HIPAA and Helcim

Helcim is proud to share its Health Insurance Portability and Accountability Act (HIPAA) program, delineating our commitment to ensuring the privacy and security of our clients' healthcare information.

We sat down with Nic Beique (Chief Executive Officer) and Stephanie Davis (Head of Compliance) recently to talk about HIPAA and Healthcare’s importance for Helcim. According to Stephanie, this program underscores our dedication to upholding the highest standards of data protection, offering peace of mind to healthcare providers and their patients.

Key advantages of the HIPAA program include enhanced data security measures, ensuring that sensitive health information is safeguarded against unauthorized access and breaches. Helcim has always prioritized making our merchants’ payments seamless and secure. With this program, we are reinforcing our commitment to helping our healthcare merchants comply with their HIPAA obligations related to privacy and security.

This not only reinforces our commitment to confidentiality and integrity in handling sensitive data but also positions Helcim as a trusted partner in the healthcare industry, enabling providers to focus on delivering quality care without compromising on data security.

Why do healthcare providers need vendors who understand HIPAA?

The goal of HIPAA is to ensure providers are keeping patient safety, information security and privacy top of mind. When choosing a vendor, supplier, or partner to help you deliver your healthcare services, you might consider asking them about the following security and privacy best practices:

Legal and regulatory requirements:

The healthcare industry is one of the most heavily regulated sectors. How does your prospective vendor help you adhere to laws and regulations designed to protect patients' privacy, ensure the safety of drugs and medical devices, and prevent fraud and abuse. Non-compliance can result in legal penalties, fines, and even criminal charges against providers.

Reputation and trust:

Health care providers that maintain a strong adherence programs are more likely to be trusted by patients, regulatory bodies, and the general public. This trust is essential for building and maintaining a strong patient-provider relationship, which is foundational to the practice of medicine. This same principle extends to vendor selection and therefore an HCP needs to ask themselves this question: “How does a potential vendor support the development of strong patient-provider trust for my practice/organization?”

Accreditation and funding:

Compliance with industry standards is often a prerequisite for accreditation by healthcare oversight bodies, which can influence an organization's eligibility for certain types of funding and insurance reimbursements. Accreditation can also be a marker of quality that attracts patients and skilled healthcare professionals. Working with vendors who partner with you to ensure your compliance needs are met can simplify your application processes.

Data protection:

In the digital age, healthcare providers collect and store vast amounts of sensitive individually identifiable health information. Compliance with data protection laws and regulations is critical to safeguarding this information from breaches, which can have severe consequences for patients and providers alike. The same rigor should be expected from any potential vendor.

Compliance in healthcare is about doing the right thing for patients, ensuring the sustainability of healthcare organizations, and meeting the legal and ethical standards set forth by regulatory bodies and expected by patients. It's an ongoing process that requires a culture of integrity, continuous education, and vigilance to adapt to changing laws and practices. Therefore in a vendor selection process, it is critical that the above considerations are kept in mind.

What is HIPAA and why is it important?

HIPAA, the Health Insurance Portability and Accountability Act, was enacted by the U.S. Congress in 1996. It is a critical piece of legislation in the healthcare industry, primarily focused on two main aspects:

Health insurance portability:

HIPAA helps ensure that individuals can maintain their health insurance coverage when they change or lose their jobs, reducing the risk of being uninsured due to pre-existing conditions or the transition between employers.

Accountability:

Perhaps more widely recognized is HIPAA's role in establishing national standards for the protection of individually identifiable health information. This part of HIPAA is crucial for safeguarding patient privacy and securing sensitive health data in the era of electronic health records (EHRs).

Why is HIPAA Important?

Protects patient privacy:

HIPAA sets standards for how personal health information (PHI) should be handled and protected. It restricts how PHI can be used and disclosed, ensuring that patients’ health information is shared only with their consent and for legitimate purposes.

Enhances patient trust:

By safeguarding patient information, HIPAA helps build trust between patients and health care providers. Patients are more likely to seek treatment and share sensitive information with a covered health care provider if they believe their data is protected.

Supports electronic health records (EHRs):

HIPAA has facilitated the transition from paper records to EHRs by setting standards for the electronic transmission of health information. This not only improves efficiency in healthcare delivery but also enhances the quality of care by making patients’ health information more accessible to health care providers.

Promotes accountability:

HIPAA includes provisions for enforcing its rules, with significant penalties for violations. This accountability ensures that covered entities (such as health plans, healthcare clearinghouses, and most health care providers) and their business associates take the necessary steps to comply with the law’s requirements.

Improves healthcare system efficiency:

By standardizing the electronic exchange of health information, HIPAA helps reduce paperwork and administrative burdens. This standardization in HIPAA supports better health care management, billing practices, and reduces healthcare fraud and abuse.

Adapts to changes in healthcare delivery:

HIPAA regulations have evolved through additional rules like the Privacy Rule, Security Rule, and the Breach Notification Rule, reflecting changes in technology and the way healthcare is delivered. These updates ensure HIPAA remains relevant in protecting patient information in a digital age.

HIPAA is a cornerstone of patient privacy and data security in the United States, ensuring that individuals' health information is handled with care and confidentiality. Its importance spans from enhancing patient trust and safeguarding privacy to improving the efficiency and quality of healthcare delivery.

What is BAA (Business Associate Agreement)?

A Business Associate Agreement (BAA) is an agreement between health care providers and their downstream vendors that sets out how both parties work together to ensure PHI is protected. These are legally binding contracts between a HIPAA-covered entity (such as hospitals, doctors’ offices, insurance companies) and a business associate (any organization or person working in association with or providing services to a covered entity that involves the use or disclosure of protected health information-PHI).

Key elements of a BAA

Permitted and Required Uses of PHI: The BAA must specify exactly how the business associate is permitted and required to use and disclose PHI, in accordance with HIPAA regulations.

Safeguards and Compliance: The business associate is required to use appropriate safeguards to prevent unauthorized use or disclosure of PHI, including implementing the requirements of the HIPAA Security Rule.

Reporting: The agreement should include provisions for reporting any use or disclosure of PHI not provided for by the contract, including incidents of breaches of unsecured PHI.

Subcontractors: Business associates must ensure that any subcontractors that create, receive, maintain, or transmit PHI on behalf of the business associate agree to the same restrictions and conditions that apply to the business associate with respect to such information. Sometimes these subcontractors are referred to as “sub processors”.

Termination: The BAA must include terms that allow for the termination of the contract by the covered entity if the business associate violates a material term of the agreement. Why is BAA useful in the context of HIPAA?

Why is BAA useful in the context of HIPAA?

Ensures compliance: BAAs are crucial for ensuring that business associates who handle PHI comply with HIPAA rules and protect the privacy and security of health information, reducing the risk of data breaches.

Clarifies responsibilities: By clearly outlining the responsibilities and expectations of both parties in handling PHI, a BAA minimizes ambiguities and sets the foundation for a compliant and secure handling of sensitive information.

Legal protection: A BAA serves as a legal mechanism that holds business associates accountable for violating its terms. This is particularly important in the case of a data breach or unauthorized disclosure of PHI, offering a layer of protection to the covered entity.

Promotes trust: By formalizing the relationship between covered entities and their business associates regarding the use and protection of PHI, BAAs help build trust among providers, business associates, and patients.

Adaptability: BAAs can be tailored to specific relationships and services, providing flexibility while ensuring that all parties remain compliant with HIPAA regulations. In essence, the BAA is a critical tool in the HIPAA compliance process, providing a formal mechanism to ensure that all parties involved in the handling of PHI are aware of their responsibilities and comply with HIPAA regulations to protect patient privacy and data security.