What Are Covered Entities Under HIPAA

October 4, 2024

Table of Content(s)

1. Introduction
2. What are covered entities as per HIPAA?
3. What are HIPAA Violations?
4. What happens when a covered entity violates HIPAA?
5. Why is it important for covered entities to follow HIPAA?
6. How to Understand HIPAA Compliance With Online HIPAA Courses?
7. Steps to enroll for an online HIPAA course?
8. Conclusion

Understanding the landscape of healthcare privacy can feel daunting. It can feel even more complicated under the rules of HIPAA (Health Insurance Portability and Accountability Act). When talking about the HIPAA covered entity, it usually refers to the group of organizations/individuals responsible for protecting data. According to a study, over 200 million Americans rely on covered entities for data protection. 

Covered entities include healthcare providers, health plans, and healthcare clearinghouses. Each of them play a vital role in the healthcare ecosystem. Read on to find more about what covered entities are, their responsibilities and contributions as per the HIPAA guidelines.

What are Covered Entities as per HIPAA?

“What is a covered entity under HIPAA?”- if you are having the same question coming to your mind over and over again, let’s solve the doubt for once and for all.

Below mentioned are the lists of Covered Entities as per HIPAA:

Healthcare Providers: Any provider of medical or health services who transmits health information in electronic form (e.g., doctors, hospitals, clinics).

Health Plans: Organizations that provide or pay for medical care. This includes health insurance companies, Medicare, Medicaid, and health maintenance organizations (HMOs).

Healthcare Clearinghouses: Entities that process or facilitate the processing of health information from one format to another. Bodies acting as intermediaries between healthcare providers and health plans.

Business Associates: While not classified as covered entities, these are individuals or organizations that perform functions on behalf of certain services to covered entities. Business associates are also subject to HIPAA regulations through contractual agreements.

Read More: What is Considered Protected Health Information Under HIPAA?

What Are HIPAA Violations?

HIPAA violations are breaches to the HIPAA law. HIPAA protects health information that is meant to be private. Violating these rules have serious consequences. 

Let’s go through the common HIPAA Violations:

Unauthorized Access: When a person accesses PHI without proper authorization or a legitimate reason, it constitutes a violation.

Inadequate Safeguards: Failing to implement sufficient physical, technical, or administrative safeguards to protect PHI can lead to breaches.

Improper Disposal of PHI: Disposing of medical records or sensitive information inappropriately, such as throwing them in regular trash, violates HIPAA regulations.

Sharing PHI without Consent: Disclosing patient information without obtaining the necessary consent or authorization from the patient is a significant violation.

Data Breaches: Unauthorized access to electronic PHI, whether through hacking or other means, can lead to substantial penalties under HIPAA.

Failure to Report Breaches: Not reporting a known breach of PHI to the affected individuals or the Department of Health and Human Services (HHS) as required is itself a violation.

Lack of Employee Training: Not providing adequate training to employees on HIPAA compliance and the handling of PHI can lead to unintentional violations.

What happens when a covered entity violates HIPAA?

A covered entity on violating HIPAA, faces terrible consequences. These include legal punishments and hefty fines. The severity of the consequence though depends on the nature and extent of violation. 

Here’s what happens when a covered entity violates HIPAA:

• Financial Penalties: The Office for Civil Rights (OCR) can impose fines that range from $100 to $50,000 per violation. This depends on the level of negligence.
• Corrective Action Plans:Covered entities may be required to implement specific corrective measures to address the violation and prevent future occurrences.
• Investigations: The OCR may conduct investigations into the violation. This could result in further scrutiny of the entity’s compliance practices.
• Loss of Reputation: Violating HIPAA can damage an organization’s reputation. This leads to loss of patient trust and potential loss of business.
• Legal Action: Affected individuals may pursue legal action against the covered entity for damages resulting from the violation.
• Potential Criminal Charges: In cases of willful neglect or malicious intent, criminal charges can be filed against individuals responsible for the violation. This leads to imprisonment.

Read More: Is Zoom HIPAA Compliant?

Why is it important for covered entities to follow HIPAA?

It is important for covered entities to follow HIPAA regulations. As these bodies handle sensitive patient information, it is important to maintain both trust and accountability. 

• Patient Trust: When confidentiality of health information is maintained, it builds trust between patients and healthcare providers. This encourages more people to seek necessary medical care.
• Legal Protection: Compliance with HIPAA helps covered entities avoid legal repercussions. This includes fines and penalties associated with violations.
• Quality of Care: Respecting privacy regulations enhances the quality of care by ensuring that patient information is used appropriately in treatment decisions.
• Risk Management: Following HIPAA guidelines helps identify and eliminate risks associated with data breaches and unauthorized access to PHI.
• Reputation Management: Organizations that demonstrate commitment to privacy and security are more likely to maintain a positive reputation within the community.
• Increased Funding Opportunities: Many funding agencies require HIPAA compliance as a requirement for loans or financial support.  

How to Understand HIPAA Compliance With Online HIPAA Courses?

Online HIPAA courses offer a flexible and comprehensive way to understand the different aspects of HIPAA regulations. Here’s how these courses can help you understand compliance:

• Flexible Learning: Online courses allow learners to study at their own pace. This accommodates busy schedules while providing essential information about HIPAA.
• Comprehensive Curriculum: Most courses cover all aspects of HIPAA compliance. This includes the Privacy Rule, Security Rule, and Breach Notification Rule. The courses ensure a thorough understanding.
• Interactive Content: Engaging formats, such as videos, quizzes, and case studies, help fasten the process of learning. They make complex concepts easier to grasp.
• Real-World Scenarios: Many courses incorporate real-world examples and scenarios to illustrate the practical application of HIPAA regulations. This makes learning fun and interesting. 
• Access to Experts: Online courses often provide access to industry experts who can clarify doubts, and share best practices for maintaining compliance.
• Up-to-Date Information: As HIPAA regulations evolve, online courses are regularly updated to reflect the latest changes. 
• Certification Opportunities: Eventually,completing a course will give you a certificate. Certifications enhance professional credentials and demonstrate a commitment to compliance.

By enrolling in an online HIPAA course you can master all the HIPAA rules for better healthcare service. You can opt for such courses individually, as well as take organizational courses. 

Steps to Enroll for an Online HIPAA Course

Here are the steps to enroll in an online HIPAA course:

1. Research Available Courses: Search for reputable providers that offer online HIPAA courses. Look for organizations with good reviews and recognized certifications.
2. Compare Course Content: Review the course syllabus to ensure it covers essential topics, such as the Privacy Rule, Security Rule, and Breach Notification Rule. Consider whether the course is suitable for your level of knowledge (beginner or advanced).
3. Check Accreditation: Verify that the course is accredited or recognized by relevant professional organizations. This further adds credibility to the training.
4. Evaluate Format and Duration: Decide on the course format (e.g., self-paced, instructor-led) and duration that best fits your schedule. Ensure the course provides flexibility in completing the modules.
5. Create an Account: Once you’ve selected a course, visit the provider’s website and create an account. This usually involves providing your name, email address, and creating a password. You will receive a confirmation email. 
6. Select Your Course: Navigate to the HIPAA course you wish to enroll in and click on the enrollment or “Register Now” button. Pay for your course and take a note of your schedule.
7. Access Course Materials: After enrollment, access the course materials through your account. Familiarize yourself with the course platform and resources available.
8. Complete the Course: Engage with the content, participate in quizzes or assignments, and complete all required modules. Take notes and ask questions if possible.
9. Obtain Certification: Upon successful completion, download or request your certification. You can use this as a proof to show your knowledge of HIPAA compliance.

Conclusion

Understanding HIPAA Covered Entity as a subject, is the most important step to ensure patient privacy. The integrity of health information, therefore the patients, lie in the hands of the healthcare bodies. With advancements in technology and data management, protecting data security has been more important than ever. By prioritizing HIPAA compliance, covered entities can benefit both the patients and the professionals by creating a secured healthcare system.