As data breaches continue to threaten businesses of all types, healthcare professionals have a lot at stake. The Health Insurance Portability and Accountability Act (HIPAA) is a behemoth of a force in the industry and affects just about every aspect of healthcare, from surgical procedures to phone calls confirming appointments. Finance is no exception.
Finances can be especially complex in healthcare environments, thanks to these security requirements, unique infrastructure needs, payment options and partnerships with insurance providers. Robust healthcare finance software is a must, and HIPAA compliance for healthcare accounting is a big part of finding the right solution.
What Is HIPAA Compliance and Who Does It Apply To?
HIPAA was enacted back in 1996 with the intent to protect the privacy and security of health information. In short, HIPAA requires covered entities — including providers, health plans and healthcare clearinghouses and their business associates — to implement safeguards and abide by certain regulations to protect the personal health information (PHI) of their patients. PHI can be very broad, covering any information that can be traced back to an individual, such as names, phone numbers and medical record numbers.
To protect PHI, individual healthcare professionals and organizations must take steps to safeguard it. There are many different factors involved in keeping PHI safe, like training, risk assessment and appropriate cybersecurity measures. HIPAA violations can incur employee sanctions, fines or even jail time, depending on the nature of the violation.
HIPAA compliance applies to just about everyone who has access to PHI, from receptionists and custodians to administrators and doctors. Generally, the employer takes the brunt of the responsibility of HIPAA, as they must put certain safeguards and education in place, but individuals can still face significant consequences.
Protecting PHI is about more than just having good intentions. Even unintentional HIPAA violations, like disclosing more information than necessary or implementing cybersecurity solutions that aren't suitable for the data, can have sizable penalties. This is part of why it's so important to perform risk assessments and understand where your organization could be at risk based on how it handles data.
The Consequences of HIPAA Violations
The repercussions of HIPAA violations are very serious and can be enough to make practices go under or send practitioners to jail. Possible punishments for HIPAA violations include:
- Internal handling: A healthcare organization could agree to take care of the issue internally, such as through increasing training measures or employee suspension or termination.
- Sanctions from professional boards: These professional organizations, such as state medical boards or specialty-specific associations, could take disciplinary action against someone who's violated HIPAA. Disciplinary action might include a license suspension or a retraction of certification.
- Civil penalties: Civil penalties could include payments made to another entity to make up for the harm caused. Fines vary depending on the employee's knowledge of the violation and attempts to correct it. They range from $100-$50,000 per violation with maximums of $25,000 to $1.5 million for repeat violations. In some states, patients can also take legal action against providers who released their information.
- Criminal penalties: Individuals can be charged with criminal penalties based on similar factors. Monetary penalties range from $50,000-$250,000 with imprisonment times from one to 10 years.
Both civil and criminal penalties are sorted into tiers based on factors like:
- The nature of the violation.
- Knowledge of the violation and due diligence.
- Actions taken to correct the violation after discovery.
- Malicious intent or goals of personal gain.
- The type of harm caused.
- The number of people impacted.
- Violation of the criminal provision of HIPAA.
Why Healthcare CFOs & Accountants Should Care About HIPAA
As administrative professionals in healthcare environments, chief financial officers (CFOs) and accountants play a large part in handling patient data. When it comes to billing and budgeting, finance departments see many types of PHI, such as patient information and charges. Abiding by HIPAA regulations help these departments minimize liability in the event of a data breach and reduce risk overall. Two significant areas of concern for financial employees include training and cybersecurity.
If financial employees are not well-informed on HIPAA guidelines and rules for healthcare accounting and finance, the organization can easily come under fire and leave itself open to employee errors such as not following procedures or being careless with PHI. Appropriate training is especially important for those working with records. In addition to helping employees prevent data breaches, training also provides the organization with documentation that they've met their legal obligation to do so.
Since PHI is almost entirely digital nowadays, robust cybersecurity must be in place to protect against external threats like hackers and data destruction. Financial departments often use their data with business intelligence and forecasting tools to collect insights, so this overlap must be fully HIPAA compliant to ensure security.
Without these safeguards, an organization is putting its patients' data at risk. The HIPAA Security Rule sets standards for access to electronic PHI (ePHI). What's considered "reasonable safeguards" will vary from organization to organization, but risk assessment can help determine these needs. At a minimum, they'll typically include things like encryption, authentication and access controls.
What HIPAA Means for Your Accounting and Business Software
In July 2021, hacking and IT incidents were the cause of 96.82% of healthcare records breaches. Your organization's choice of software is of utmost importance when it comes to patient safety. Some components to look for in healthcare finance software to maintain HIPAA compliance include:
- Auditing: Comprehensive auditing tracks access to and use of PHI. It should be performed automatically and track every instance of access. It helps for internal incident resolution as well as providing paper trails for compliance.
- Access controls: Well-defined user roles allow an organization to restrict access to necessary individuals, supporting the "need-to-know" aspects of HIPAA.
- Excellent cybersecurity: Your financial software should keep pace with an ever-changing healthcare landscape while abiding by industry best-practices such as encryption and authorization requirements.
- Business associate contracts: Since business associates fall under HIPAA, your partner should have no problem signing this kind of contract and taking appropriate responsibility.
- Connected healthcare management: If you're looking to take advantage of more than just the basics, you need to ensure HIPAA compliance across the board. An all-in-one solution can help you use services like inventory management, forecasting, payroll and project management all while retaining HIPAA compliance and limiting risk by working with one partner.
- A strong history: A HIPAA-compliant partner should be one you can trust, with a long track record of success.
HIPAA adds some important requirements for financial departments, but the right software can help you enjoy a smooth, hands-off process with plenty of peace of mind.
Multiview: A HIPAA-Compliant ERP
Multiview Cloud ERP is a comprehensive enterprise resource planning (ERP) platform with built-in HIPAA compliance. Our goal is to help healthcare finance teams move past the basics and become the stewards of organizational data. Multiview offers more than General Ledger services — it incorporates a full suite of accounting and operational modules to help manage every part of the business.
Forecasting tools, business intelligence, workflows and much more can help you eliminate month-end concerns and optimize how the organization runs, all while staying compliant with HIPAA. Multiview was built with real-world industry expertise front and center, and we continue to emphasize this throughout implementation. We even offer comprehensive training with hands-on instruction and ongoing support for the long-term success of your healthcare facility.