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HIPAA

Health Insurance Portability and Accountability Act

What is HIPAA?

HIPAA (Health Insurance Portability and Accountability Act) is a U.S. federal law enacted in 1996 that establishes national standards for the protection of sensitive patient health information, known as Protected Health Information (PHI).

The HIPAA Security Rule specifically focuses on electronic PHI (ePHI) and requires covered entities and their business associates to implement appropriate administrative, physical, and technical safeguards to ensure the confidentiality, integrity, and availability of ePHI.

When Does HIPAA Apply?

Healthcare Providers

Hospitals, clinics, doctors, dentists, pharmacies, and other healthcare providers who transmit health information electronically.

Health Plans

Health insurance companies, HMOs, company health plans, and government healthcare programs.

Business Associates

Any organization that handles PHI on behalf of a covered entity, including IT vendors, billing companies, and consultants.

Key Requirements

Administrative Safeguards
Physical Safeguards
Technical Safeguards
Organizational Requirements
Policies and Procedures
Documentation Requirements
Risk Analysis and Management
Workforce Training
Access Controls
Audit Controls
Integrity Controls
Transmission Security

Non-Compliance Penalties

HIPAA violations can result in significant penalties:

  • Tier 1:$100 - $50,000 per violation (unaware of violation)
  • Tier 2:$1,000 - $50,000 per violation (reasonable cause)
  • Tier 3:$10,000 - $50,000 per violation (willful neglect - corrected)
  • Tier 4:$50,000+ per violation (willful neglect - not corrected)

Annual maximum penalties can reach $1.5 million per violation category.

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