iSenseHUB HIPAA Compliance Policy
Effective Date: January 1, 2023
Review Date: July 1, 2024
Policy Number: HUB001.2HIPAA
1. Purpose
This compliance policy outlines iSenseHUB’s commitment to adhering to the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and its implementing regulations. As a provider of customized AI software solutions to businesses and institutions that handle Protected Health Information (PHI), it is imperative that iSenseHUB ensures the confidentiality, integrity, and availability of PHI in compliance with HIPAA.
2. Scope
This policy applies to all employees, contractors, and third-party vendors of iSenseHUB who may access, manage, or handle PHI as part of their responsibilities.
3. Definitions
- PHI (Protected Health Information): Any individually identifiable health information that is transmitted or maintained in electronic form, paper form, or oral form.
- ePHI (Electronic Protected Health Information): PHI that is stored or transmitted electronically.
- Covered Entity: An entity that is subject to HIPAA regulations, including healthcare providers, health plans, and healthcare clearinghouses.
- Business Associate: A third-party vendor or service provider that performs services on behalf of, or provides certain functions to, a covered entity that involves access to PHI. iSenseHUB operates as a business associate to its clients.
4. Compliance Officer and Responsibilities
The Chief Compliance Officer (CCO) is responsible for overseeing compliance with HIPAA regulations and implementing this policy. The CCO will:
- Ensure all employees are trained on HIPAA requirements.
- Conduct regular risk assessments.
- Maintain documentation of compliance efforts.
- Serve as the point of contact for compliance inquiries or concerns.
5. Policies and Procedures
The following policies and procedures will be implemented to ensure HIPAA compliance:
5.1 Privacy Rule Compliance
- Access Control: Access to ePHI is limited to authorized personnel only. Role-based access controls will be implemented.
- Minimum Necessary Standard: Only the minimum necessary amount of PHI will be accessed or disclosed for any purpose.
- Patient Rights: Patients will be informed of their rights regarding their health information, including their right to access, amend, and restrict disclosures of their PHI.
5.2 Security Rule Compliance
- Risk Analysis: Conduct regular risk assessments to identify vulnerabilities within systems that store or transmit ePHI.
- Administrative Safeguards:
- Develop and enforce security policies and procedures.
- Provide regular training and awareness programs for employees.
- Physical Safeguards:
- Implement physical access controls to facilities containing ePHI.
- Utilize secure areas for data processing and storage.
- Technical Safeguards:
- Employ encryption standards for data at rest and in transit.
- Implement robust authentication mechanisms for accessing systems containing ePHI.
5.3 Training and Awareness
- All staff will undergo mandatory HIPAA training upon hire and annually thereafter.
- Ongoing training will include updates on policies, security protocols, and risk management practices.
5.4 Business Associate Agreements (BAAs)
- iSenseHUB will enter into a Business Associate Agreement with any clients that are covered entities, outlining the safeguards for protecting PHI.
- BAAs will ensure that all third-party vendors who may access PHI are compliant with HIPAA regulations.
5.5 Incident Response and Reporting
- Establish a procedure for reporting and investigating breaches or potential breaches of PHI.
- Incidents will be documented and reported to affected parties and the Department of Health and Human Services (HHS) as required by HIPAA.
6. Compliance Monitoring and Auditing
- Regular audits will be conducted by the compliance team to ensure adherence to this policy.
- Compliance reports will be generated and reviewed by management to address any discovered issues.
7. Documentation and Record Maintenance
- Maintain all documentation related to HIPAA compliance, including training records, risk assessments, incident reports, and BAAs, for at least six years.
8. Review and Updates
- This policy will be reviewed annually, or sooner if necessary, to incorporate new regulatory requirements or operational changes.
9. Enforcement
- Violations of this policy will result in disciplinary action up to and including termination of employment or contract.
10. Contact Information
For questions regarding this policy, please contact:
Chief Compliance Officer: info@isensehub.ai
Acknowledgment
All employees and relevant third-party vendors will be required to acknowledge receipt and understanding of this policy.
Signature:Chief Compliance Officer
iSenseHUB 01/01/2023 (Updated: 07/01/2024)