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The Health Insurance Portability and Accountability Act (HIPAA)

HIPAA is the abbreviation of ‘The Health Insurance Portability and Accountability Act’.  It is a US federal law governing the protection and privacy of sensitive, patient health care information.  Proposed in 1996 by Congress, HIPAA was finally brought into enforcement by the Department of Health and Human Services (HHS) in 2001.

The objective of HIPAA is to encourage the development of an effective health information system.  Likewise, the standards introduced must strike a balance between efficiently transmitting health care data to ensure quality patient care, whilst enforcing all necessary measures to secure personal data.  This goal was achieved by establishing a set of standards relating to the movement and disclosure of private health care information.

HIPAA incorporates administrative simplification provisions, designed to help with the implementation of national standards.  As such, HIPAA is broken down into 5 core rules and standards. The HHS assigned government bodies, such as the OCR (Office for Civil Rights) and CMS (Centers for Medicare & Medicaid Services) to organise and enforce these rules and standards.  The OCR was assigned to administer and enforce the Privacy Rule and more recently, the Security Rule.  CMS implements and governs electronic data exchange (EDI) including Transactions and Code Set standards, Employer Identification Standards and the National Identifier Standard.

HIPAA Rules and Standards

Privacy rule: Addresses the appropriate safeguards required to protect the privacy of personal health information.  It assigns limits and conditions concerning the use and disclosure of personal information held by healthcare organisations or any other businesses affiliated with these organisations.

Security Rule: The Security Rule complements the Privacy Rule but focuses specifically on Electronic Protected Health Information (EPHI). It defines three processes where security safeguards must be implemented to ensure compliance: administrative, physical, and technical.

Transactions and Code Set Standards: In this instance, the term transactions, refers to electronic exchanges involving the transfer of information between two parties. HIPAA requires the implementation of standard transactions for Electronic Data Interchange (EDI) of health care data. HIPAA also adopted specific code sets for diagnosis and procedures to be used in all transactions.

Employer Identification Standards: HIPPA requires that employers have standard national numbers that identify them on all transactions – The Employer Identification Number (EIN)).

National Identification Standards: All healthcare organisations that qualify under HIPAA legislation, using electronic communications must use a single identification number (NPI) on all transactions.

What are the implications of HIPAA in terms of File Transfer?

To ensure compliance with HIPAA in terms of large file transfer, Healthcare organisations must:

  • Protect the privacy of all individually identifiable health information that is stored or transmitted electronically.
  • Limit disclosures of protected health information whilst still ensuring efficient, quality patient care.
  • Enforce stringent requirements for access to records.
  • Implement policies, procedures and technical measures to protect networks, computers and other electronic devices from unauthorised access.
  • Effectuate business associate agreements with business partners that safeguard their use and disclosure of PHI.
  • Update business systems and technology to ensure they provide adequate protection of patient data.

Our specialists at Pro2col can help you to source and implement a HIPAA compliant, secure file transfer solution to suit your business requirements.  Please contact us on 0333 123 1240 for more information.

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