At every level, the healthcare industry continues to grapple with protecting sensitive information from unauthorized access. And whether you’re a national healthcare enterprise or a small, virtual private practice offering mental health or other services via telehealth services, HIPAA violations can cost you.
In fact, the smaller your practice, the more damage the fines and penalties that come with a violation could cause — because they eat up more of your budget and could even threaten cash flow or sustainability.
Though HIPAA regulations can seem daunting, there are concrete strategic steps your virtual private practice can take to ensure HIPAA compliance. Here’s what you need to know.
The Health Insurance Portability and Accountability Act of 1996 (HIPAA) was created to regulate how healthcare practitioners and other covered entities could create, store, and share confidential patient information (often termed personally identifiable information [PII] or protected health information [PHI]).
First introduced by the Department of Health and Human Services (HHS) in 1996 and continually updated in the years since, HIPAA regulations govern what healthcare providers and adjacent businesses can do with information that can identify an individual, including:
Complying with HIPAA is important both for consumer trust and because of the penalties the federal government may impose when it discovers violations. These can include both civil and criminal penalties that include hefty fines or even prison time for crimes committed knowingly and under false pretenses.
Healthcare providers of all types (both virtual and in-person), hospitals, medical facilities, other caregivers, insurance companies, and companies that process health information for others (vendors and clearinghouse companies) are all subject to HIPAA compliance.
HIPAA rules are important, but the specifics and details can be a lot to follow. These rules fall under any of four overarching categories or goals: privacy, security, breach notifications, and enforcement.
The HIPAA Privacy Rule “establishes national standards to protect individuals’ medical records” and PHI. It applies to healthcare organizations that conduct electronic transactions of certain types, meaning it applies to any healthcare organization with electronic records or stored patient data.
PHI includes any information that could identify a patient, such as name, address, phone number, and medical diagnoses.
This rule limits what organizations can do with this kind of data, requiring that they store, transmit, and otherwise use it securely and only in specific ways related to treatment, payment, and healthcare operations.
Complying with the privacy rule requires following careful procedures with patient data and relying on only those digital tools and platforms that can demonstrate HIPAA compliance themselves. For virtual private practices, this extends to the tools they use to facilitate virtual appointments and telehealth.
Consequences for violating the privacy rule vary based on extent, seriousness, willfulness, and number of offenses. But they can be steep:
The HIPAA Security Rule deals with electronic protected health information (ePHI) that covered entities (including your virtual private practice) create, receive, use, or maintain.
The distinction here is subtle: The privacy rule focuses on whether you keep PHI private, while the security rule focuses on whether you put the right technical safeguards in place to “ensure the confidentiality, integrity, and security” of the ePHI you touch.
It’s possible, then, to break the security rule without actually breaking the privacy rule. You could identify in a security risk assessment or audit that you don’t have the right safeguards in place and then fix the problem before a privacy violation happens.
The inverse is less likely: while it’s possible to have appropriate or compliant safeguards in place and still suffer a data breach, most privacy violations occur because of some violation of the security rule.
Quick note: PHI and ePHI differ only in form. One is physical (printed statements, envelopes, forms, charts), and the other is digital (PDFs of these statements, envelopes, forms, and charts, as well as other digital representations of data).
The consequences for non-compliance with the security rule are largely the same as for the privacy rule: hefty fines and possible jail time for criminal violations.
The HIPAA Breach Notification Rule requires covered entities to notify those affected by a breach of unsecured protected health information in most situations. Even if the breach doesn’t fail the privacy or security rules in such a way as to incur a penalty, a failure to disclose it can result in a violation of this rule.
The goal of this rule is to provide patients with information when their PHI is compromised so they can take action if necessary.
As defined by this rule, a breach is “an impermissible use or disclosure under the Privacy Rule that compromises the security or privacy of the protected health information” and where there is more than a low probability that this impermissible use resulted in compromise of the data.
There are also limits on what qualifies as a breach related to who’s involved. Unintentional acquisition by a workforce member of a covered entity working in good faith is not considered a breach.
For example, a receptionist opening the wrong patient’s file is technically impermissible, but it likely doesn’t qualify as a breach or violation. The same is true if the patient may have momentarily seen that information on the staff member’s screen, since it’s unlikely that the patient can retain or use (compromise) that data.
Once an organization determines an event qualifies as a breach, they must notify affected patients within 60 days.
Last up is the HIPAA Enforcement Rule, which lays out procedures and provisions connected to investigations and compliance, along with more detailed information on the civil monetary penalties for violations.
This rule is less like the others in that it isn’t a rule an organization fails under; instead, it’s more of a clarifier about what happens when an organization fails under one of the other three.
Virtual private practices rely on technology tools for nearly every part of their day-to-day operations. It’s vital to rely on tools that support HIPAA compliance — and, where possible and relevant, that hold some kind of certification indicating that compliance.
The tools you use can either help or hurt your ability to comply with HIPAA — and you don’t want to assume that a violation relating to a tool you’re using will be anyone else’s fault.
Virtual practices face elevated and unique risks here because they rely more heavily on certain types of tools than in-person practices do. Video conferencing is one example. It’s core to the virtual visit, but there are risks of surveillance and breaches that don’t have in-person counterparts.
Document transmission is another area of concern. While in-person practices more frequently send documents electronically to patients, virtual practices may need to do so more frequently or may feel the need to do so in real time during an electronic visit. Jumping to the most convenient tool or whatever’s on hand might not be the most secure choice.
Virtual practices are also much more likely to rely on a virtual address for privacy, but only some virtual mail services comply with the standards here. HIPAA compliance in a virtual mailbox service like Stable is achievable and certainly worth pursuing. Stable is HIPAA-compliant and adheres to SOC 2 Type 2 security standards, giving practices the compliance support they need.
It’s also a good idea to look for SOC 2 compliance for virtual addresses. This is distinct from HIPAA and other cybersecurity standards, and SOC 2 is both more flexible and more comprehensive than HIPAA.
SOC 2 certification involves proving compliance with five “trust principles”: security, availability, processing integrity, confidentiality, and privacy.
SOC 2 certification indicates stronger overall controls and better practices, which means that most providers, vendors, and partners that can demonstrate SOC 2 compliance can also demonstrate HIPAA compliance.
Outside auditors assess a business for SOC 2 compliance standards to determine whether or not it earns its certification, but the business must then maintain ongoing compliance. Auditors assess for the presence of communication and data encryption, network and application firewalls, and rigorous access controls to ensure data is secure.
Stable’s virtual mailbox service is compliant with both HIPAA and SOC 2 Type 2, so virtual practices can breathe a sigh of relief knowing that their virtual address, mailbox, and mail handling services are taken care of correctly. Stable also offers additional privacy-focused features such as mail shredding.
Compared to a less secure platform that relies on whoever works at the local pack-and-ship storefront, Stable provides clear and compelling value.
A BAA is an agreement between you and a business associate (such as a software or service vendor) that states that the business associate will follow HIPAA compliance guidelines and that offloads liability from your practice to that business associate for violations that originate from the business associate.
In this way, your practice is protected from HIPAA penalties that aren’t your fault.
Software providers that are already SOC 2 certified and HIPAA compliant shouldn’t resist signing a BAA. If they do, it may be a red flag that should steer you to a different vendor.
It’s crucial for virtual private practices to conduct regular risk assessments for their practice, seeking to identify potential violations of the privacy, security, or breach notification rules, as well as operational gaps or vulnerabilities that could lead to breaches and violations.
Proactively addressing issues before they turn into violations can save your practice from both reputational and financial penalties. In the process, you’ll also free up your practice to focus on providing strong patient care rather than constantly fighting operational fires and compliance challenges.
Remember, the best defense is a good offense — and given today’s landscape, you need as strong a defense as you can muster! The HIPAA Journal identified a stunning 725 major healthcare security breaches in 2023, exposing more than 133 million records! These threats evolve quickly, and so must your security posture.
A few tips to ensure you’re protecting patient data:
If your virtual private practice would benefit from a virtual address and/or virtual mailbox, a HIPAA-compliant solution is a must — and in this category, Stable leads the way.
Stable provides high-quality, trustworthy virtual mail handling services from our own network of facilities that we own, control, and operate. That’s how we can offer such stringent security certifications, including HIPAA and SOC 2 compliance.
Using a virtual mailbox has other benefits, too, like keeping your home address private (for home-based practitioners) and providing a more prestigious business address that elevates your practice’s online presence.
It’s time for stronger HIPAA compliance along with the many other benefits of using a virtual mailbox. Start your virtual mailbox with Stable today!
