The HIPAA Administrative Simplification provisions ensure consistent electronic communication in healthcare across the U.S. They do this by creating standards that reduce paperwork, streamline business within the healthcare industry, and safeguard health information. These regulations can apply directly to email and its use for both transactions and patient communication.
By following the HIPAA provisions when sending or receiving emails, organizations can mitigate the risk of disclosures and breaches of protected health information (PHI).
See also: HIPAA compliant email: The definitive guide
HIPAA’s Administrative Simplification provisions
HIPAA stands for the Health Insurance Portability and Accountability Act of 1996. The legislation sets national standards for the defense of medical records and patients’ PHI. Healthcare organizations must comply with HIPAA to protect patient privacy and safeguard sensitive health information.
The HIPAA Administrative Simplification provisions were created in response to advancements in technology within healthcare as well as the lack of a consistent approach to data exchange. They aim to standardize electronic healthcare transactions and how data is collected, stored, and transmitted. The goal is to improve efficiency and effectiveness, reduce costs, and protect patients.
There are three points to the provisions:
- Standardization: Create consistent formats for electronic health records (EHRs) and other health data to allow different systems to communicate
- Efficiency: Simplify administrative tasks related to data management, such as billing and claims processing
- Protection: Establish clear rules on accessing and using patient information
The implementation of the provisions wasn’t without challenges as organizations figured out how to translate them to their needs and abilities.
See details: Health Insurance Portability and Accountability Act (HIPAA) Compliance
5 rules to enforce the Administrative Simplification provisions
Five HIPAA-related rules are used to enforce the Administrative Simplification provisions.
Privacy Rule – covers the protection of PHI, including when it can be disclosed and to whom, as well as standards for compliance
Security Rule – sets the security standards needed to protect electronic PHI (ePHI) through administrative, physical, and technical safeguards
Transactions and Code Sets Rule – creates a set of standard codes to identify medical procedures and transactions, such as claims, payment and remittance advice, and claims status
Unique Identifiers Rule – distinguishes the National Provider Identifier (NPI) as the only identifier number used by healthcare plans, Medicare, Medicaid, and other government programs
Enforcement Rule – establishes the standards of enforcing HIPAA and penalizing uncompliant covered entities
Email and the Administrative Simplification provisions
The HIPAA Privacy and Security Rules protect HIPAA email communication. HIPAA allows employees to include PHI in an email but requires certain safeguards to guard against unauthorized access. A structured system should be in place to secure email and ensure patient confidentiality.
The provisions require covered entities and their business associates to make reasonable efforts to limit the use or disclosure of PHI to the minimum necessary to accomplish the intended purpose. Accordingly, PHI should only be disclosed for permitted purposes, such as treatment, payment, and healthcare operations. Moreover, sending or receiving PHI in an email should only be done with an individual's written authorization.
HIPAA email compliance means ensuring the confidentiality, integrity, and availability of the information given in an email.
Learn more: Mitigating human error in email handling to prevent HIPAA breaches
What makes email security HIPAA compliant?
HIPAA compliant email security must be layered to be effective. It must encompass methods that address access, storage, and the safe transmission of all messages. HIPAA compliant email security should include several of the different security features listed below.
- Up-to-date email policies and procedures
- The use of a HIPAA compliant email platform
- A signed business associate agreement (BAA) with the platform
- Encryption for data in transit and at rest
- Access and authentication controls
- Spam filters
- Malware detection
- An incident response plan
- Audit trails
- Employee awareness training
The consequences of a successful email breach can be severe, even leading to business and financial losses. For healthcare organizations, a data breach can also lead to compromised patient information and even patient death. Following HIPAA’s guidelines, including the Administrative Simplification provisions, when protecting email keeps the severity of breach issues to a minimum. Furthermore, it lets healthcare organizations focus on their patients and patient care.
FAQs
Does HIPAA apply to email?
Yes, HIPAA applies to email when it involves the transmission of PHI.
Can patient information be sent via email?
According to the U.S. Department of Health and Human Services (HHS), “The Security Rule does not expressly prohibit the use of email for sending e-PHI.” However, covered entities must implement policies and procedures based on HIPAA standards for access control, integrity, and transmission security of ePHI. These measures must “protect the integrity of, and guard against unauthorized access to e-PHI.”
What is an example of a HIPAA violation email?
An example of a HIPAA violation email is an unencrypted email containing PHI sent to the wrong recipient.
How do you know if an email is HIPAA compliant?
An email is HIPAA compliant if encrypted, sent using secure methods, and follows all administrative, technical, and physical safeguards required by HIPAA.
Kapua Iao
