The Health Insurance Portability and Accountability Act of 1996 is a federal law that establishes a national standard of protection for patient health or personal information. Behavioral health businesses cannot disclose this information without the patient’s consent. Moreover, every facility must be regulated according to HIPAA compliance rules.Â
By the end of this article, you will be able to understand:
- HIPAA regulations
- Records that are protected under HIPAA laws
- Requirements of a facility for HIPAA compliance
- Complications if you do not follow HIPAA
- HIPAA Assessments to follow
- Common questions regarding HIPAA and mental health
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Understanding Behavioral Health HIPAA Laws
HIPAA behavioral health regulations are the same as medical specialties with few exceptions. HIPAA laws for mental health practices and behavioral health businesses include the following:
Privacy Rules
Privacy rules of HIPAA compliance cover all aspects of the privacy of a patient, including:
- Know the identifiable elements of individual information
- How the information will be used, disclosed, and protected
- Right to access, amend, and request an accounting for disclosure of PHI
However, security rules differ for different treatment modalities and accord with the state laws where the facility operates.
Security Rules
This rule states that all covered entities, including yours, must protect patient health information records from:
- Unauthorized access, use, and discloser of information
- Making amendments or destruction of information without prior consent
These rules cover administrative, technical, and physical safeguards to ensure data privacy across all platforms.
Breach Notification Rules
This rule explains when and how a person will be notified if some information is leaked or breached without prior consent or mistakenly. Generally, you will need to notify within 60 days through notification to both the patient and the Department of Health and Human Services.
Applying HIPAA to Behavioral Health BillingÂ
There are certain exceptions when it comes to billing in behavioral health practices.
- While dealing with insurance companies, you can share the records after written authorization.
- This complies with only a portion of the information that is not personally harmful to the patient’s integrity.
Failing to adhere to the standards set by the state laws or health department could potentially result in penalties.
Records Protected under HIPAA Regulations
HIPAA sets an overview of guidelines to follow when you are complying:
- Information doctors, nurses, or other healthcare providers have added to personal records is liable to protection under HIPAA
- Communication in terms of consultation or guidance healthcare providers had with each other
- Billing information and insurance options
- Medical-related complications determined in the record
Before you begin your services with the client, you must ensure that a written document of privacy and policy is provided depicting every regulation under HIPAA law and how you will use their information.
Requirements for HIPAA Compliance of Your Behavioral Health Business
Let’s dive into a quick guide on the requirements that must be met by your business practices to comply with the HIPAA behavioral health laws.
Developing Privacy and Policy
To meet the above-mentioned security, privacy, and breach notification rules, your facility must have a written policy and procedure book depicting all the HIPAA compliance rules. There should be a clear-cut answer to the what, when, and how questions regarding the use of personal health information.
Training Staff on HIPAA Compliance
Your facility staff must be well-trained regarding the state and federal regulations of HIPAA laws for the market you are operating. Seek expert help in training them or hire a qualified staff member who takes care of all the regulatory compliance in the behavioral health industry. Also, they should be retrained annually to equip them with the latest trends and laws.
Hire Security Officer Expert in HIPAA Regulation Implementation
Your facility should have a trained officer with HIPAA expertise to ensure it handles all regulatory implementations in the facility environment. The officer should also monitor the staff and environment to check if the facility follows its required policies and procedures to avoid any penalties.
Agreements with Business Associates
Most behavioral health or general medical facilities operate with certain business associates that include:
- Email marketing services
- Electronic health record management software
- Online appointment scheduling services
- Cloud storage providers for the records
You will need to sign a business associate agreement with the respective businesses to comply with HIPAA laws of privacy and security and ensure your business’s protective and legal authority.
What Happens if You Don’t Comply With the HIPAA Laws
First and foremost, you will be fined heavily. Statistics show that up until 2024, facilities not regulated by HIPAA rules have been fined $142,663,772.00. Penalties for HIPAA violations depend on the type of offense committed and the type of behavioral health facility. They range from $100 to $50,000 the first time.Â
Risk Assessment and Audits in HIPAA Compliance
The most important aspect of HIPAA compliance that provides certainty to regulatory obligations is to conduct thorough risk assessments and audits regularly to keep up the records. This includes:
- Finding out potential risks and flaws lacking in your facility regarding breach
- Prepare a comprehensive plan to mitigate the challenges and risks
- Regularly review your plan to ensure compliance
You can also seek expert guides like Strategique Partners to help you audit your site comprehensively and devise a recovery plan!
Get to Know More About Your HIPAA Requirements Through Strategique Partners
Running a behavioral health facility involves many regulations and standards that must be followed. Strategique Partners is an expert behavioral health advisory firm that provides comprehensive solutions to all legal and accreditation requirements for behavioral health business startups.Â
Let’s consult to discuss how you can comply with your business facility with the latest HIPAA regulations!
Frequently Asked Questions Regarding Mental Health Practices and HIPAA
Some of the common queries often asked about mental health startups and regulations are:
What Is Included in Mental Health Records?
It includes a person’s social, behavioral, and relational information with other people. It also includes mental health disorder information such as alteration in behavioral and mood swings, history of relationship with the mental health care provider, and history of payments for mental health services.
Who Can Access Your Mental Health Record?
Only licensed facilities following HIPAA compliance regulations with licensed therapists, nurses, and clinical staff can access the patient health record for service purposes.
What Are the Four Types of Mental Health?
Four main types of mental health include:
- Mood disorders (depression and bipolar)
- Anxiety disorders
- Personality disorders
- Psychotic disorders (schizophrenia)
These can be the basis of programs in your mental health facility.
How to Become a HIPAA-Compliant Business Associate?
HIPAA-compliant business associates must protect the security and privacy of patients’ health information. To become HIPAA business associates, they must complete training and comply with the regulation standards set by HIPAA to protect individual PHI. They will also need to sign an agreement ensuring the protection and breach notification of their client’s data and privacy.
What is a Covered Entity?
Facilities that completely comply with HIPAA regulations and ensure the 1996 US federal Laws on Health Insurance Portability and Accountability Act covered entities. They can be either organizations or individual facilities.
Related Resources:
- How to Achieve JCAHO Behavioral Health Standards?
- Insider Tips on How to Get a Behavioral Health License Successfully?
- How Can Behavioral Health Branding Help Your Business?
- 7 Expert Guided Solutions to Improve Your Behavioral Health Revenue Cycle
- Why Should You Hire Drug Rehab Consultants to Open Your Rehab Center?
From Author
Fighting legal battles could be cumbersome, especially when dealing with behavioral health businesses. Families often file lawsuits against facilities that do not adhere to regulatory standards. In my years of experience, I have seen facilities not meeting the quality standards of HIPAA go bankrupt or struggle to hold due to legal battles. I have assisted many in setting up the latest HIPAA regulations for their facility and helped them maintain the standard to avoid any mishap! Let’s discuss how we can achieve that!
