If you’re a health organization seeking HIPAA compliance, you might wonder about the frequency of HIPAA training for your staff.
While the HIPAA rules don’t state a fixed schedule for the training, it’s a good idea to have HIPAA training once a year, as suggested by industry experts.
HIPAA training is essential to keep your employees up-to-date with the latest policies and regulations so that they can apply the techniques in their daily operations.
This post will discuss HIPAA training frequency, requirements, and best practices to keep the patients’ data secure while being HIPAA-compliant.
HIPAA training is mandatory if anyone belongs to a Covered Entity’s or Business Associate’s workforce.
Covered Entities: Organizations or individuals that provide health services, such as hospitals, clinics, health insurance companies, healthcare clearinghouses, and doctors. Think of them as the primary sources of health information.
Business Associates: External individuals or companies that perform services for or on behalf of Covered Entities, which might involve accessing patient data.
Whether full-time, part-time, or temporary, all employees should be educated on HIPAA policies.
If volunteers work at your health organization, they should be trained even if they’re not directly handling patient data.
Medical students, interns, or anyone training at a health facility must be familiar with HIPAA regulations.
External parties working for or with your healthcare organization should be trained if they might come in contact with patient information.
Any individual who might see, hear, write, or electronically access PHI in any form, even if their primary job function isn’t directly related to patient care, must be trained.
To know the frequency of HIPAA training in the healthcare industry, It’s crucial to understand the requirements and nuances of the HIPAA Privacy and Security Rules.
Every workforce member in a covered entity needs training. However, the content and depth should align with their specific roles.
Those directly handling PHI are particularly important, given the sensitive nature of the information they manage.
The Privacy Rule, particularly in section 45 CFR 164.530(b)(1), outlines the timing for these privacy training sessions.
For new hires, many organizations aim for initial training within 30 days of joining. Some even suggest proper training before the new employee accesses any PHI, sometimes a week prior.
An updated or periodic refresher training is needed when there’s a substantial change in the Privacy Rule or processes that influence an employee’s role. This should happen within what the rule describes as a ‘reasonable period of time’.
Unlike the Privacy Rule, the Security Rule emphasizes implementing a consistent and ongoing security awareness training program for every member of an organization’s workforce, including management. This mandate extends to both covered entities and their associated business partners.
When a new employee becomes part of the workforce, security awareness training should be imparted promptly, ensuring they are well-equipped to deal with potential cyber threats.
The rising number of healthcare data breaches reported to the HHS Office for Civil Rights showcases the urgency of such measures. With attackers constantly refining their tactics and adopting innovative techniques, staying a step ahead with regular training is imperative.
Specifically, the Security Rule outlines addressable specifications, encompassing vital aspects like:
Here’s a table that breaks down the roles, their training frequencies, and what kind of training they need:
| Role | Frequency of Training |
Type of Training |
| Covered Entities (All Staff) | Annual Training (Recommended) | – HIPAA Privacy and Security Protocols – Changes, revisions, or additions to HIPAA regulations |
| Newly Hired Employees | Upon commencement of role (One-off event) | – HIPAA fundamentals basic knowledge – PHI handling and disclosure circumstances – Consequences of non-compliance |
| Employees after Policy Change | After any significant policy/procedure change | – Updated training based on the new policies and procedures |
| Business Associates | Consistent/Regular Interval | – Security awareness for the entire workforce – Handling and protection of ePHI |
| All Workforce Members | Ongoing basis (as per Security Rule) | – General security awareness – Handling and protection against cyber threats, especially if they don’t have direct access to ePHI |
If a HIPAA audit or risk analysis shows employees aren’t following the rules or have inadequate training, they may need additional training, either company-wide or for specific departments.
What’s included in HIPAA Training content? Here’s the breakdown:
While a general understanding of HIPAA regulations is crucial for all staff, certain roles may require more specific HIPAA training for employees tailored to their responsibilities.
Certain aspects, such as the detailed history of HIPAA, may not be a legal requirement for all employees to understand deeply.
The primary focus of the training should be on the aspects of HIPAA that directly affect an employee’s role and responsibilities, such as understanding and protecting PHI, security measures, breach prevention, and the specific requirements of the Privacy and Security Rules.
Overloading employees with too much unnecessary information could obscure HIPAA’s key purposes and requirements.
Let’s explore the various avenues available for organizations to ensure that their staff is well-versed with HIPAA regulations:
The following are the consequences of non-compliance with HIPAA policies:
Organizations can face fines ranging from $100 to $50,000 (or more) per violation, with an annual maximum of $1.5 million for repeated violations of the same provision.
These amounts can add up quickly, especially if multiple breaches occur simultaneously.
Individuals who knowingly misuse or disclose unsecured protected health information (PHI) can face criminal charges alongside civil penalties.
Penalties range from fines to imprisonment (up to $250,000 and up to 10 years imprisonment), depending on the severity and intent of the violation.
A breach can damage an organization’s reputation, leading to a loss of trust from patients or clients, which means decreased business, clients, and revenue.
Entities that have faced penalties or have been found non-compliant may be subject to more frequent and detailed audits. This can be resource-intensive and may force the organization to allocate additional funds and personnel to compliance efforts.
Entities that have faced penalties or have been found non-compliant may be subject to more frequent and detailed audits. This can be resource-intensive and may force the organization to allocate additional funds and personnel to compliance efforts.
Here are some best practices that health organizations should consider when setting up and managing their HIPAA training programs:
The HHS provides comprehensive guidelines on HIPAA regulations. Their website includes employee training materials, FAQs, and regular updates on any regulation changes.
The AMA offers a range of HIPAA training resources tailored for medical professionals. Their modules cover various topics, from basics to advanced compliance issues.
MLN, part of the Centers for Medicare and Medicaid Services, offers a useful HIPAA fact sheet. This reference guide is especially beneficial for those pressed for time.
These materials provide a thorough overview of HIPAA compliance. It’s possible to download files containing adequate training modules for the full course.
For organizations that prioritize streamlined, efficient training that caters directly to the nuances of a digital health company, Exos by MedStack offers a robust solution.
Key offerings from Exos include:
Yes, HIPAA training can be provided more than once a year, but it’s important not to overtrain. care should be taken to ensure that training is tailored to the role and responsibilities of each workforce member, and not to provide too much unnecessary training that might obscure the key purposes of the rules.
It is essential to document all aspects of HIPAA training. This includes:
All these documents should be stored securely and be readily accessible in case of an audit or investigation.
Yes, it is permissible to provide computer-based HIPAA training. However, it is important to ensure that the online or computer-based training covers all necessary topics related to the HIPAA Privacy and Security Rules and is tailored to the specific roles and responsibilities of the training employees.
The responsibility for providing HIPAA training lies with the covered entities and business associates.
HIPAA does not specify a set expiration date for training. Still, it does require that comprehensive training be provided periodically and whenever there is a material change in policies or procedures.
Investing in HIPAA training is not just about avoiding penalties; it’s about ensuring the safety and security of your patients’ data and, ultimately, their well-being. Stay informed, stay compliant, and stay secure.
If you want to ensure your organization is HIPAA compliant and that your employees are properly trained, consider using Exos by MedStack.
With our HIPAA compliance software, you can equip your team with the necessary knowledge and skills to handle PHI compliantly and defend against cyber threats.
Learn how MedStack can help you.