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When considering some of the latest statistics related to Health Insurance Portability and Accountability Act of 1996 (HIPAA) violations and consequences, ensuring compliance is more critical than ever. For example, healthcare data breaches are increasing year-over-year, yet 75% of healthcare organizations say their infrastructure is not prepared to respond to cybersecurity threats effectively. 

HIPAA is a U.S. federal law. It sets national standards for healthcare providers to maintain the privacy of patients' protected health information (PHI), including electronically protected health information (ePHI). If you collect, store, or process any kind of patient or medical data, you need to be aware of HIPAA and how it affects your operations.

But what does it really mean to be HIPAA compliant? This article offers a comprehensive checklist for HIPAA compliance so you know you're on the right track.

Our six key takeaways from this guide include the following:

  • HIPAA, a federal law in the United States, ensures healthcare providers maintain patient privacy concerning protected health information (PHI).
  • Three types of HIPAA-covered entities include healthcare providers, health plans, and healthcare clearinghouses. 
  • Key areas of concern organizations that want to be HIPAA compliant should prioritize in 2025.
  • Those who are non-compliant can face fines for accidental negligence, ranging from $100 to $50,000 per incident. 
  • The HIPAA compliance checklist focuses on the Current HIPAA Privacy Rule, the HIPAA Security Rule, and the HIPAA Breach Notification Rule.
  • Integrate.io can help with HIPAA compliance via an ETL tool that prioritizes information security.

Introduction

When considering some of the latest statistics related to Health Insurance Portability and Accountability Act of 1996 (HIPAA) violations and consequences, ensuring compliance is more critical than ever. For example, healthcare data breaches are increasing year-over-year, yet 75% of healthcare organizations say their infrastructure is not prepared to respond to cybersecurity threats effectively. 

HIPAA is a U.S. federal law. It sets national standards for healthcare providers to maintain the privacy of patients' protected health information (PHI), including electronically protected health information (ePHI). If you collect, store, or process any kind of patient or medical data, you need to be aware of HIPAA and how it affects your operations.

But what does it really mean to be HIPAA compliant? This article offers a comprehensive checklist for HIPAA compliance so you know you're on the right track.

What Is Protected Health Information (PHI)?

It's important to clarify that HIPAA does not apply to all healthcare data or all data handled by healthcare organizations — only to protected health information (PHI). So, what is PHI exactly?

Protected health information is any healthcare data that uniquely identifies a specific individual based on patient data. 

Data that can identify patients and is therefore considered PHI includes:

  • First, middle, and last names
  • Date of birth and/or death
  • Contact information, such as a home address, phone number, email address, etc.
  • Social Security number, account number, or other ID numbers
  • ID photographs
  • Biometric data, such as fingerprints, iris recognition, facial recognition, etc.
  • Information about health conditions, including dates of treatment
  • Healthcare payment information

HIPAA requires "covered entities" to safeguard PHI, including electronic health records (EHR). The three types of HIPAA-covered entities include:

  1. Healthcare providers: Doctors, dentists, psychologists, clinics, nursing homes, pharmacies, etc.

  2. Health plans: Health insurers, HMOs, company health plans, Medicare, Medicaid, etc.

  3. Healthcare clearinghouses: Third-party middlemen between healthcare providers and health plans

In addition to covered entities, HIPAA also applies to "business associates." A business associate of a covered entity is a third party that may use or disclose PHI from the covered entity. Examples of business associates include subcontractors, consultants, and health information technology providers.

What Is HIPAA Compliance?

"HIPAA compliance" refers to the rules concerning the processes and workflows of healthcare providers. The U.S. Department of Health and Human Services (HHS) is tasked with enforcing HIPAA regulations.

Whistleblowers can report HIPAA violations to the HHS Office for Civil Rights (OCR). Penalties for HIPAA non-compliance vary, depending on the severity of the incident and the intentionality. Fines for accidental negligence range from $100 to $50,000 per incident. Violation penalties are based on a four-tier structure. Factors considered include an organization's financial history, prior history, and severity of harm. These penalties could officially change in 2023.

However, intentionally disclosing protected health information and medical records is sometimes a criminal act. Possible penalties for this latter category include fines and prison time.

Read more: The Ultimate Guide to HIPAA Compliance

Also, discover the power of Integrate.io when aiming to integrate data from various systems into data warehouses and lakes. Learn more about how to enhance data observability and streamline your HIPAA compliance with Integrate.io.

Try it yourself: sign up for your 14-day free trial today, then schedule your ETL setup meeting to go over what to expect.

Key Considerations For HIPAA Compliance in 2025

Modernization of healthcare data processes continues to progress at a rapid pace, and organizations that are required to comply with HIPAA regulations need to stay abreast of any potential risk areas that could affect their compliance. What are the top concerns that organizations that need to prioritize HIPAA compliance in 2025 should focus on? 

  • The increasing sophistication of cyberattacks: Cybercriminals are constantly developing new and more sophisticated ways to attack organizations. In 2025, organizations will need to be more vigilant than ever in protecting their data from cyberattacks
  • The rise of artificial intelligence (AI) and machine learning (ML): AI and ML are powerful tools that can be used to improve healthcare, but they also pose new risks to patient privacy. Organizations will need to carefully consider the privacy implications of using AI and ML before deploying them.
  • The growing use of cloud computing: Cloud computing is a convenient and cost-effective way to store data, but it can also raise security concerns. Organizations will need to make sure that their cloud providers are HIPAA compliant and that their data is encrypted and protected.
  • The increasing importance of data governance: Data governance is the process of managing and controlling data assets. In 2025, organizations will need to have strong data governance practices in place to ensure that their data is accurate, complete, and secure.
  • The need for a culture of compliance: HIPAA compliance is not just about implementing technical safeguards. It is also about creating a culture of compliance within an organization. In 2025, organizations will need to make sure that all employees are aware of their HIPAA obligations and that they are trained on how to protect patient privacy.

In addition to these new concerns, organizations will also need to continue to focus on the following HIPAA compliance priorities:

  • Risk assessment and management: Organizations need to regularly assess the risks to their patient data and implement appropriate safeguards.
  • Incident response: Organizations need to have a plan in place for responding to data breaches and other security incidents.
  • Training and awareness: Organizations need to train all employees on HIPAA compliance and how to protect patient privacy.
  • Vendor management: Organizations need to make sure that their vendors are HIPAA compliant and that their data is protected.

By addressing these concerns and priorities, organizations can help to ensure that they are HIPAA compliant and that they are protecting the privacy of their patients.

HIPAA Checklist: Make an Action Plan

How can organizations in the healthcare industry ensure they comply with HIPAA? What are some of the must-dos and must-haves for healthcare organizations handling PHI?

In 2025, several new HIPAA requirements are expected. Awareness of these changes is essential to protect any organization responsible for PHI.

Understand the Current HIPAA Privacy Rule

The HIPAA Privacy Rule governs how healthcare organizations can collect, store, and process "individually identifiable health information." The rule includes definitions of PHI, covered entities, and business associates, as discussed above. It also outlines the cases in which covered entities can potentially disclose PHI without the individual's permission, such as:

  • To the individuals themselves
  • For purposes of treatment, payment, and healthcare operations
  • For activities in the public interest and benefit, including for public health authorities, law enforcement, or coroners; to protect victims of violence and abuse; for medical research, etc.
  • For use in an anonymized "limited data set" 

To comply with the HIPAA Privacy Rule, you need to understand whether it applies to you and your organization and, if so, how:

  • Are you considered a covered entity or business associate under HIPAA?
  • What kind of healthcare data do you handle?
  • How do you manage this data?
  • Do you share this data?
  • Who do you share it with, if anyone?
  • Are you required to share the data with certain entities?

Additionally, review these potential 2023 updates to the HIPAA Privacy Rule: 

  • Clients can access their personal health patient information within 15 calendar days, with a possible 15-day extension. Previously, this window was 30 days to respond with a possible 30-day extension.
  • Fees and fee structures for health information requests are changing. When requesting an electronic health record, the individual will only be charged a reasonable, cost-based fee limited to labor. 
  • Clients can review their health information in person. If they choose, they can take photos also. 
  • How clients are advised of their rights is changing. These changes include updating clients about their rights, the process to request their complete health information file, and the approximate fees for doing so. Understand the HIPAA Security Rule

The HIPAA Security Rule defines security standards for your organization's data security and cybersecurity for electronic health records. It defines three types of security measures that covered entities and business associates must maintain:

  • Administrative safeguards: workforce training and education programs about how to keep data secure, internal security audits and risk assessments, etc.
  • Physical safeguards: security personnel in areas where sensitive data lives, workstation security, etc.
  • Technical safeguards: IT access controls, transmission security measures, encryption, etc.

The HIPAA Security Rule does not formally define any specific security or privacy practices that organizations must follow. Instead, each covered entity must decide which measures are most reasonable and appropriate to follow (with the potential of non-compliance penalties as a motivator).

For 2023, there are no sweeping planned changes to the HIPAA Rule. However, it's imperative you remain familiar with the latest security policies and security practices.

Understand the HIPAA Breach Notification Rule

The HIPAA Breach Notification Rule governs how organizations must respond in the event of a data breach. For example, the unauthorized disclosure of PHI. Potential issues with healthcare data security are physical break-ins, theft of IT equipment, hacking, ransomware, sending PHI to the wrong recipient, and discussing PHI in public or on social media.

The HIPAA Breach Notification Rule includes important details regarding:

  • Notification timelines. All individuals affected by a data breach must be notified within 60 days following the breach's discovery.
  • Data breaches. Minor breaches (affecting less than 500 individuals) must be reported to HHS annually. Major breaches must be reported to HHS within 60 days of the discovery.
  • Improper disclosures. Any improper use or disclosure of PHI is considered a data breach unless the organization can convincingly demonstrate that there was a low probability of compromise.
  • Encrypted disclosures. The improper disclosure of encrypted PHI is not considered a data breach since the information is unreadable and unusable by third parties without the decryption key.

Recommended reading: Privacy & Security Rules for Healthcare Marketers

How Integrate.io Can Help With HIPAA

If your organization handles PHI, you must become HIPAA compliant, understand the vulnerabilities, and initiate strategic compliance efforts. But, in practice, how can you execute the technical safeguards required by HIPAA?

One crucial piece of the puzzle is using an ETL tool to protect sensitive and confidential data throughout the entire data integration process. Integrate.io is a powerful, feature-rich ETL and data integration tool that prioritizes information security. Our cybersecurity protocols include SSL/TLS encryption, physical security, network security, and system security. Our no-code data pipeline platform fully complies with HIPAA's standards for business associates, making us a valuable partner for any healthcare organization.

Dive deeper into our ELT and CDC knowledge base to learn more about monitoring and security. 

Ready to experience how Integrate.io makes it easier to process data while staying compliant with HIPAA? Sign up for your ETL trial and then schedule your ETL Trial meeting so we can go over what to expect

Related Reading: Using ETL for HIPAA Compliance