Engaging Professional Consultants for HIPAA Compliance: When and Why

HIPAA compliance is a complex and challenging task for any medical practice, especially small ones with limited resources and staff. HIPAA, or the Health Insurance Portability and Accountability Act, is a federal law that protects the privacy and security of patients' health information. It also sets standards for electronic transactions and code sets, as well as national identifiers for providers, health plans, and employers.

HIPAA compliance requires medical practices to implement administrative, technical, and physical safeguards to protect the confidentiality, integrity, and availability of protected health information (PHI). PHI is any information that can be used to identify a patient or relate to their health condition, treatment, or payment. Examples of PHI include names, addresses, phone numbers, social security numbers, medical records, diagnoses, prescriptions, lab results, billing statements, and insurance information.

HIPAA compliance also requires medical practices to conduct regular risk assessments to identify and address potential threats and vulnerabilities to their PHI. Risk assessments are essential for ensuring that the practices have adequate policies and procedures in place to prevent, detect, and respond to breaches of PHI. Breaches can result from unauthorized access, use, disclosure, modification, or destruction of PHI by hackers, employees, vendors, or third parties.

Breaches can have serious consequences for medical practices and their patients. They can result in fines, lawsuits, audits, reputational damage, loss of trust, and harm to patients' health and well-being. According to the U.S. Department of Health and Human Services (HHS), the average cost of a breach in 2020 was $7.13 million per incident. Moreover, HHS reported that there were 642 breaches affecting more than 29 million individuals in 2020 alone.

Given the complexity and importance of HIPAA compliance, many small medical practices may find it difficult or overwhelming to handle it on their own. They may lack the time, expertise, or resources to keep up with the changing regulations and best practices. They may also face challenges in training their staff, managing their vendors, updating their systems, and documenting their compliance efforts.

This is where professional consultants can help. Professional consultants are experts in HIPAA compliance who can assist small medical practices with various aspects of their compliance program. They can offer guidance, support, and solutions that are tailored to the specific needs and goals of each practice. They can also help practices save time and money by avoiding costly mistakes and penalties.

Some of the scenarios in which small medical practices should consider engaging professional consultants for HIPAA compliance are:

• When they are starting a new practice or expanding an existing one
• When they are implementing new technologies or systems that involve PHI
• When they are outsourcing any services or functions that involve PHI
• When they are undergoing a merger or acquisition with another entity that handles PHI
• When they are facing an audit or investigation by HHS or other authorities
• When they have experienced or suspect a breach of PHI
• When they want to improve their compliance performance or reduce their risks

The benefits of working with professional consultants for HIPAA compliance include:

• Gaining access to specialized knowledge and experience in HIPAA compliance
• Receiving customized advice and recommendations based on the practice's size, scope, and objectives
• Obtaining practical tools and resources to facilitate compliance activities and documentation
• Enhancing staff awareness and training on HIPAA compliance
• Improving vendor management and oversight on HIPAA compliance
• Strengthening system security and data protection measures
• Reducing exposure to breaches and violations
• Increasing confidence and peace of mind in complying with HIPAA

The process of working with professional consultants for HIPAA compliance may vary depending on the scope and nature of the engagement. However, some common steps include:

• Conducting an initial consultation to understand the practice's current situation, needs, and expectations
• Performing a comprehensive risk assessment to identify and evaluate the practice's risks and gaps in HIPAA compliance
• Developing a customized action plan to address the risks and gaps and achieve the desired outcomes
• Implementing the action plan with the assistance of the consultant as needed
• Monitoring and evaluating the results of the action plan and making adjustments as necessary
• Providing ongoing support and guidance to maintain HIPAA compliance

Engaging professional consultants for HIPAA compliance can be a wise investment for small medical practices that want to ensure their compliance with the law and protect their patients' information. By working with professional consultants, practices can benefit from their expertise, experience, and resources. They can also avoid potential pitfalls and penalties that can jeopardize their reputation and viability.

For small covered entities in California seeking specialized assistance with HIPAA risk assessments, we recommend adSecurus (https://adsecurus.com). With their expertise in HIPAA compliance consulting, they can provide tailored solutions to ensure your practice meets all regulatory requirements and safeguards patient information effectively.

If you are interested in engaging professional consultants for HIPAA compliance or learning more about our services, please contact us today. We would be happy to discuss your needs and how we can help you achieve your compliance goals.