Understanding HIPAA: Defining Protected Health Information

Understanding HIPAA: Defining Protected Health Information

The Health Insurance Portability and Accountability Act (HIPAA) is a federal law that was enacted in 1996. HIPAA is aimed at safeguarding the privacy and confidentiality of personal health information (PHI) and electronic protected health information (ePHI). It is important to understand what counts as PHI and ePHI to comply with HIPAA regulations. This article aims to define protected health information and provide insights into how HIPAA protects it.

What is Protected Health Information (PHI)?

Protected health information (PHI) is any health information that can be tied to an individual. This includes information that is created, received, transmitted, or maintained by a covered entity or its business associates. Examples of PHI include medical and financial information, insurance claims, diagnosis data, and demographic information such as name and address.

HIPAA defines covered entities as healthcare providers, health plans, and healthcare clearinghouses. Business associates are entities that perform functions or provide services on behalf of the covered entity. The covered entity must have a business associate agreement (BAA) in place to ensure that the business associate complies with HIPAA regulations.

HIPAA also defines two types of PHI- identifiable and de-identifiable. Identifiable PHI contains information that can be used to identify an individual. De-identifiable PHI does not contain any information that can be used to identify an individual, and the risk of the information being re-identified is very low.

How does HIPAA protect PHI?

HIPAA protects PHI by outlining standards for the privacy, security, and breach notification of PHI. Covered entities and business associates are required to adhere to these standards to ensure that PHI is protected. Compliance with HIPAA regulations involves implementing administrative, physical, and technical safeguards.

Administrative safeguards involve policies, procedures, and documentation to manage the security of PHI. Physical safeguards include measures such as locked doors and secure storage to protect against unauthorized access. Technical safeguards include electronic key management, access controls, and encryption technologies to secure PHI.

In the event of a breach, HIPAA requires covered entities and business associates to provide breach notifications to affected individuals, the Department of Health and Human Services, and in some cases, the media. Moreover, covered entities and business associates must also implement risk assessments and contingency plans to address security incidents and potential threats to PHI.

Conclusion

HIPAA is critical to protecting personal health information and electronic protected health information. Understanding the definition of PHI and ePHI is key to complying with HIPAA regulations. Covered entities and business associates must also implement safeguards and adhere to the standards outlined by HIPAA to protect PHI. Compliance with HIPAA standards requires continual risk assessments and implementation of administrative, physical, and technical safeguards.

It is important to understand and comply with HIPAA regulations to protect the privacy and confidentiality of personal health information and electronic protected health information. Healthcare providers, health plans, and healthcare clearinghouses, as well as their business associates must adhere to the standards outlined by HIPAA for the protection of PHI.