What Is the Hipaa Enforcement Rule

Companies and business partners involved must comply with HIPAA rules to avoid enforcement penalties. Understanding the rules and properly implementing compliance measures is essential. Security Rule – describes what health care providers must do to prevent the unintentional disclosure or destruction of electronic patient information and physically protect those records. Depending on what the OCR and DOJ decide, a company may face civil and criminal penalties for a particularly egregious violation. HHS publishes a list of relevant case studies that break down the reasons for some past cases (anonymized for security reasons). The application rule is available at www.hhs.gov/ocr/hipaa/FinalEnforcementRule06.pdf. View our annual number of reported law enforcement cases nationally and by state. In addition to the basic thresholds set, the severity of the fine or penalty imposed depends on many factors. For example, HHS may exercise its discretion to resolve an issue without imposing a fine, or apply a lower-level fine to a higher-level violation. As mentioned above, four main rules make up the core of HIPAA for professionals – the three non-enforcement rules define the prescribed regulations that a company must follow to protect PHI. However, this has not always been the case. Initially, HIPAA only included the privacy rule, and the security rule was added shortly thereafter to protect electronic PHI (“ePHI"). HIPAA enforcement rules apply when an organization does not comply with HIPAA rules for privacy, security, and breach notification.

HIPAA violations have significant consequences. HIPAA is enforced through various enforcement actions dictated by the U.S. Department of Human Rights (OCR) Office of the U.S. Department of Health and Human Services (HHS). Failure to comply with HIPAA has significant consequences. Businesses will not only have to bear the financial losses; They will also cause reputational damage and other business costs. Worse still, serious violations can even lead to criminal penalties. For these reasons, organizations must vigorously ensure HIPAA compliance to avoid these challenges. Even in the event of a breach, the company should contact an experienced compliance consultant to guide them through the process and ensure immediate resolution. Regardless of the type of HIPAA violation to which the business entity belongs, if the organization is subject to enforcement action, it must act quickly and prudently to limit sanctions or at least mitigate risk and liability in the event of a violation.

With the regular and much-needed updating of critical standards such as HIPAA, auditors and compliance professionals must be constantly on their guard to review and familiarize themselves with these new developments. One of the latest updates of this type is the Health Information Portability and Accountability (HIPAA) application rule, which has caused a stir in the industry due to confusion about its applicability. To clarify a few things, the HIPAA app is not applicable as long as organizations value the privacy and security of their customers` protected health information (PHI) while complying with HIPAA compliance requirements. For healthcare organizations, HIPAA compliance is essential. HHS has established specific rules for HIPAA compliance. The application rule includes guidelines for compliance, investigation and sanctions in the event of infringement. It also outlines procedures and fines for imposing civil penalties on registered businesses that violate HIPAA requirements. The Office of Civil Rights within HHS is responsible for investigating the violation.

Based on the investigation, the OCR determines whether the relevant company or business partner has complied with the HIPAA security and privacy rule or whether the rule has been violated. The OCR verifies the information and evidence is collected for each case. If the evidence indicates that the captured entity was not compliant, OCR will attempt to resolve the case with the captured entity through voluntary compliance, corrective action, and/or resolution agreement. The rule explains that not only are healthcare providers responsible for their own actions, but can also be held responsible for hipaa violations arising from the actions of people working under their direction, including paid employees, interns, and volunteers. Omnibus Rules – The HIPAA omnibus rule prescribes the implementation of the Health Information Technology Act for Economic and Clinical Health (HITECH). This was introduced as the fourth rule to strengthen PHI privacy and data security protection under HIPAA. This extends the scope of HIPAA commitments to business partners and their subcontractors. This rule includes changing the standard for reporting violations, expanding patient access rights and restricting the disclosure of PSR, establishing new rules for the use and disclosure of PSR, clarifying the enforcement approach, and addressing obligations under the Genetic Information Non-Discrimination Act, 2008 (GINA). “Psychologists need to be aware that the agency now has clear guidelines on how it will enforce HIPAA and what the penalties are if you don`t comply," says Alan Nessman, JD, special counsel on legal and regulatory affairs at the APA`s Practice Directorate.

The following is a summary of OCR enforcement actions and current monthly results, including the number of cases where corrective action was taken, no violations were found, or other solutions were found. .