days. 

How Does the HIPAA Security Rule Apply to Healthcare Offices in Philadelphia? 

As mentioned, the HIPAA Security Rule is a document that lists all of the rules that healthcare providers must follow when handling patient data. The law contains a variety of technical and non-technical standards to which healthcare organizations must comply. Before the HIPAA Security Rule, there were no standard set of rules governing how healthcare organizations in Philadelphia had to use patient data. 

Some of the primary provisions medical facilities must follow according to the Security Rule are as follows:

1. Organizations must ensure the availability and confidentiality of all transmitted, created, or received patient data. 
2. Providers must identify and protect against all reasonably anticipated threats to patient data security and integrity.
3. Providers must make sure that their workforce complies with the rules set out by HIPAA. 
4. Healthcare organizations must protect against all reasonably anticipated disclosures or unauthorized use of patient data.

In these ways, the Security Rule holds Philadelphia medical practices directly responsible for ensuring that patient data is not unlawfully disclosed. 

When deciding which security measures to use, organizations are permitted by the HSS to take into consideration things like the cost of various security measures compared to annual revenue, their current technical and defensive hardware, and the risks posed to patient confidential information. All of these could differ depending on the size of the organization. 

Regardless of your practice’s size, however, it is always recommended that you 

Options for Implementing HIPAA-Compliant Security Measures

Different organizations choose varying methods to ensure their IT complies with HIPAA regulations. Some decide to manage their in-house, while others outsource the task to Managed Service Providers. 

Do-It-Yourself HIPAA Compliance 

Some healthcare organizations opt to take their HIPAA compliance into their own hands by relying on internal resources to maintain IT systems and cybersecurity. Members of the organization usually meet to discuss all of the terms of the Security Rule and how they will follow them. 

Following these steps is crucial in maintaining HIPAA compliance within your practice:

1. Use a self-assessment checklist to determine whether the organization currently abides by HIPAA standards. 
2. Use a risk assessment tool, such as the one provided by the ONC for Health Information Technology. This tool reveals the threats facing a healthcare provider and includes guidance on how to mitigate them. 
3. Finally, many organizations choose to use tools such as the NIST HIPAA Security Rule Toolkit to ensure they’re remaining compliant with the Security Rule over time. This tool is helpful for restructured organizations or those who have changed their IT infrastructure. 

Keep in mind that while do-it-yourself HIPAA compliance might seem appealing and more cost-effective, it’s not for everyone. Some organizations have the internal expertise to abide by the Security Rule, but many don’t. Trying to manage your practice’s HIPAA compliance yourself could end up costing you more money in incident fines in the long run.

Outsourced HIPAA Compliance In Philadelphia

The alternative approach to maintaining HIPAA compliance yourself is to outsource IT management to a third-party service provider that specializes in Managed IT Services for Healthcare providers. When providers outsource, they have access to teams of skilled technicians who understand the Security Rule inside out and know how to make sure the organization obeys it.

Additionally, healthcare-focused Managed Service Providers are able to provide an expert perspective on the IT operations of medical offices specifically and manage your IT according to your practice’s needs.

Some of the services MSPs provide to ensure healthcare facilities remain compliant include the following: 

Gap Analysis

A gap analysis investigates your current practices and then quantifies how far from full HIPAA compliance you are currently. Gap analysis examines factors such as how organizations store data records, how they report on incidents, and how many of their senior staff are trained on the Security Rule. 

Remediation

MSPs also help healthcare service providers put into place systems that help them become more compliant, based on the results of the gap analysis. 

Cybersecurity Planning

Finally, MSPs help organizations in Philadelphia maintain HIPAA compliance by bolstering their cybersecurity plans to meet HIPAA regulations and streamlining operations to adapt to that plan.

If your medical practice needs assistance to ensure your IT systems maintain compliance with HIPAA, contact Proper Sky today so that our team of experts can help.