What you need to know about HIPAA investigations

The security and privacy of health care information is vital, and it’s regulated by the Health Insurance Portability and Accountability Act (HIPAA). Medical entities therefore have to ensure that they are compliant with HIPAA regulations. However, should you be investigated by HIPAA, you ought to have an idea of what you need to know about dealing with HIPAA investigations.

HIPAA requires that health care providers exercise extreme care, in ensuring that protected health information (PHI) is safeguarded. Medical entities or their business associates are expected to exercise reasonable diligence, with regards to the privacy and security of PHI.

When a medical practice is satisfying the legal requirements to be HIPAA compliant, it makes it a lot easier for health care attorneys to assist with an investigation.

Why you may be investigated

A medical entity may face an investigation as a result of the findings of a random audit, or because of a complaint lodged against them. HIPAA will launch an investigation, in cases where there is reasonable cause to indicate that there has been an omission or violation of the provisions of HIPAA. Failure to act prudently in the management of medical records, can result in a complaint being filed.

Preparing for a HIPAA Investigation

HIPAA investigations typically relate to the violation of privacy and security rules, or breach notification rules.  Medical entities should therefore ensure that they have a balanced compliance program in place. The organization’s compliance policy should be clearly articulated, and the necessary procedures implemented. They should also have personnel in place who are knowledgeable about HIPAA requirements, and can manage the compliance process efficiently.

Nelson Hardiman, Los Angeles, CA, provides legal counsel for medical practices, to ensure that they are HIPAA compliant. They also assist clients in responding to HIPAA investigations. Please call 310-203-2800 today for an appointment.

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