A Complete Overview of HIPAA Compliance

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A Complete Overview of HIPAA Compliance

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In 1996, the U.S. federal law called the Health Insurance Portability and Accountability Act (HIPAA) was passed. Its purpose was to set national standards for protecting Protected Health Information (PHI). This law covers healthcare providers, health plans, and health economics health care clearinghouses (generally referred to as covered entities) and their business associates. [1]

1. HIPAA Privacy Rule

The Privacy Rule standards govern the use and disclosure of individuals’ protected health information by covered entities subject to the Rule.

The Privacy Rule contains standards for the rights of individuals to understand and control how their health information is used. It protects individual health information while allowing perpetrators access to health information to provide high-quality health care and protect the community’s health. The Privacy Rule allows important utilizarion of information while protecting the privacy of individuals who seek care and healing. [2]

2. HIPAA Security Rule

While the HIPAA Privacy Rule protects PHI, the Security Rule protects a portion of information covered by the Privacy Rule. This portion is all individually identifiable health information that a covered entity creates, receives, maintains, or transmits electronically. This information is referred to as electronic protected health information, or e-PHI. The Security Rule does not cover PHI that is transmitted orally or in written form. [2]

3. Types Of HIPAA

The components of HIPAA comprise five titles to serve multiple purposes and address issues concerning patients and healthcare workers. [3]

Title I – Health Care Access, Portability, and Renewability

Title II – Preventing Health Fraud and Abuse; Administrative Simplification.

Title III – Tax-Related Health Provisions

Title IV – Application and Enforcement of Group Health Plan Requirements

Title V – Revenue Offsets

4. Why was HIPAA established?

The statute aims to establish confidentiality systems within healthcare facilities and beyond.
The primary goal of HIPAA is to protect the privacy of PHI. [4]

5. Whom does HIPAA cover?

All individuals working in healthcare facilities or private offices [4]

Students
Non-patient care employees
Healthcare plans (e.g., insurance companies)
Billing companies
Electronic medical record companies

6. What are the main goals of HIPAA?

To restrict the use of PHI to people with a need to know.
To impose sanctions on anyone who does not adhere to confidentiality regulations. [4]

7. What types of health information are protected?

Any health information that includes an identifier pertaining to the individual (e.g., name, social security number, telephone number, email address, street address, and other personal identifiers).

8. Core Requirements for Compliance

Administrative Safeguards	Physical Safeguards	Technical Safeguards
Develop privacy and security policies Conduct risk assessments Assign a privacy officer and security officer	Limit physical access to facilities and devices Implement workstation security Secure backup media	Encrypt electronic PHI (ePHI) Use secure access controls and audit logs Enable automatic logoff features

9. Common HIPAA Violations

Snooping on Healthcare Records [5]
Failure to Conduct a Risk Assessment Organization-Wide.
Failure to Manage Security Risks / Absence of Risk Management Process.
Denying Patients Access to Health Records/Going over the Time Limits to Provide Access.
Failure to Implement a HIPAA-Compliant Business Associate Agreement.
Inadequate Controls for Access to ePHI.
Failure to implement Encryption or Other Measure to Protect ePHI on Portable Devices.
Failing to provide Notification of Breach within the 60-day Deadline.
Unpermitted Disclosures of PHI.
Inadequate Disposal of PHI.

Conclusion

HIPAA compliance is a legal regulation and setup to safeguard the trust of patients and the integrity of data. There are many professionals that have roles and responsibilities in the compliance process from healthcare providers to technology vendors, they all need robust policies, technical safeguards, and ethical practices. Anyone working in compliance and staying compliant on behalf of patients is contributing also to their security, transparency, and accountability in a data driven healthcare industry.

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References

CDC. (2024, September 10). Health insurance portability and accountability act of 1996 (HIPAA). Public Health Law. https://www.cdc.gov/phlp/php/resources/health-insurance-portability-and-accountability-act-of-1996-hipaa.html
Moore, W., & Frye, S. (2019). Review of HIPAA, part 1: History, protected health information, and privacy and security rules. Journal of Nuclear Medicine Technology, 47(4), 269–272. https://doi.org/10.2967/jnmt.119.227819
(2024, September 29). A complete overview of **HIPAA law** and compliance. Sprinto. https://sprinto.com/blog/hipaa-law/
Edemekong PF, Annamaraju P, Afzal M, et al. Health Insurance Portability and Accountability Act (HIPAA) Compliance. [Updated 2024 Nov 24]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK500019/
(N.d.). Hipaajournal.com. Retrieved August 1, 2025, from https://www.hipaajournal.com/common-hipaa-violations/