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What is a Privacy Rule?

A Privacy Rule is a set of standards designed to safeguard individuals' medical records and other personal health information. It ensures that personal health data is properly protected while allowing the flow of information needed to provide high-quality health care. Curious about how this impacts your healthcare experience? Discover the balance between confidentiality and care in our full exploration.
A. Leverkuhn
A. Leverkuhn

A privacy rule or privacy act is a regulation that is set up to protect the private information of individuals or other parties. In many industries, a privacy rule is self-assigned, where a business takes on privacy protection measures to satisfy their customers that they are safeguarding their personal information. However, the most prominent privacy rules and legals measures are designed to protect individuals and households.

Perhaps the most notable health privacy rule is known as HIPAA, or the Health Insurance Accountability and Portability Act. Passed in 1996, this piece of legislation establishes medical privacy laws for a range of businesses. HIPAA sets up specific medical records privacy rules to make sure that a patient's medical information is not released to an unauthorized party.

Under HIPAA, medical providers are expected to keep patient information and records confidential.
Under HIPAA, medical providers are expected to keep patient information and records confidential.

Health insurance companies, most health care providers such as doctors offices and hospitals, and other medically related businesses need to comply with the requirements of HIPAA. Some other kinds of businesses do not need to comply with HIPAA, as their practices are not covered under the legislation. Some of these include school districts, law-enforcement agencies, human resources departments, and other businesses that may not have a primary role in keeping medical records on-site.

The information that is private under HIPAA consists of a patient's medical history, specific information about a medical visit, and nearly anything else that a doctor or nurse will have access such as charts and notes. HIPAA rules also extend to a lot of data that health insurance companies use. Because of the broad scope of the information included in the HIPAA privacy rule, it can be challenging for businesses to comply with this law.

Almost all medically related businesses take strict care to provide compliance with HIPAA. This can take many forms, from safeguarding paper or electronic records, to preventing unauthorized communications within an office or hospital setting. Hospitals go to great lengths to keep their verbal communications compliant with HIPAA. This may include setting up artificial noise sources next to a registration desk, or creating special code identities for patients and procedures.

For an office handling a large amount of patient health data, there may be more attached to HIPAA compliance. File cabinets holding medical information may need to be subject to a multi-key system to ensure they are not accessible by unauthorized users. Workers keeping paper or electronic files on their desks or computers may need to take specific steps to “lock” information if they step away from a work area. All of these efforts are toward making sure that the HIPAA privacy rule is upheld across a specific business enterprise.

Frequently Asked Questions

What is the Privacy Rule and who does it apply to?

The Privacy Rule, established under the Health Insurance Portability and Accountability Act (HIPAA) of 1996, sets national standards for the protection of individuals' medical records and other personal health information. It applies to covered entities, which include health plans, health care clearinghouses, and health care providers that conduct certain health care transactions electronically. According to the U.S. Department of Health & Human Services, the rule requires appropriate safeguards to protect the privacy of personal health information and sets limits and conditions on the uses and disclosures that may be made of such information without patient authorization.

How does the Privacy Rule benefit patients?

The Privacy Rule benefits patients by providing them with significant rights over their health information, including rights to examine and obtain a copy of their health records and to request corrections. The Office for Civil Rights (OCR) enforces the Privacy Rule, which ensures that individuals' health information is properly protected while allowing the flow of health information needed to provide high-quality health care. Patients are also given the right to be informed about privacy breaches concerning their health information.

What types of information are protected under the Privacy Rule?

Under the Privacy Rule, protected health information (PHI) includes any information held by a covered entity that concerns health status, provision of health care, or payment for health care that can be linked to an individual. This includes any part of an individual's medical record or payment history. As outlined by the Centers for Medicare & Medicaid Services, PHI is information, including demographic data, that relates to the individual’s past, present, or future physical or mental health or condition, the provision of health care to the individual, or the past, present, or future payment for the provision of health care to the individual, and that identifies the individual or for which there is a reasonable basis to believe can be used to identify the individual.

Can a patient's health information be shared without their consent under the Privacy Rule?

Yes, there are circumstances under which a patient's health information can be shared without their consent under the Privacy Rule. These exceptions typically involve situations related to public health and safety. For instance, covered entities may disclose PHI without consent for public health purposes, including reporting of disease or injury, reporting vital events such as births or deaths, and conducting public health surveillance, investigations, or interventions, as stated by the Centers for Disease Control and Prevention. Other exceptions include disclosures for law enforcement purposes, to avert a serious threat to health or safety, or as required by state or federal law.

How does the Privacy Rule handle the use of de-identified data?

The Privacy Rule recognizes that de-identified data poses a lower risk to individual privacy. Therefore, it does not restrict the use or disclosure of health information that has been de-identified in accordance with the rule's standards. According to the National Institutes of Health, de-identification can be achieved by removing all 18 elements that could be used to identify the individual or their relatives, employers, or household members. Alternatively, an expert can determine that the risk of re-identification is very small. Once de-identified, the information is no longer considered PHI under the Privacy Rule, allowing for broader use and disclosure for research, public health, or other purposes.

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    • Under HIPAA, medical providers are expected to keep patient information and records confidential.
      By: andreiorlov
      Under HIPAA, medical providers are expected to keep patient information and records confidential.