Security Regulation Compliances in Healthcare Research Paper

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Health Insurance Portability and Accountability Act

HIPAA is the acronym for Health Insurance Portability and Accountability Act of 1996. HIPAA addresses health coverage for people who lose their jobs, reduces health care fraud, develops standards, and protects healthcare information. HIPAA mandates standards for safeguarding and confidential handling of personal health information to avoid access from unauthorized sources. HIPAA addresses five broad initiatives: patient confidentiality, billing, and fraud in the healthcare industry. The Act protects health workers by providing them with insurance due to job loss. In addition, the Act establishes the standard for electronic transmission and storage of PHI and specifies tax requirements for medical spending entities (HIPAA Journal, 2017). It provides guidelines for public group health plans and regulates insurance provided to employees.

HIPAA addresses storage and transmission through the privacy and security rule. The privacy rule restricts data access by only allowing specified parties that use the data. The privacy rule establishes a balance between client confidentiality and access that medical practitioners require to provide quality care. The privacy rule employs the concept of minimum necessary as it limits data access to the portions needed for patient care. The security rule establishes standards for protecting health information electronically from creation, processing, accessing, or storing healthcare information. The security rule addresses technical and non-technical vulnerabilities to secure electronic data PHI.

There are three types of safeguards physical, technical, and administrative. Physical safeguards entail facilities that house data servers, devices used to access electronic data, data backups, and disposal procedures. Physical safeguards entail authentications that ensure only authorized personnel can access customer data. These include passcodes, key fobs, alarms, and computer privacy filters. Technical safeguards entail practices that protect the electronic database from unauthorized access. The precautions include data encryption, unique user identifiers, automatic log-off, regular data audit, and strong passwords. Administrative safeguards entail office policies that regulate data protection practices, including employee training, risk management protocols, and contingency plans.

HIPAA compliant organizations entail covered entity that uses or has access to PHI, including health clearinghouses. Health clearinghouses act as third-party intermediaries between healthcare providers and health insurers. Healthcare organizations generate payment claims to the health insurer for services offered to pay its portion. Health clearinghouses receive the medical bill and transform it into the American National Standard Institute format. In addition, the clearinghouse verifies the validity of the claim by examining for errors and fraud before submitting it to the health insurer. Health clearinghouses must be HIPAA compliant as they are exposed to protected health information in translating data. The PHI includes the patient’s name, address, medical record number, phone number, and health insurance beneficiary number. Non-compliance attracts a civil penalty based on the degree to which the entity was aware of HIPAA non-compliance.

Family Educational Rights and Privacy Act

The Family Educational Rights and Privacy Act (FERPA) is a federal law enacted in 1974 to protect students’ education information privacy. The Act’s primary purpose is to grant parents, and eligible students access to education records and prevent disclosing information to third parties without consent. Students attain a qualified status when they turn 18 years old or enroll in a post-high school institution, thus transferring rights from the parent to the student. The Act implements confidentiality through three primary rights accorded to parents and eligible students, including the right to inspect and review students’ educational records. Parents and students can schedule a hearing to challenge a record they deem inaccurate. In case of rejection of corrections, they have a right to include a written record regarding the complaint (Tierney, 2020). Schools are prohibited from sharing educational records without the consent of the parents or students.

The student information transmitted includes records that directly relate to the student and are maintained by an educational institution or by third parties acting on behalf of the institution. The protected student information includes grade reports, transcripts, and school progress reports. However, directory information, including student name, address, and honors, is not protected and can be shared with third parties. Institutions state the information to be disclosed, allowing parents to submit an opt-out form regarding disclosing directory information. The Act states that data disclosure requires signed consent, and institutions must ensure that student records are protected from third parties.

The most vulnerable points are file transfer and storage; thus, there is a need for institutions to handle these attacks. Most institutions implement firewalls, virtual networks, multi-factor authentication, limit access to specific users, and monitor logins and file access. FERPA regulation covers all educational institutions that enroll students below 18 years and receive federal money, including Pell grants. A FERPA violation leads to cease-and-desist orders from authorities as a warning. Continued breach of the Act results in the federal government freezing payments and denying Department of Education funding eligibility.

Sarbanes Oxley Act

The Sarbanes Oxley Act (SOX), enacted by the U.S Congress in 2002, addresses the issue of corporate governance and accountability. The Act protects shareholders from fraudulent practices and accounting errors emanating from unethical behavior by company executives. SOX lists compliance requirements for storing and disclosing financial information to the shareholders. The basics of the SOX Act include keeping data secure and free from tampering, tracking security breaches, storing event logs for independent auditing, and proving compliance for 90 days (Tunggal, 2022). SOX approach to data storage, transmission, and handling vulnerabilities are included in the disclosure and compliance audit requirements.

The Act requires the chief executive officer and chief financial officer to sign and verify their reports are following SOX compliance. The two principal finance officers must certify that the reports represent the company’s financial position. Compliance audits test a company’s internal controls and verify the credibility of the financial statements. Companies are required to prove compliance with regulations for 90 days with documentation. In addition, the data should be available in the form of a paper trail for independent auditors to evaluate. Companies should report data breaches and their resolutions and provide access to event data logs for auditors to verify.

Vulnerabilities in corporate governance include embezzlement of funds by executives, falsifying balance sheet figures, hacked financial statements, inflated revenues, and manipulation of audited financial statements by company authors. The Sarbanes Oxley Act helps companies handle these vulnerabilities by implementing cybersecurity controls using a reliable framework, hiring independent auditors to reduce conflict of interest between shareholders and the company, data backup protocols, and transferring responsibility for accurate financial reports to executives. These internal controls demonstrate the company reports are transparent and store data correctly.

The Act affects all public companies as they must follow all stipulated provisions. A public company is an entity whose ownership is traded through shares in a public offering. The general public can wholly or partially own a public company. The SOX regulation applies to public companies as shareholders claim part of their assets and thus are entitled to reports showing the company’s financial position. The legal consequences for violating the regulation include fines or criminal convictions for top executives.

References

HIPAA Journal. (2017). HIPAA Journal.

Tierney, K. (2020). . JotForm.

Tunggal, A. T. (2022). . Up Guard.

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IvyPanda. (2023, April 14). Security Regulation Compliances in Healthcare. https://ivypanda.com/essays/security-regulation-compliances-in-healthcare/

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IvyPanda. 2023. "Security Regulation Compliances in Healthcare." April 14, 2023. https://ivypanda.com/essays/security-regulation-compliances-in-healthcare/.

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